中醫食療對中國杭州社區中年高血壓陰虛體質患者作用的研究

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中醫食療對中國杭州社區中年高血壓陰虛體質患者作用的研究

 

Author: 沈翠珍
Shen, Cuizhen
Title: 中醫食療對中國杭州社區中年高血壓陰虛體質患者作用的研究
Zhong yi shi liao dui Zhongguo Hangzhou she qu zhong nian gao xue ya yin xu ti zhi huan zhe zuo yong de yan jiu
The effect of Chinese food therapy on community dwelling middle-aged hypertensive Patients with yin deficiency in Hangzhou, China
Degree: Ph.D.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations.
Hypertension -- Diet therapy.
Medicine, Chinese.
Department: School of Nursing
Pages: xxiii, 415 leaves : ill. (some col.) ; 30 cm.
Language: Chinese
InnoPac Record: http://library.polyu.edu.hk/record=b2307181
URI: http://theses.lib.polyu.edu.hk/handle/200/3705
Abstract: Background: Traditional Chinese Medicine (TCM) experts thought that the prevalence of hypertension is related to body constitution. Epidemiological studies have shown 14%-50% of people with hypertension have Yin-deficiency. Since body constitution is relatively stable and dynamic variable, body constitution with Yin-deficiency might be adjusted. Some studies indicate Chinese Food Therapy (CFT) is the major way to restore the Yin-Yang imbalance. However, there is no study using CFT to hypertensive patients with Yin-deficiency. Aims: The purposes of this study are: (1) to determine the Assessment Scale on Common Symptoms of Body Constitution with Yin-Deficiency (ASCSBC).(2) to evaluate the effectiveness of CFT in restoring Yin-Yang balance of middle-aged hypertensive patients with Yin deficiency to evaluate the effectiveness of CFT in controlling blood pressure of hypertension with Yin deficiency. (4) to evaluate the effectiveness of CFT in improving hypertensive patient's quality of life.(5) to evaluate the effectiveness of health education in improving knowledge of hypertension and modification of lifestyle for hypertensive patients with Yin-Deficiency. Methods: Double-blinded, randomized controlled trial was designed. Eighty-five hypertensive patients who met the inclusive criteria recruited from two community health service centres were divided into the intervention group and the control group. The intervention group (n=48) received specific dietary instructions and corresponding management of their antihypertensive medication if indicated and brief health education, whilst the control group (n=37) received routine support involving brief health education for 12 weeks and follow-up 4 weeks. Due to assessment of body constitution with Yin-deficiency, the ASCSBC was designed and tested its validation and reliability Data were collected at baseline, after intervention at four, eight, 12 and 16 weeks follow-up. Comparisons were made to examine the effects of Chinese food therapy on Yin-deficiency symptoms, reduction of hypertensive medication, blood pressure and quality of life of hypertensive patients and to determine the effects of health education in improving knowledge of hypertension and modifying lifestyles for hypertensive patients with Yin-Deficiency. Results: ASCSBC has been shown the high validation and reliability. The intervention group had gradual reduction in the numbers of Yin-Deficiency patients as well as improvement in most of the Yin-deficiency symptoms such as dry throat, red tongue, little coating, cracked tongue, insomnia, dysphoria and so on after intervention 4, 8, 12 and 16 weeks follow-up, and significant differences were found compared to the control group and baseline respectively (P<0.001). Mean scores of SF-36 in eight domains, Physical Component Summary (PCS), Mental Component Summary (MCS) and Total Score (TS) were increased in the intervention group after intervention 12 and 16 weeks follow-up. Eleven items except for Mental Health (MH) had significant differences compared to the control group (P=0.032-0.000) after intervention 12 weeks. As mean scores of SF-36 were compared from baseline to 12 weeks and 16 weeks, there were significantly difference in six domains (except for Role limitations due to physical health RP, Vitality VT) or five domains (expect for VT, Social function SF and Role limitations due to emotional problems RE), PCS, MCS and TS in the intervention group respectively (P<0.05 or P<0.01 or P <0.001), while there were no significant differences except for SF in the control group. Significant differences were found in SBP in the intervention group compared from baseline to after 4 and 8 weeks respectively (P=0.005 and 0.008). The number of reducing antihypertensive medication is higher than that of the control group (P<0.001) after intervention, while there were no significant difference in the mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) compared to the control group at 4, 8, 12 and 16 weeks follow-up. The mean scores of knowledge related to hypertension were increased after intervention 12, 16 weeks (P<0.01 and P<0.001 respectively), while no significant differences were found compared to the control group. Compared from baseline to after intervention 4, 8, 12 and 16 weeks follow-up, there were significant differences in diet habits, exercise, taking medication regularly, self administration of blood pressure and views for effects of Traditional Chinese Medicine lowering blood pressure (P<0.05 or P<0.01 or P<0.001). Conclusions: ASCSBC might be used to assess the body constitution with Yin-deficiency in clinical practice. The study has been shown that CFT may contribute to Yin-Yang balance, improve quality of life and control blood pressure. The results has supported the theory of body constitution adjustment and provided the evidence for CFT becoming major way of the non-pharmacy therapies on hypertensive patients.

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