Clinical application of standardized diagnosis and treatment of orthostatic hypotension in a patient with diabetes mellitus and orthostatic hypotension： a case report

Zhang Yuhang; Wang Yichun; Liu Shufen; Ding Rongjing; Wang Han

doi:10.13406/j.cnki.cyxb.004085

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Clinical application of standardized diagnosis and treatment of orthostatic hypotension in a patient with diabetes mellitus and orthostatic hypotension： a case report

Frontiers in brain science and neuropsychiatric disorders\—orthostatic hypotension and related disorders | 更新时间：2026-05-13

- Clinical application of standardized diagnosis and treatment of orthostatic hypotension in a patient with diabetes mellitus and orthostatic hypotension： a case report
- Journal of Chongqing Medical University Vol. 51, Issue 5, Pages: 608-613(2026)
- 作者机构：
  
  1.中国医学科学院北京协和医学院，北京协和医院康复医学科，北京　100730
  2.中国医学科学院北京协和医学院，北京协和医院神经科，北京　100730
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.004085
  CLC： R747.8
- Received：13 February 2026，
  
  Revised：2026-03-16，
  
  Accepted：27 March 2026，
  
  Published：28 May 2026
- 稿件说明：
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张宇航，王一淳，刘淑芬，等.直立性低血压规范化诊疗在糖尿病合并直立性低血压患者中的临床应用：1例病例报道[J].重庆医科大学学报，2026，51（5）：608-613.

Zhang Yuhang,Wang Yichun,Liu Shufen,et al.Clinical application of standardized diagnosis and treatment of orthostatic hypotension in a patient with diabetes mellitus and orthostatic hypotension： a case report[J].Journal of Chongqing Medical University,2026,51(5):608-613.
张宇航，王一淳，刘淑芬，等.直立性低血压规范化诊疗在糖尿病合并直立性低血压患者中的临床应用：1例病例报道[J].重庆医科大学学报，2026，51（5）：608-613. DOI： 10.13406/j.cnki.cyxb.004085.

Zhang Yuhang,Wang Yichun,Liu Shufen,et al.Clinical application of standardized diagnosis and treatment of orthostatic hypotension in a patient with diabetes mellitus and orthostatic hypotension： a case report[J].Journal of Chongqing Medical University,2026,51(5):608-613. DOI： 10.13406/j.cnki.cyxb.004085.

摘要

目的

分析1例神经科和康复医学科共同诊治的2型糖尿病（type 2 diabetes mellitus，T2DM）合并直立性低血压（orthostatic hypotension，OH）患者的临床诊断与治疗过程。

方法

通过回顾患者的诊疗过程和随访，详细介绍《直立性低血压诊断与处理中国多学科专家共识》推荐的诊断路径的临床应用，以及“四步管理法”对于该患者的应用效果。

结果

通过规范诊断路径对OH进行了全面、精准的定位和定性诊断，并实施OH规范化管理和治疗，患者的体位不耐受症状显著缓解，肌肉力量、平衡能力、日常生活能力等均得到明显改善，生活质量显著提高。

结论

OH规范化诊疗路径以及“四步管理法”的应用，对于复杂的T2DM合并OH患者具有重要的临床意义和价值。

Abstract

Objective

To analyze the clinical diagnosis and treatment process of a patient with type 2 diabetes mellitus （T2DM） comorbid with orthostatic hypotension（OH） jointly diagnosed and treated by Department of Neurology and Department of Rehabilitation Medicine.

Methods

By reviewing the diagnosis，treatment，and follow-up data of the patient，this article introduced the clinical application of the diagnostic pathway recommended in Chinese Multidisciplinary Expert Consensus on Diagnosis and Management of Orthostatic Hypotension，as well as the application effect of the “four-step management approach” in this patient.

Results

A comprehensive and accurate localizing and etiological diagnosis of OH was established via a standardized diagnostic pathway. Following standardized management and treatment of OH， the patient’s orthostatic intolerance was markedly alleviated； muscle strength， balance function， and activities of daily living were significantly improved， with a substantial enhancement in quality of life.

Conclusion

The standardized diagnosis and treatment pathway of OH and the application of the “four-step management approach” have important clinical significance and value in patients with complex comorbidities of T2DM and OH.

关键词

Keywords

references

王　含，李　凡，陈琦玲，等 . 直立性低血压诊断与处理中国多学科专家共识 [J ] . 中国循环杂志， 2024 ， 39 （ 11 ）： 1058 - 1069 ．

Wang H ， Li F ， Chen QL ， et al . Chinese multidisciplinary expert consensus on diagnosis and management of orthostatic hypotension [J ] . Chin Circ J ， 2024 ， 39 （ 11 ）： 1058 - 1069 ．

Farrell MC ， Shibao CA . Morbidity and mortality in orthostatic hypotension [J ] . Auton Neurosci ， 2020 ， 229 ： 102717 ．

李贯绯，张逊娟，庞　猛，等 . 社区中老年人群慢性直立不耐受综合征患病率及影响因素分析 [J ] . 中华全科医学， 2023 ， 21 （ 7 ）： 1184 - 1187，1196 ．

Li GF ， Zhang XJ ， Pang M ， et al . Prevalence and associated factors of chronic orthostatic intolerance in communities [J ] . Chin J Gen Pract ， 2023 ， 21 （ 7 ）： 1184 - 1187，1196 ．

李彦琳，唐玮婷，李双杏，等 . 2型糖尿病体位性脑血流动力学变化与其不良预后的相关性研究 [J ] . 中风与神经疾病杂志， 2025 ， 42 （ 11 ）： 974 - 978 ．

Li YL ， Tang WT ， Li SX ， et al . Postural cerebral hemodynamic changes in patients with type 2 diabetes mellitus and their association with adverse outcomes [J ] . J Apoplexy Nerv Dis ， 2025 ， 42 （ 11 ）： 974 - 978 ．

Zhou Y ， Ke SJ ， Qiu XP ， et al . Prevalence，risk factors，and prognosis of orthostatic hypotension in diabetic patients：a systematic review and meta-analysis [J ] . Medicine ， 2017 ， 96 （ 36 ）： e8004 ．

张宇航，王　含，丁荣晶 . 多系统萎缩伴神经原性直立性低血压多学科协作康复一例 [J ] . 协和医学杂志， 2025 ， 16 （ 2 ）： 448 - 453 ．

Zhang YH ， Wang H ， Ding RJ . Multiple system atrophy with neurogenic orthostatic hypotension：a multidisciplinary collaborative rehabilitation case report [J ] . Med J Peking Union Med Coll Hosp ， 2025 ， 16 （ 2 ）： 448 - 453 ．

刘文玲，丁荣晶，李祥晨，等 . 非心原性晕厥康复中国专家共识 [J ] . 中国循环杂志， 2023 ， 38 （ 11 ）： 1103 - 1111 ．

Liu WL ， Ding RJ ， Li XC ， et al . Chinese expert consensus on rehabilitation therapies for patients with non-cardiac Syncope [J ] . Chin Circ J ， 2023 ， 38 （ 11 ）： 1103 - 1111 ．

Mizrak HI ， Kufaishi H ， Hecquet SK ， et al . Contemporary prevalence of diabetic neuropathies in individuals with type 1 and type 2 diabetes in a Danish tertiary outpatient clinic [J ] . J Diabetes Complications ， 2024 ， 38 （ 6 ）： 108761 ．

Blum I ， Barkan A ， Kuritzky A ， et al . Cardiac denervation and other multisystem manifestations caused by isolated autonomic neuropathy in a young diabetic patient [J ] . Am J Med Sci ， 1980 ， 280 （ 2 ）： 87 - 93 ．

Tannus LRM ， Cobas RA . Autonomic neuropathy in diabetes [J ] . Arch Endocrinol Metab ， 2026 ， 70 （ 1 ）： 1 - 20 ．

Pham S ， Mock G ， Camferdam R . Acarbose unveiled： a breakthrough in postprandial hypotension treatment [J ] . Cureus ， 2024 ， 16 （ 6 ）： e62378 ．

中国老年保健医学研究会高血压防治分会 . 餐后低血压管理的中国专家共识 [J ] . 中华高血压杂志（中英文）， 2025 ， 33 （ 1 ）： 4 - 13 ．

Hypertension Prevention and Control Branch of Chinese Research Society of Geriatric Health Care . China expert consensus on postprandial hypotension management [J ] . Chin J Hypertens ， 2025 ， 33 （ 1 ）： 4 - 13 ．

Ren GC ， Chi XS ， Huang PP ， et al . Risk assessment of the top 50 drugs associated with drug-induced orthostatic hypotension： a disproportionality analysis of the FAERS and JADER databases [J ] . Sci Rep ， 2025 ， 15 （ 1 ）： 10359 ．

Williams B ， Mancia G ， Spiering W ， et al . 2018 ESC/ESH Guidelines for the management of arterial hypertension： The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension [J ] . J Hypertens ， 2018 ， 36 （ 10 ）： 1953 - 2041 ．

Park JW ， Okamoto LE ， Biaggioni I . Advances in the pathophysiology and management of supine hypertension in patients with neurogenic orthostatic hypotension [J ] . Curr Hypertens Rep ， 2022 ， 24 （ 3 ）： 45 - 54 ．

陈洪艳，李海燕，张　然，等 . 腹带干预对老年患者餐后低血压的预防作用 [J ] . 武警医学， 2023 ， 34 （ 5 ）： 377 - 379，383 ．

Chen HY ， Li HY ， Zhang R ， et al . Prophylactic effects of abdominal bandage intervention on postprandial hypotension in elderly patients [J ] . Med J Chin People’s Armed Police Force ， 2023 ， 34 （ 5 ）： 377 - 379，383 ．

Elgebaly A ， Abdelazeim B ， Mattar O ， et al . Meta-analysis of the safety and efficacy of droxidopa for neurogenic orthostatic hypotension [J ] . Clin Auton Res ， 2016 ， 26 （ 3 ）： 171 - 180 ．

Parsaik AK ， Singh B ， Altayar O ， et al . Midodrine for orthostatic hypotension： a systematic review and meta-analysis of clinical trials [J ] . J Gen Intern Med ， 2013 ， 28 （ 11 ）： 1496 - 1503 ．

Zhang J ， Guo LX . Effectiveness of acarbose in treating elderly patients with diabetes with postprandial hypotension [J ] . J Investig Med ， 2017 ， 65 （ 4 ）： 772 - 783 ．

Duval GT ， Raud E ， Gohier H ， et al . Orthostatic hypotension and cognitive impairment：Systematic review and meta-analysis of longitudinal studies [J ] . Maturitas ， 2024 ， 185 ： 107866 ．

Hohler AD ， Amariei DE ， Katz DI ， et al . Treating orthostatic hypotension in patients with Parkinson’s disease and atypical Parkinsonism improves function [J ] . J Parkinsons Dis ， 2012 ， 2 （ 3 ）： 235 - 240 ．

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