原发性高血压早期肾损害与中医证型的相关性研究

Study on the Relationship between Early Nephritic Injures by Essential Hypertension and Traditional Chinese Medicine Syndrome Patterns

目的:探讨原发性高血压(EH)早期肾损害与中医证型的关系。方法:对122例EH早期肾损害患者进行中医辨证分型,并测定其与25例正常人的尿五蛋白(白蛋白(A lb)、转铁蛋白(TRF)、免疫球蛋白(IgG)、α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG))及肾动脉血流(平均肾动脉收缩期最大血流速度(Vs)、平均肾动脉血流阻力指数(R I))。结果:与正常对照组比较,气虚血瘀组、肝火亢盛组、痰湿壅盛组尿五蛋白均明显升高(P<0.05,P<0.01);阴虚阳亢组、阴阳两虚组仅尿α1-MG升高(P<0.05),肝火亢盛组Vs增快明显(P<0.05);余下4组Vs与正常组比较,无明显差异(P>0.05);5组R I与正常对照组比较,差异有显著性(P<0.05,P<0.01)。结论:EH早期肾损害的两项检测指标与中医证候有明显相关性,虚实夹杂证、实证肾动脉血管阻力增加显著,肾小管、肾小球损害明显;虚证肾动脉血管阻力轻度增加,肾小管轻度受损。

Objective：To study the relationship between early nephritic injures by essential hypertension（EH） and TCM Syndrome patterns. Method：To analyse traditional Chinese medicine syndrome patterns of 122 cases with early nephritic injures by EH. Five protein in urine （microalbuminuria（ Alb ）, transferrin（ TRF）, immunoglobulin G （IgG）, α1-microglobulin（ α1-MG）, β2-microglobulin （β2-MG） ） and Bloodstream of arteria renalis （ mean systolic max volume speed of arteria renalis（Vs） ,mean volume resistance index of arteria renalis（RI） ） of the 122 cases of EH patient and 25 cases of normal person were examined. Result： Compared Qi deficiency and blood stasis group, liver firer intense group, phlegm and dampness intense group with control group , five protein in urine were markedly increased（P 〈0. 05,P 〈0. 01）. Compared hyperactivity Yang due to deficient Yin group and double Yin Yang deficiency group with control group ,only α-MG was markedly increased（ P 〈 0.05 ）, β2-MG was not significant between the two groups. There are marked difference between liver fire intense group and control group （ P 〈 0. 05 ） ,no difference between the other groups and control group（ P 〉0.05 ）. There are marked difference of RI between five group of EH and control group （P 〈0. 05 ,P 〈0. 01）. Conclusion： There are marked relation between the two type index of early nephritic injures by EH and traditional Chinese medicine syndrome patterns . Vascular resistance of arteria renalis was markedly increased with excessive syndrome and double excessive deficiency syndrome. Renal tubular and glomeruli were markedly injured , creased with deficiency syndrome. Renal tubular was slightly vascular resistance of arteria renalis was slightly ininjured.