老年收缩期高血压中医证型与颈动脉硬化的临床研究

Relationship Between Carotid Atherosclerosis and Traditional Chinese Medical Syndrome Patterns in Aged Patients with Isolated Systolic Hypertension

【目的】观察不同中医证型老年收缩期高血压(ISH)与颈动脉粥样硬化(CAS)发生与程度的关系。【方法】选择老年ISH患者120例(老年ISH组),按不同中医证型分为4型,观察各型患者中医证型与颈动脉粥样硬化的关系。同时选择30例健康人作为正常对照组。【结果】老年ISH组的颈动脉内膜中层厚度(IMT)最大值(dIMTm ax)较正常对照组明显升高,两组比较差异有显著性意义(P<0.01)。在老年ISH患者中医证型与dIMTm ax及CAS发生率方面,与其他证型比较,痰湿壅盛型的dIMTm ax明显升高(P<0.01)。【结论】老年ISH各中医证型中,dIMTm ax的异常和颈动脉硬化发生率以痰湿壅盛型的改变最明显,提示中医痰证在老年ISH患者AS发病中有内在的病理基础,为老年ISH患者CAS从痰证辨证论治提供了客观依据。

Objective To investigate the relationship between the incidence and degree of carotid atherosclerosis （CAS） and traditional Chinese medical （TCM） syndrome patterns in aged patients with isolated systolic hypertension （ISH）. Methods A prospective cohort trial was applied. Thirty healthy volunteers were in the normal control group. One hundred and twenty aged ISH patients were classified into four TCM syndrome patters. The relationship between TCM syndrome patters and CAS was studied. Results The maximum carotid intimamedia thickness （IMTmax） was larger in aged ISH patients than the normal control group （P 〈0. 01 ）. In the aged ISH patients, IMTmax and CAS incidence were higher in the pattern of excessive accumulation of phlegm and dampness （P 〈0.01 compared with other patterns）. Conclusion In the aged ISH patients with different TCM syndrome patterns, IMTmax and CAS incidence are much higher in the pattern of excessive accumulation of phlegm and dampness, indicating that phlegm syndrome is probably the main pathogenesis of atherosclerosis in aged ISH patients, which can supply some evidence for the syndrome differentiation of atherosclerosis in aged ISH patients based on the theory of phlegm.