心脏脚踝血管指数与高血压病中医证型关系研究

Relationship between cardio ankle vascular index and TCM syndrome types of hypertension

目的观察高血压病患者心脏脚踝血管指数（cardio ankle vascular index，CAVI）变化及其与中医证型的关系。方法对151例高血压病患者和29例健康受试者（对照组）进行问卷调查和CAVI检测，并对高血压病患者进行辨证分型。分析高血压病患者CAVI值与健康者的差异以及不同中医证型高血压病患者CAV!值的差异。结果单纯高血压组CAVI值较对照组明显升高（P〈0．05），有合并症（糖尿病、冠心病等）高血压组CAVI值较对照组及单纯高血压组均有明显增高（P〈0．05），校正年龄影响后，这种差异仍然存在。高血压患者辨证分型，各证型CAVI值：瘀血阻络证〉痰浊壅盛证〉阴阳两虚证〉阴虚阳亢证〉气阴两虚证〉肝火亢盛证。虚实夹杂证CAVI值较实证、虚证增高P〈0．05）。痰瘀证组CAVI值较非痰瘀证组增高（P〈0．05），校正年龄影响后，差异仍然存在。结论高血压加速了动脉硬化的进展，血糖、血脂等对动脉硬化也有一定的影响；动脉硬化可能与痰瘀关系更密切。

Objective To observe the changes of cardio ankle vascular index （ CAVI ）, and the relationship between CAVI and TCM syndrome types in hypertension patients. Methods The questionnaire and CAVI detection were carried out in 151 hypertension patients and 29 health personsl the control group）, and otherwise,the hypertension patients were given TCM syndrome differentiation and classification. The difference of CAVI value between the hypertension patients and control group, and that among different TCM syndrome types were analyzed. Results CAVI value in the patients with simple hypertension was higher than that in the control group（ P 〈 0.05 ）. CAVI value in the hypertension patients with complications （diabetes, coronary heart disease, etc. ） was higher than that in the control group and patients with simple hypertension （ P 〈 0.05 ）. After correcting for age influence the above differences could be observed too. CAVI values in different TCM syndrome types of hypertension showed as follows：syndrome of blood stasis obstructing collaterals 〉 syndrome of turbid phlegm stagnation 〉 syndrome of deficiency of both yin and yang 〉 syndrome of hyperactivity of yang due to yin deficiency 〉 syndrome of deficiency of both qi and yin 〉 syndrome of liver-fire hyperactivity. CAVI value in syndrome of deficiency complicated with excessiveness was higher than that in excess syndrome or deficient syndrome （ P 〈 0.05 ）. CAVI value in phlegm-stasis syndrome was higher than that in non-phlegm-stasis syndrome （P 〈 0.05 ）. After correcting for age influence the above differences could be observed too. Conclusion In TCM syndrome differentiation and classification the hypertension patients with syndrome of deficiency eomplieated with excessiveness and phlegm - stasis syndrome have higher CAVI values,which indicates that arteriosclerosis is related to phlegm stasis more closely.