原发性高血压中医体质与颈动脉粥样硬化的相关性研究

Study on the Relation between TCM Constitution and Carotid Atherosclerosis in Essential Hypertension Patients

目的探讨原发性高血压患者中医体质与颈动脉粥样硬化(AS)的关系。方法对201例原发性高血压患者进行中医体质辨识,在发生率最高的三种体质中各随机抽取30例患者,进行颈动脉超声检测,比较收缩期峰值血流速度(SPV)、血管阻力指数(RI)、内膜中层厚度(IMT)和斑块严重程度等指标。结果郁滞质组SPV最低,左侧颈总动脉为(53.06±7.15)cm/s和右侧颈总动脉(53.54±7.60)cm/s与内热质、协调质比较有统计学意义(P<0.01)。郁滞质的高血压患者较内热质、协调质患者内径增宽更明显(P<0.01)。郁滞质和内热质的高血压患者IMT增厚较协调质患者更明显(P<0.01)。结论在原发性高血压患者,中医体质以"郁"和"热"为主;郁滞质发生颈动脉粥样硬化时以斑块形成为主,内热质以RI的增高和IMT的增厚等AS表现为主。

Objective To study the correlation between traditional Chinese medicine（TCM） constitutional features and carotid atherosclerosis in patients with essential hypertension（EH）. Methods Questionnaire on TCM constitution was performed in 201 cases of EH for clinical investigation. Thirty patients were randomly selected in three highest frequency types of constitutions. The systolic pressure velocity（SPV）, resistant index（RI）,inteima- media thickness（IMT）and severity of atherosclerotic plaque were measured by the carotid artery ultrasound examination. Results The SPV of left common carotid artery（CCA）and right CCA in stagnation constitution group were 53.06% and 53.54% respectively,which was lower than that in other two groups（P〈0.01）. The internal diameter of CCA and internal carotid artery（ICA）in stagnation constitution group were wider than that in other two groups（P〈0.01）. The IMT of CCA and ICA in stagnation constitution group and heat constitution group was thicker than that in other groups（P〈0.01）. Conclusion Principal TCM constitution were stagnation constitution and heat constitution in patients with essential hypertension. The charateristics of stagnation constitution was atherosclerotic plaque,while the charateristics of heat constitution was increasement of RI and IMT thickening.