原发性高血压患者中医证型分布及其与生化指标的相关性

Distribution of TCM Syndrome Types of Essential Hypertension and Their Relationship to Biochemical Indicators

目的:探讨高血压的中医证候分布情况及其与生化指标的关系,为深入探讨高血压病因病机和高血压辨证的客观化提供可能依据。方法:收集320例原发性高血压患者的临床资料和进行辨证分型,检测其血清生化指标,运用统计学方法进行数据分析。结果:各证型按所占比例排列为:痰浊壅盛型>阴虚阳亢型>阴阳两虚型>肝火亢盛型;肝火亢盛型的年龄显著低于其它3种证型(均为P<0.05);肝火亢盛型的甘油三酯(TG)水平显著高于其它各证型(P<0.05);阴阳两虚型和痰浊壅盛型的肌酐(Cr)阳性率显著高于肝火亢盛型(均为P<0.05);肝火亢盛型的C反应蛋白(CRP)阳性率显著低于痰浊壅盛型、阴虚阳亢型和阴阳两虚型(分别为P<0.01,P<0.05,P<0.01)。结论:高血压出现率最高的证型为痰浊壅盛型;肝火亢盛型高血压患者相对年龄较低且更易出现脂质代谢紊乱;高血压阴阳两虚型更多出现肾损害;痰浊壅盛型更易出现高血压早期肾损害;肝火亢盛型患者血管内皮炎症反应相对较轻。

Objective：To investigate the distribution of TCM syndrome types of essential hypertension and their relationship to biochemical indicators so that to supply possible evidence to researching the mechanism of EH disease and the objectification of its TCM syndromes. Methods ： TCM syndrome type of 320 EH patients were determined and their serum biochemical indicators were detected,followed by statistic assay. Results：TCM syndrome frequency were as followed, from high to low： accumulation of sputum wetness（ASW） 〉 Yin deficiency and overwhelming Yang（YDOY） 〉 deficiency of Yin and Yang （DYY） 〉 overwhelming liver fire （OLF） ;average age of OLF was significantly lower than others（P 〈0. 05 all） ;Serum TG level of OLF patients was statistically higher than that of others（ P 〈 0. 05 all） ; Positive rate of Cr in DYY and ASW were notably higher than that in OLF（ both P 〈0. 05） ;OLF patients had significantly lower CRP positive rate than ASW,YDOY and DYY（P 〈0. 01 ,P 〈0.05 ,P 〈0.01 ,respectively）. Conclusion：The most prevalent TCM syndrome type was ASW; EH OFL patients have relatively younger ages and more susceptbility to lipid metabolism disorder; EH DYY patients has more renal damages prevalence while EH ASW patients more easily suffer from early renal damages;Vascular endothelial inflammation is less visible in EH OFL patients.