原发性高血压中医证型与相关危险因素的关系

Relationship between TCM Syndrome Types and Related Risk Factors of Essential Hypertension

目的观察原发性高血压(EH)不同中医证型与血浆同型半胱氨酸(Hcy)、血脂异常、体质指数及腹围的关系。方法根据《中药新药临床研究指导原则(试行)》对260例EH患者进行辨证分型。用酶联免疫分析法测定患者血浆Hcy浓度,并采集记录患者年龄、性别、体质指数、腹围及血脂异常情况。结果 260例EH患者中,肝火亢盛证56例,阴虚阳亢证77例,痰湿壅盛证73例,阴阳两虚证54例。EH痰湿壅盛证的Hcy水平最高,与其他证型比较,差异具有统计学意义(P<0.05或P<0.01);男性EH患者伴高同型半胱氨酸血症(HHcy)发生率高于女性;且与其他证型相比,男性痰湿壅盛证HHcy发生率最高;痰湿壅盛证患者血脂异常发生率最高;痰湿壅盛证患者体质指数与肝火亢盛证及阴阳两虚证比较偏高,差异具有统计学意义(P<0.05),与阴虚阳亢证比较无明显差异;痰湿壅盛证患者的腹围与阴虚阳亢证及阴阳两虚证比较差异有统计学意义(P<0.01或P<0.05),与肝火亢盛证无明显差异。结论痰湿壅盛证患者在EH中医证型中所占比例最高,而且与引发或影响EH的诸多危险因素密切相关。

Objective To observe the regularities of distribution of TCM syndrome types and the relationships between TCM syndrome types and levels of plasma homocysteine（Hcy）,BMI,abdominal circumferences and abnormality of blood lipid in inpatients with essential hypertension（EH）.Methods The syndrome types of 260 EH patients were differentiated according to Guiding Principle of Clinical Research on New Drugs of Traditional Chinese Medicine（for Trial Implementation）.The levels of plasma HCY were measured by enzyme linked immunosorbent assay,and age,gender,blood lipid,BMI and abdominal circumferences were recorded.Results The TCM syndrome types of EH were in sequence of hyperactivity of yang due to yin deficiency（77 cases） excessive damp-phlegm（73 cases） overabundant liver-fire（56 cases） deficiency of both yin and yang（54 cases）.The level of plasma HCY in excessive damp-phlegm group was the highest（P0.05,P0.01）.The prevalence rate of hyperhomocystinemia（HHcy） in male patients was higher than that in female.The prevalence rate of blood lipid abnormality in excessive damp-phlegm group was the highest.BMI in excessive damp-phlegm group was higher than that in both overabundant liver-fire group and deficiency of both yin and yang group（P0.05）.Abdominal circumference in excessive damp-phlegm group was higher than that in deficiency of both yin and yang group（P0.05） and hyperactivity of yang due to yin deficiency group（P0.01）.Conclusion Excessive damp-phlegm is the most common syndrome of the four TCM syndrome types of EH,and it is closely related to the risk factors inducing or influencing EH.