高血压病靶器官损害与中医证型相关性研究

Correlation study on target organ damage and TCM syndrome type in patients with hypertension

目的探讨原发性高血压病不同中医证型与靶器官损害的相关性。方法选择176例原发性高血压患者经中医辨证分为四型:肝火亢盛26例,阴虚阳亢51例,痰湿壅盛54例,阴阳两虚45例;选取正常健康者20例作为对照组。对各组肌酐、24 h尿蛋白定量、超声心动图及颈动脉内中膜厚度(IMT)等高血压靶器官损害进行相关性研究。结果①痰浊中阻证IMT及斑块数量较其他三组高,且有显著性差异。②阴阳两虚证左心室肥厚发病率较其他三组高,且有显著性差异。③阴阳两虚证血肌酐及24 h尿白蛋白定量均较其他三组高,且有显著性差异。结论①高血压病伴动脉粥样硬化性疾病可作为痰浊中阻证辨证的参考指标。②血肌酐及24 h尿白蛋白定量可作为阴阳两虚证辨证的客观化指标。③高血压病伴充血性心力衰竭可作为阴阳两虚证辨证的参考指标。

Objective It is to approach thecorrelation between target organ damage （TOD） and TCM Syndrome Type in patients with essential hypertension （EH）. Methods 176 patients with essential hypertension were divided into 4 type by TCM syndrome type：26 cases with liver-fire hyperactivity type, 51 cases with yin deficiency and yang hyperactivity type, 54 cases with excessive phlegm-dampness type and 45 cases with yin-yang deficiency type. 20 cases of normal people were selected for control. The indexes of TOD as SCr, quantitative test for urinary protein in 24 -hour, uhrasoundcardiogram and carotid inti- rna-media thickness （IMT） in patients with EH were detected and used to analyze the correlation. Results ①The IMT and plaque number in the syndrome of excessive phlegm-dampness were higher than that in the other groups, the differences were significant. ②The incidence of left ventricular hypertrophy （LVH） in the syndrome of yin-yang deficiency was higher than that in the other groups, the differences were significant.③The levels of SCr and UEA in the syndrome of yin-yang deficiency were higher than that in the other groups, the differences were significant. Conclusion ①EH with atherosclerosis can be applied as the subjective index for the syndrome of excessive phlegm-dampness. ②The increase of SCr or UEA can be applied as the subjective index for the syndrome of yin-yang deficiency. ③EH with CHF can be applied as the subjective index for the syndrome of yin-yang deficiency.