高血压病中医证型与2型糖尿病及其相关危险因素分析

Study on the Relationship between Hypertension TCM Patterns and Type 2 Diabetes Mellitus and the Analysis on Its Risk Factors

目的:探讨高血压病中医证型、危险因素及2型糖尿病的关系,揭示高血压病中西医病因病机,为高血压病合并2型糖尿病的前期研究提供新的思路及依据。方法:选取高血压病患者400例,运用OGTT进行评定,按其是否合并2型糖尿病分为2组。同时重点询问病史(家族史、冠心病史、糖尿病史和脑卒中史);测定身高(H)、体质量(W);检测空腹血糖(FPG)、餐后2小时血糖(2hPBG),血脂四项总胆固醇(CHOL)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)以及尿酸(UA),并进行血压测定。计算体重指数(BMI)=W(kg)/[H(m)]2。结果:1高血压合并2型糖尿病组中医证型以阴虚阳亢证多见,其次为痰湿壅盛、肝火亢盛、阴阳两虚。2高血压合并2型糖尿病组(A组)各指标相比较,A组患者家族史、冠心病史及收缩压明显高于高血压病不合并2型糖尿病组(B组)(P<0.05);B组患者BMI、TC、TG、FPG、2hPBG、HDL、LDL、UA与A组相比无显著性差异(P>0.05)。结论:1A组患者中医证型以虚实夹杂为主,以阴虚阳亢证多见;2甘油三酯、BMI增高以及高血压家族史、冠心病史、收缩压高是高血压合并2型糖尿病的主要危险因素。

Objective： To provide new thinking and evidence for preliminary study of hypertension complicated with type 2 diabetes mellitus （T2DM） by exploring the connections of hypertension TCM patterns and its risk factors to T2DM, as well as revealing the etiology and pathogenesis of hypertension. Methods： Altogether 400 hyper- tension patients were judged by OGTT and separated into two groups according to whether they were complicated with T2DM. Meanwhile, medical history （family history, the history of coronary heart disease, diabetes mellitus and stroke） of all the patients was inquired; height （H） and body weight （W） were detected; fasting plasma glucose （FPG）, 2h postprandial blood glucose （2hPBG）, total cholesterol （CHOL）, triglyceride （TG）, high density lipoprotein （HDL）, low density lipoprotein （LDL） and uric acid （UA） were measured, and blood pressure deteceted. Body weight was calculated （BMI）=W（kg）/[H（m）]^2. Results： ① Yin-deficiency and Yang-hyperactivity was the most com- mon TCM pattern in the patients suffering from hypertension complicated with T2DM, the next were accumulation of phlegm-damp, hyperactivity of liver-fire and dual deficiency of Yin-yang. ② the complication （A） group was obviously higher than hypertension （B） group in family history, the history of coronary heart disease and systolic pressure; there was no significant difference when B group was compared with A group in BMI, TC, TG, FPG, 2hPBG, HDL, LDL and UA （P〉0.05）. Conclusion： ①The patients suffering from hypertension complicated with T2DM is maily of intermingled deficiency-excess pattern, Yin-deficiency Yang-hyperacfivity pattern could be seen most frequently;② The main risk factors of hypertension complicated with T2DM are TG, the increase of BMI, family history of hypertension, the history of coronary heart disease and high systolic pressure.