高血压患者心血管危险因素与中医体质的关系

Relationship between Cardiovascular Risk Factors and TCM Constitution in Patients with Hypertension

目的探讨高血压病患者血同型半胱氨酸、颈动脉粥样硬化、身体质量指数等危险因素与中医体质的相关性。方法采用中医体质问卷对268例原发性高血压患者进行中医体质调查并分类,所有患者均测量身高、体重,计算身体质量指数,检测总胆固醇、甘油三酯、低密度脂蛋白水平、血清HCY水平,采用彩色多普勒超声诊断仪检测颈总动脉平均内膜中层厚度(IMT)。结果痰湿质、湿热质的患者吸烟多见,与平和质、气虚质、阴虚质、阳虚质、气郁质、特禀质比较有显著差异(P<0.01);阴虚质、痰湿质患者糖尿病发病多见,与平和质、阳虚质、湿热质、血瘀质、气郁质、特禀质相比较有显著差异(P<0.01);BMI以痰湿质及湿热质患者较高,与平和质、阴虚质、气郁质、特禀质相比较,有显著差异(P<0.01);痰湿质、湿热质、血瘀质患者的甘油三酯明显升高,与平和质、特禀质患者比较有明显差异(P<0.05);血瘀质、痰湿质、平和质、湿热质患者的总胆固醇明显升高,与气虚质、气郁质患者比较差异明显(P<0.01);痰湿质、血瘀质患者的低密度脂蛋白明显升高,与阳虚质、湿热质相比差异显著(P<0.01);血瘀质患者的血同型半胱氨酸水平明显升高,与阴虚质、痰湿质、湿热质相比差异明显(P<0.01);血瘀质、痰湿质、阴虚质患者平均颈总动脉内膜中层厚度与平和质、特禀质、气郁质相比明显增厚(P<0.05)。结论高血压患者体质分类与心血管危险因素有一定的相关性。

Objective To investigate the correlation between the serum homocysteine in patients with essential hypertension, carotid atherosclerosis,body mass index,risk factors and TCM constitution. Methods Using the TCM constitution questionnaire in 268 cases of primary hypertension patients with TCM physique investigation and classification,all the patients were measured height,weight,body mass index was calculated,serum total cholesterol,triglyceride,low density lipoprotein levels and serum HCY level were detected,and the mean intima-media thickness of color Doppler ultrasonography（ IMT） of common carotid artery was checked. Results Phlegm dampness and damp heat patients were more smoking,comparing with the quality of the hot and humid,flat and quality,qi deficiency,yin deficiency,yang deficiency,qi stagnation,special intrinsic quality,there was significant difference（ P〈0. 01）. Yin deficiency and phlegm wet patients were more diabetes,and comparing with the peace constitution,yang deficiency,dampness heat and blood stasis,qi stagnation,special intrinsic quality,and there was significant difference,（ P〈0. 01）. BMI in phlegm wet matter and dampness heat were higher,comparing with the flat and soft,yin deficiency,qi stagnation,special intrinsic quality,there were significant differences（ P〈0. 01）. The triglyceride of phlegm dampness,damp heat,blood stasis patients increased,comparing with the gentleness,the intrinsic quality,there was significant difference（ P〈0. 05）. The total cholesterol of blood stasis,phlegm dampness,damp heat,and quality of patients with increased significantly,comparing with qi deficiency,qi stagnation,and there was significant difference（ P〈0. 01）. The low density lipoprotein of phlegm dampness,blood stasis patients increased significantly,comparing with yang deficiency,damp heat,and there was significant different（ P〈0. 01）. The blood homocysteine level of blood stasis patients increased significantly,comparing with yin deficiency,phlegm dampness,damp heat,and there was significant difference（ P〈0. 01）. There was significant difference on mean carotid artery intima-media thickness between blood stasis,phlegm,yin deficiency patients and gentleness,intrinsic quality,qi stagnation（ P〈0. 05）. Conclusion There was correlation between physical classification and cardiovascular risk factors in patients with hypertension.