H型高血压的中医证型特点探讨

Discussion on characteristics of TCM syndrome type of H-type hypertension

目的:观察H型高血压患者的中医证型特点及与性别、家族史、吸烟史、高血压分级、病程及年龄的相关性。方法:选取符合入选标准的H型高血压患者300例,记录其血浆同型半胱氨酸(HCY)指标;将纳入的病例辨证分为阴虚阳亢证、肝火亢盛证、阴阳两虚证、痰湿壅盛证等4个证型,统计中医证型分布与性别、家族史、吸烟史、高血压分级、病程及年龄的相关性。结果:H型高血压的证型分布特点:痰湿壅盛证占的比例最高(49.67%),与其他三型比较有显著差异(P<0.05),明显高于肝火亢盛(26.67%)、阴阳两虚(5.00%)、阴虚阳亢(18.67%),其他三型两两比较无差异(P<0.05)。结论:痰湿壅盛型为H型高血压中医辨证的主要证型。H型高血压的中医证型分布与性别、家族史、吸烟史、高血压分级无明显相关,而与病程及年龄具有明显相关性。

Objective： To observe the characteristics of TCM syndrome type of patients with H-type hypertension and the correlativity between TCM syndrome type and sex,family history,smoking history,hypertension grading,course of disease,age. Methods： 300 cases of patients with H-type hypertension,who met the inclusion criteria,were selected. Their indexes of plasma homocysteine（ HCY） were recorded. The included cases were divided according to syndrome differentiation into 4 syndrome types,i. e. syndrome of hyperactivity of yang due to yin deficiency,syndrome of exuberance of liver fire,syndrome of deficiency of both yin and yang and syndrome of phlegm-dampness obstruction. The correlativity between distribution of TCM syndrome type and sex,family history,smoking history,hypertension grading,course of disease,age was analyzed statistically. Results： The distribution characteristics of syndrome type of H-type hypertension as follows： the proportion of syndrome of phlegmdampness obstruction was highest（ 49. 67%）,and obviously higher than syndrome of exuberance of liver fire（ 26. 67%）,syndrome of hyperactivity of yang due to yin deficiency（ 18. 67%） and syndrome of deficiency of both yin and yang. For other three syndrome types,compared each other between two,there was no difference. The age of syndrome of exuberance of liver fire was smallest,its course of disease was mostly less than or equal to 5 years,and its HCY level was lowest. The HCY level of syndrome of phlegm-dampness obstruction was highest.Conclusion： The syndrome of phlegm-dampness obstruction is a main syndrome type of TCM syndrome differentiation of H-type hypertension. Its distribution of TCM syndrome type is not obviously correlative to sex,family history,smoking history,hypertension grading,but obviously correlative to course of disease and age.