上海和甘肃地区原发性高血压人群胰岛素抵抗与中医证型的相关性初探

Relationship between Insulin Resistance and TCM Syndromes Type in Hypertensive Population in Shanghai and Gansu Areas

目的探讨上海和甘肃地区原发性高血压(EH)人群胰岛素抵抗(IR)与中医证型的分布特征,以期对EH病人中医综合防治工作提供一定的科学依据。方法运用流行病学调查研究方法,采用问卷调查、体格检查及血生化检查等方式,收集病人基本信息、既往史及中医证候,并检测血糖及胰岛素水平,结合四诊情况进行中医辨证,对相关数据进行统计分析。结果①两地区EH病人中医证型分布总体呈阴虚阳亢型(44.6%)>痰湿壅盛型(33.7%)>肝火亢盛型(13.7%)>阴阳两虚型(8.0%);其中上海地区阴虚阳亢型最多,甘肃地区痰湿壅盛型最多。②伴有IR的EH病人共582例(58.2%),其中上海地区297例(59.4%),甘肃地区285例(57.0%),两地区EH病人IR发生率比较差异无统计学意义(P>0.05),但两地区IR水平比较差异有统计学意义(P <0.05)。③两地区EH病人中医证型中IR发生率均呈痰湿壅盛型>阴虚阳亢型>肝火亢盛型>阴阳两虚型。结论甘肃与上海地区EH病人中医证型分布不同,甘肃地区IR水平高于上海地区,两地区均为痰湿壅盛型IR阳性率最高。

Objective To investigate the distribution status of insulin resistance(IR)and TCM syndromes type in patients with essential hypertension(EH)in different areas,in order to provide a scientific basis for the comprehensive prevention and treatment of EH patients.Methods Epidemiological investigation and research were used,and questionnaires,physical examinations and blood biochemical examinations were used.Basic patient information,past medical history and TCM syndromes were collected,and detected blood sugar and insulin levels were detected.TCM syndromes were differentiated by the four diagnostics and statistical analyzed the related data.Results①The distribution of TCM syndromes in EH patients in the two areas was:yin deficiency yang hyperactivity type(44.6%)>stagnation of phlegm dampness type(33.7%)>liver fire hyperthyoidism(13.7%)>yin yang deficiency(8%).The yin deficiency yang hyperactivity type in Shanghai area were the most,and the stagnation of phlegm dampness type in Gansu area was the most.The difference in TCM syndrome type between the two areas was statistically significant(P<0.05).②A total of582(58.2%)EH patients with IR were selected,including297(59.4%)in Shanghai and285(57.0%)in Gansu.The incidence of IR in EH patients in the two areas was not statistically significant(P>0.05).But the difference in IR levels between the two areas was statistically significant(P<0.05).③The incidence of IR in TCM syndromes of EH patients in both regions was stagnation of phlegm dampness type>yin deficiency yang excess type>overabundant liver fire type>yin and yang deficiency type.Conclusion The distribution of TCM syndromes in EH patients in two areas was different.The IR level in Gansu is higher than that in Shanghai.The highest IR incidence rate in both regions is the phlegm dampness type.