高血压中医证型与出凝血指标的相关性分析

Relatiaonship between TCM syndrome type and coagulation index of hypertension

目的探讨高血压中医证型与出凝血指标的相关性。方法根据中医证型相关诊断标准于2017年9月至2018年5月将符合入选标准的294例高血压患者分为肝火亢盛组(42例)、阴虚阳亢组(14例)、阴阳两虚组(64例)、痰湿壅盛组(134例)和气虚痰阻组(40例),分析各组患者血栓弹力图各指标[凝血时间(R)、凝血速率(K)、纤维蛋白功能(Angle)、血小板聚集(MA)、凝血幅度下降速率(Ly30)、纤活指数(EPL)、凝血指数(CI)、30min振幅(A30)、血凝块溶解剩余百分比(CL30)],以及活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、国际标准化比值(INR)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)、纤维蛋白降解产物(FDP)、抗凝血酶(AT)及血小板计数((PLT)的变化。结果肝火亢盛组患者PLT高于其他各组,且与气虚痰阻组、阴阳两虚组比较,差异均有统计学意义(P<0.05);肝火亢盛组患者FIB、D-D、FDP均低于其他各组,且与阴阳两虚组比较,差异均有统计学意义(P<0.05)。结论阴阳两虚证高血压患者较其他各证型处于高凝状态,肝火亢盛证患者与其他各证型比较,呈低凝状态,与中医理论一致。

Objective To study the correlation between Traditional Chinese Medicine(TCM)syndrome type and coagulation index of hypertension.Methods According to the diagnostic criteria related to TCM syndrome types,from September 2017 to May 2018,patients with hypertension who met the inclusion criteria were divided into the liver-fired stagnation group,the yin deficiency yang stagnation group,the yin and yang deficiency group,the phlegm-dampness group,the qi deficiency and stagnation group.We analyzed the indexes of thromboelastography(R,K,Angle,MA,LY30,EPL,CI,A30,CL30),activated partial thromboplastin time(APTT),prothrombin time(PT),prothrombin time ratio(INR),thrombin time(TT),fibrinogen(FIB),D-dimer(DD),fibrin degradation products(FDP),antithrombin(AT)and platelet(PLT)between five groups.Results The PLT of liver-fired stagnation group was higher than other groups.There were statistically significant differences between the liver-fired stagnation group,the qi deficiency and stagnation group and the yin and yang deficiency group(P<0.05).The FIB,DD and FDP of the liver-fired stagnation group were lower than other groups,and there were statistically significant differences between the liver-fired stagnation group with the yin and yang deficiency group(P<0.05).Conclusion Yin and yang deficiency syndrome patients of hypertensive patients were hypercoagulable compared with other groups,and liver-fired stagnation syndrome patients of hypertensive patients were hypocoagulable compared with other groups,consistent with TCM theory.