原发性高血压中医证型与靶器官损害的相关性研究

Correlation between TCM Syndrome Types and Target Organ Damage in Primary Hypertension

目的观察原发性高血压病人中医证型分布规律及其与靶器官损害的相关性。方法选取2014年12月—2015年12月乌鲁木齐市中医医院心脑病科入院的原发性高血压病人168例,采集病人的一般资料、中医证候以及靶器官损害资料。比较168例原发性高血压病人中医证型、24h动态血压、颈动脉内中膜厚度、颈动脉斑块检出率以及室间隔厚度。结果 168例原发性高血压病人中医证型分布从高到低依次为:痰湿壅盛证>肝火亢盛证>阴虚阳亢证>阴阳两虚证(分别为59.5%、16.7%、14.3%、9.5%)。肝火亢盛证和痰湿壅盛证24h舒张压(SBP)值高于阴虚阳亢证,差异有统计学意义(P<0.05),其余各组间比较差异无统计学意义(P>0.05)。痰湿壅盛证和肝火亢盛证24h收缩压(DBP)、24h平均血压(MBP)值较高,与其他证型比较差异无统计学意义(P>0.05)。痰湿壅盛证颈动脉内中膜厚度(IMT)值最大,与阴虚阳亢证、阴阳两虚证比较,差异有统计学意义(P<0.05),其余各组间比较差异无统计学意义(P>0.05);痰湿壅盛证晨峰血压比例最高;痰湿壅盛证颈动脉斑块检出率最高;痰湿壅盛证室间隔厚度最大,与肝火亢盛证、阴虚阳亢证比较,差异有统计学意义(P<0.05),其余各组间比较差异无统计学意义(P>0.05)。结论原发性高血压病人以痰湿壅湿证最为常见;痰湿壅盛证病人24hSBP、24hDBP、24hMBP值以及晨峰比例最高;痰湿壅盛证病人IMT值、室间隔厚度值及颈动脉斑块检出率最高。

Objective: To observe the distribution of traditional Chinese medicine (TCM) syndrome types in patients with primary hypertension and its correlation with target organ damage. Methods: One hundred and sixty eight patients with primary hypertension admitted to the Department of Cardio cerebral Diseases of Urumqi Traditional Chinese Medicine Hospital from December 2014 to December 2015 were enrolled.The general data,TCM symptoms,and target organ damage data of the patients were observed. The TCM syndrome type distribution,24h ambulatory blood pressure,carotid intima media thickness(IMT),carotid artery plaque detection rate,and ventricular septal thickness were observed. Results: The distribution of TCM syndromes in 168 patients with primary hypertension was phlegm dampness syndrome (59.5%),liver fire hyperactivity syndrome (16.7%),yin deficiency and yang hyperactivity syndrome (14.3%),deficiency syndrome of yin and yang (9.5%),respectively.The 24h systolic blood pressure SBP value in liver fire hyperactivity syndrome and phlegm dampness syndrome was the highest,and the difference was statistically significant compared with yin deficiency and yang hyperactivity syndrome ( P <0.05).There was no significant difference between the other groups ( P >0.05).24h diastolic blood pressure DBP and 24h mean blood pressure MBP were the highest in liver fire hyperactivity syndrome and phlegm dampness syndrome,and there was no significant difference compared with other groups ( P >0.05).IMT in phlegm dampness syndrome was the highest,and the difference was statistically significant compared with that in yin deficiency and yang hyperactivity syndrome,and deficiency syndrome of yin and yang ( P <0.05).There was no significant difference between other groups ( P >0.05).The phlegm dampness syndrome has the highest ratio of morning peak blood pressure.The detection rate of carotid plaque was the highest in phlegm dampness syndrome. The thickness of the ventricnlar septern in phlegm dampness syndrome was the largest,and the difference was statistically significant compared with that in yin deficiency and yang hyperactivity syndrome,and deficiency syndrome of yin and yang ( P <0.05). Conclusion Phlegm dampness syndrome is the most common type of hypertension in Urumqi.Among the patients with phlegm dampness syndrome,the highest 24h SBP,24h DBP,24h MBP values,and morning peak ratio were the highest.The IMT value,ventricular septal thickness value and carotid artery plaque detection rate were highest in patients with phlegm dampness syndrome.