高血压200例脉象及病机分析

Analysis of pulse condition and pathogenesis in 200 cases of hypertension

目的:探讨高血压的脉象特征及演变规律,并通过脉象探讨高血压的中医发病机制。方法:2018年6月-2019年6月收治高血压患者200例,运用中医四诊仪结合手诊,按不同年龄、不同病程、不同高血压分级、有无靶器官损害及臂踝脉搏波传导速度(PWV)进行归纳分析,得出不同组的脉象特征及转化规律。结果:年轻、病程短、无靶器官损害,以滑脉多见;年龄大、病程长、有靶器官损害,以弦脉多见;动脉硬化严重的可见弦大脉。高血压的脉象演变过程是由滑到弦,再到弦大,提示高血压中医发病机制是由阳盛到阴伤,到阴虚阳亢、阴不涵阳、阳越于上,或夹痰饮。结论:治疗应谨守育阴潜阳、抑木培土之大法。

Objective:To explore the pulse characteristics of hypertension and its evolutionary law,and to explore the traditional Chinese medicine pathogenesis of hypertension through pulse condition.Method:From June 2018 to June 2019,200 patients with hypertension were selected.The traditional Chinese medicine four diagnostic instrument combined with hand diagnosis was used,according to different ages,different courses of disease,different levels of hypertension,with or without target organ damage,and brachial-ankle pulse wave velocity(PWV)for inductive analysis,and get the pulse characteristics and transformation rules of different groups.Results:Slippery pulse is more common in patients with younger age,short course of disease,and without target organ damage.Stringy pulse is more common in patients with old age,long course of disease,and target organ damage.In patients with severe arteriosclerosis,stringy large pulse can be seen.The evolution of the pulse of hypertension is from slippery to stringy,then to large stringy,suggesting that the traditional Chinese medicine pathogenesis of hypertension is from predominant yang to damage of yin,to asthenic yin causing predominant yang,yin does not contain yang,yang crosses over the top,or with phlegmatic retention.Conclusion:Treatment should adhere to the general method of replenishing yin and checking exuberance of yang,reinforcing the earth to check the wood.