原发性高血压伴2型糖尿病患者中医辨证分型与血清Hcy、AAR、肾功能指标的相关性探究

Correlation between TCM Syndrome Differentiation and Serum Hcy,AAR and Renal Function indicators in Patients with Essential Hypertension and Type 2Diabetes Mellitus

目的:探究原发性高血压(EH)伴2型糖尿病(T2DM)患者中医辨证分型与血清同型半胱氨酸(Hcy)、血浆醛固酮/血浆肾素活性比值(ARR)及肾功能指标的相关性。方法:纳入我院2020年4月至2022年4月期间120例EH伴T2DM患者作为研究对象,收集患者的中医四诊资料,统计中医证型分布情况,比较不同证型患者一般资料、血清Hcy、ARR及肾功能指标[肌酐(Scr)、尿素氮(BUN)、尿白蛋白肌酐比值(UACR)]。结果:患者中医证型按照构成比由高到低依次为痰浊壅盛证、阴虚阳亢证、阴阳两虚证、肝火亢盛证;四种证型患者性别、体质量指数比较差异无统计学意义(P>0.05),肝火亢盛证患者年龄小于其他三型(P<0.05),阴阳两虚证患者年龄大于其他三型(P<0.05);痰浊壅盛证血清Hcy及ARR高于其他三型(P<0.05),阴阳两虚证Scr、BUN、UACR值高于其他三型(P<0.05),肝火亢盛组Scr低于其他三型(P<0.05)。结论:EH伴T2DM患者的中医辨证分型与Hcy、ARR及肾功能指标有关,可为中医辨证分型提供依据。

Objective:To explore the relationship of TCM syndrome differentiation with serum homocysteine(Hcy),plasma aldosterone/plasma renin activity(ARR)and renal function indicators in patients with essential hypertension(EH)complicated with type 2diabetes mellitus(T2DM).Methods:120patients with EH and T2DM in the hospital from April 2020to April 2022were included as the research subjects.The data of TCM four diagnostic methods of patients were collected and the distribution status of TCM syndrome types were counted.The general data,serum Hcy,ARR and renal function indicators[serum creatinine(Scr),blood urea nitrogen(BUN),urinary albumin-creatinine ratio(UACR)]were compared among patients with different syndrome types.Results:According to the constituent ratio from high to low,the TCM syndrome types of patients were phlegm turbidity ac-cumulation syndrome,yin deficiency and yang hyperactivity syndrome,yin-yang deficiency syndrome and liver fire hyperactivity syndrome.There were no statistical differences in gender and body mass index(BMI)among the four syndrome types(P>0.05),the age of patients with liver fire hyperactivity syndrome was younger than that of the other three types(P<0.05),and the age of patients with yin-yang deficiency syndrome was older than that of the other three types(P<0.05).Serum Hcy and ARR in phlegm turbidity accumulation syndrome were higher than those of the other three types(P<0.05),the Scr,BUN and UACR of yin-yang deficiency syndrome were also higher than those of the other three types(P<0.05).The Scr was lower in the liver fire hyperactivity syndrome than in the other three types(P<0.05).Conclusion:TCM syndrome differentiation of patients with EH and T2DM is related to Hcy,ARR and renal function indicators,which can provide the basis for TCM syndrome differentiation.