有关高血压病中医不同证型心脏结构及功能变化比较的研究

目的：探讨高血压病中医不同证型在高血压患者中的构成分布规律，及不同证型高血压患者的心脏结构及功能的各个指标的变化情况。为高血压病中医辨证论治提供现代医学参考依据及客观量化指标。方法：选取我院2012年1月-2013年1月200例高血压患者。有3名中职以上职称的中医师根据临床资料及2002版有关高血压的中医证候诊断标准进行辨证，同时结合心脏彩超，应用超声心动图指标分析200例高血压患者心脏结构及功能。辨证中医证型。根据高血压患者的具体病情分为4个证型1]。分别为痰湿壅盛型、肝火亢盛型、阴虚阳亢型、阴阳两虚型。分析4个证型在高血压的在年龄和病程上的分布规律，以及4个证型在心脏结构和功能上的差异。结果：①4个证型在年龄和病程上的分布有着明显的差异：年龄较低病程较短者多以肝火亢盛型、痰湿壅盛型为主；年龄较高病程较长者多以阴阳两虚型为主。②肝火亢盛型多以舒张压明显升高，阴阳两虚型多以收缩压明显升高，痰湿壅盛型和肝火亢盛型，多以1～2级高血压为主，阴虚阳亢型和阴阳两虚型多为3级高血压。③高血压不同危险程度在不同证型分布上有着明显的差异：低、中危高血压患者多以痰湿壅盛型、肝火亢盛型为主，高危患者多以肝火亢盛型、阴虚阳亢型为主，重高危患者以阴阳两虚型和阴虚阳亢型者为主.④不同证型高血压患者的心脏结构及功能有明显差异-不同证型的高血压患者其左室肥厚和心功能参数之间有明显差异。结论：①高血压中医辨证在分布变化上呈现规律分布。②不同证型在，临床上的表现有明显的差异。③分析高血压痛中医证型对临床上治疗高血压有重要的指导意义。

Comparative study on cardiac structure and the various indicators changes of function in different syndromes of hypertensive patients

Objective： To explore the distribution of TCM different syndromes of patients with hypertension, and hypertensive patients with different syndromes of cardiac structure and function of the various indicators of changes in the situation. Provided reference for modem medicine and objective quantitative indicators for TCM differential treatment. Methods： Our hospital from January 2012 to January 2013, 200 cases of hypertension were selected. There are three more titles vocational practitioners based on clinical data and the 2002 edition of hypertension syndromes related diagnostic criteria for differentiation, combined with echocardiography, echocardiography to analyzed 200 cases of hypertension indicators cardiac structure and function. TCM syndrome types： According to the specific condition of patients with hypertension is divided into four syndromes, analyzing four syndromes in age and duration of hypertension on the distribution, as well as four syndromes in cardiac structure and functional differences. Results： （2）Four syndromes in the course of the distribution of age and have obvious differences： The patients with lower age and shorter duration mainly to irascibility hyperactivity type and phlegm dampness type; the patients with higher age and longer duration mainly to yin and yang deficiency type. （3）Irascibility hyperactivity type mostly diastolic blood pressure was significantly increased, Yin and yang deficiency type mostly significantly higher systolic blood pressure, phlegm dampness type and irascibility hyperactivity type mostly grade 1 -2 hypertension based, Yinxu Yangkang type and Yin and yang deficiency type mostly 3 hypertension. （3）Different degree of risk of hypertension in the distribution of different syndromes are quite different： Low, medium risk patients with hypertension and many more phlegm dampness type, irascibility hyperactivity type-based, high-risk patients and more to irascibility hyperactivity type, hyperactivity type-based, Heavy -risk patients with yin and yang and yin deficiency type dominated. （4）Hypertensive patients with different syndromes of cardiac structure and function were significantly different： Different syndromes in patients with hypertension and left ventricular hypertrophy in their heart function parameters were significantly different. Conclusion： （1）TCM hypertension presented on changes in the distribution of regular distribution. （2）Different syndromes in the clinical manifestations are obvious differences. （3）Analyzing hypertension syndromes has important guiding significance on the clinical treatment of hypertension.