高血压病患者胰岛素抵抗与中医辨证分型的相关性研究

目的 探讨高血压病患者胰岛素抵抗与中医辨证分型之间的内在联系。方法：在大庆地区高血压监测人群中严格筛选出无心，脑，肾等并发症的早期高血压病患者２０９你，按照中医辨证分型标准发为肝火亢盛型，痰湿壅盛型，阴虚阳亢型及阴阳两虚型４例，并与健康对照组作胰钫素敏感性比较。结果：（１）高血压病各证型与健康对照组比较均存在明显的胰岛素抵抗（Ｐ〈０．０５），若将健康对照组的胰岛素敏感性定为１．００，则肝火亢盛型，

Study on Relationship between Insulin Resistance and Syndrome Differentiation Typing in Hypertensive Patients

OBJECTIVE: To find the relationship between insulin-resistance and Syndrome Differentiation typing (SDT) in hypertensive patients. METHODS: Two hundred and nine patients of early stage hypertension with no complication of heart, brain or kidney were selected and classified into 4 types according to SDT, the Liver-Fire exuberant type (A), the Phlegm-Dampness abundant type (B), the Yin-Deficiency and Yang-Excess type (C) and the both Yin-Yang Deficiency type (D). Their insulin sensitivity were examined and compared with that of 40 healthy subjects. RESULTS: (1) Compared with healthy subjects, all hypertensive patients had apparent insulin resistance (P < 0.05). If the insulin sensitivity of healthy subjects was defined as 1, that of patients of type A, B, C and D were 0.54, 0.58, 0.65 and 0.80 respectively. (2) Comparison between the insulin sensitivity of type A, B and C showed no significant difference, while they were compared with type D, the difference was significant (P < 0.05), that is, the insulin sensitivity of type D was close to that of healthy subjects. (3) The fasting blood insulin of type D was obviously lower and the insulin sensitivity of type D was obviously higher than that of the other three types (P = 0.0001). (4) After adjusting age, sex and body mass indexes, multivariate regression analysis demonstrated that insulin sensitivity was closely correlated with SDT (P = 0.0001). CONCLUSION: Insulin resistance is one of the pathological basis for SDT in hypertension.