3006例原发性高血压患者中医证型与生化指标的相关性研究

目的观察原发性高血压患者中医证型分布规律与临床生化指标的关系,为深入探讨其病因病机和高血压辨证客观化提供依据。方法按纳入标准选择2013年1月1日—2018年6月30日北京市东城区38个社区卫生中心诊治的原发性高血压患者3006例,充分收集患者中医四诊信息,对其进行辨证分型,并进行统计分析。结果高血压各证型分布比例从高到低依次为:阴虚阳亢证>肝火上炎证>气血亏虚证>痰湿壅盛证>瘀血阻络证>阴阳两虚证>肾精不足证。各证型的性别构成比较差异有统计学意义(P均<0.05)。各证型患者间血糖水平比较差异无统计学意义(P均>0.05);痰湿壅盛证的总胆固醇、尿酸水平高于其他证型,其中与阴虚阳亢证、气血亏虚证比较差异均有统计学意义(P均<0.05);痰湿壅盛证的高密度脂蛋白胆固醇水平明显低于其他证型,其中与阴虚阳亢证、肝火上炎证、气血亏虚证、瘀血阻络证、阴阳两虚证相比差异均有统计学意义(P均<0.05);肝火上炎证的三酰甘油水平高于其他证型,其中与阴虚阳亢证、气血亏虚证、阴阳两虚证比较差异均有统计学意义(P均<0.05);瘀血阻络证的血同型半胱氨酸水平最高,其中与阴虚阳亢证、肝炎上炎证、气血亏虚证、痰湿壅盛证比较差异均有统计学意义(P均<0.05)。结论阴虚阳亢证在高血压患者中所占比重最高;各证型高血压患者血同型半胱氨酸水平普遍高于正常水平;痰湿壅盛证患者的血脂代谢紊乱程度高于其他证型,且血尿酸水平最高。

Correlation between TCM syndromes and biochemical indexes in 3006 patients with essential hypertension

Objective It is to observe the relationship between the distribution of TCM syndromes and clinical biochemical indexes in patients with essential hypertension,so as to provide evidences for in-depth discussion of the etiology,pathogenesis and objectification of hypertension syndrome differentiation.Methods 3006 patients with essential hypertension were selected according to the inclusion criteria,and their information of the four diagnosis of TCM was fully collected for syndrome differentiation and statistical analysis.Results The distribution proportion of various syndromes of hypertension from high to low were as follows:Yin deficiency and Yang hyperactivity syndrome>liver fire flaming syndrome>Qi and blood deficiency syndrome>excessive accumulation of phlegm-dampness syndrome>blood stasis obstructing collaterals syndrome>deficiency of Yin and Yang syndrome>deficiency of kidney essence syndrome.The sex ratio of all syndromes was significantly different.There was no statistically significant difference in the blood glucose levels of patients of each syndrome type(P>0.05).The TC and UA levels of excessive accumulation of phlegm-dampness syndrome were higher than those of the other syndromes,the differences were significant compared with Yin deficiency and Yang hyperactivity syndrome,Qi and blood deficiency syndrome and the HDL level was significantly lower than those of the other syndromes,the differences were significant except deficiency of kidney essence syndrome(P<0.05).The TG level of liver fire flaming syndrome was higher than that of the other syndrome types,and the difference was statistically significant(P<0.05).The HCY level of the blood stasis obstructing collaterals syndrome was the highest,the differences were significant compared with Yin deficiency and Yang hyperactivity syndrome,liver fire flaming syndrome,Qi and blood deficienly syndrome,excessive accumulation of phlegm-dampness syndrome.Conclusion Yin deficiency and Yang hyperactivity syndrome accounts for the highest proportion in patients with hypertension.The level of homocysteine was higher than normal in patients with various syndromes of hypertension.The degree of dyslipidemia in patients with excessive accumulation of phlegm and dampness was higher than other syndroms.Uric acid was the highest in patients with excessive accumulation of phlegm and dampness.