原发性高血压病中医辨证分型与胰岛素抵抗的相关性研究

目的:探讨原发性高血压病(EH)中医证型与胰岛素抵抗(IR)及高胰岛素血症(HI)的关系。方法:将高血压病的4种证型及对照组各选30例,测定空腹血中胰岛素(INS)、C肽及血糖(BS)水平,计算胰岛素敏感指数(ISI)。结果:EH组与正常组相比较,空腹INS、C肽显著升高,ISI显著降低(P<0.01)。EH肝火亢盛、阴虚阳亢型与对照组相比,空腹INS、C肽显著升高,ISI显著降低(P<0.01);这两型与痰湿壅盛、阴阳两虚型相比,INS、C肽及ISI水平差异亦有统计学意义(P<0.05)。而痰湿壅盛、阴阳两虚型与对照组比较,各项指标差异无统计学意义(P>0.05)。结论:EH患者常伴IR及HI,IR(HI)主要体现于肝火亢盛、阴虚阳亢证型。

The relatirity of insulin resistance and syndrome differentiation typing in essential hypertension

Objective: To study the relativity of insulin resistance(IR), hyperinsulinism(HI) and syndrome differentiation typing(SDT) in essential hypertension(EH). Methods: One hundred and twenty hypertension patients were selected and classified into 4 types according to SDT: the yin-deficiency and yang-excess type, the liver-fire exuberant type,the phlegm-dampness abundant type and the yin-yang deficiency type, with 30 cases in each group. Meanwhile, 30 healthy people were selected to make up the control group. The serum insulin(INS), C-peptide and blood glucose level were measured and the insulin sensitve index(ISI) was calcuated. Results: Compared with the control group, the INS and c-peptide were obviously higher and ISI was lower in EH patients(P<0.01), and it was the same phenomena in the yin-deficiency and yang-excess type as well as the liver-fire exuberant type(P<0.01); differences could also be found when the index of the two types of EH was compared with those of the other types(P<0.05), however, there was no difference among the phlegm-dampness abundant type, the yin-yang deficiency type and the control group(P<0.05). Conclusion: Hypertension patients have apparent IR and HI, which exist mostly in yin deficiency and yang-excess type and liver-fire exuberant type.