原发性高血压病中医体质与并发症相关性研究

目的探讨原发性高血压病中医体质与颈动脉粥样硬化（AS）、左室肥大、肾损害的关系。方法对498例原发性高血压病患者进行中医体质辨识,在发生率最高的3种体质中各随机抽取30例患者,进行心脏、颈动脉彩超检查,测定收缩期峰值血流速度（SPV）、心脏左室壁厚度、左室重量指数、颈动脉内膜中层厚度（IMT）和斑块严重程度;抽血查血脂、肾功能和尿β2微球蛋白等。结果阴虚质组SPV最低,左侧颈总动脉为（55.73±13.66）cm/s,右侧颈总动脉为（55.42±8.61）cm/s,与痰湿质组、气虚质组比较差异有统计学意义（P〈0.01）。颈动脉斑块严重程度依次为阴虚质组〉痰湿质组〉气虚质组,差异有统计学意义（P〈0.01）。阴虚质组患者左心功能改变明显,而痰湿质组患者肾功能改变、尿β2微球蛋白增加又较气虚质组明显,差异有统计学意义（P〈0.05）。结论原发性高血压病患者靶器官损害、并发症的发生与体质有关,辨识体质并加以干预有利于高血压病的防治。

Correlation Study of TCM Constitution and Complications of Essential Hypertension

Objective To explore the correlation of TCM constitution and carotid atherosclerosis(AS),left ventricular hypertrophy,renal damage of essential hypertension.Methods A total of 498 cases of essential hypertension were identified with TCM constitution,and each 30 patients were selected randomly from the three type of highest incidence to take heart and carotid ultrasonic examination,and detect cardiac ventricular wall thickness,carotid artery intima-media thickness(IMT) and plaque severity.Peak systolic flow velocity(SPV),IMT and the severity of plaque,left ventricular mass were compared.Blood lipid,renal function and urine beta 2 microglobulin were also examined.Results SPV of Yin deficiency group was the lowest,the left carotid artery was(55.73±13.66)cm/s and the right carotid artery was(55.42± 8.61)cm/s,with statistical difference with phlegm-dampness group and Qi deficiency group(P <0.01).Carotid artery plaque severity were Yin deficiency group > phlegm-dampness group > Qi deficiency group,the difference was statistically significant(P <0.01).The change of left heart function of Yin deficiency group was significant,and the change of renal function and urine beta 2 microglobulin of phlegm-dampness group were more obvious than Qi deficiency group,the difference was statistically significant(P < 0.05).Conclusion Target organ damage and complications in patients with essential hypertension are related with TCM constitution,and identification and intervention is beneficial to the prevention and treatment of hypertension.