原发性高血压患者中医分型与现代医学分型的关系

对146例原发性高血压患者作中医辨证分型,并进行各种临床观察及实验室检查。发现原发性高血压患者绝大多数属气阴两虚型及阴虚阳亢型。阴虚阳亢型血浆肾素活性均值(包括基础及激发值)明显高于气阴两虚型,且其中高肾素型较多,低肾素型较少,年龄较轻,病情较轻,24小时尿量及白天尿量较多,而注射速尿后尿量较少,气阴两虚型则相反。认为阴虚阳亢型相当于Laragh等所指的肾素依赖型,而气阴两虚型相当于Laragh等所指的容量依赖型。

Relationship between the Types of Traditional Chinese Medical Classification and Classification of Pathophysiologic Changes in Patients with Essential Hypertension

146 patients with essential hypertension (EH) were studied including traditional Chinese medical classification, clinical observations and laboratory examinations. The results showed: (1) Most patients with EH were classified to types of Yin deficiency Yang excess and Qi-Yin deficiency. The two types have not only different traditional Chinese medical symptoms and signs, but also different pathophysiologic changes. (2) There are higher average plasma renin activity (basal and under stimulation) levels in patients with type of Yin deficiency Yang excess than in patients with type of Qi-Yin deficiency. (3) The incidence of high-renin hypertension is higher in patients with type of Yin deficiency Yang excess than in patients with type of Qi-Yin deficiency. (4) The patients of Qi-Yin deficiency type are older, less urine excretion, more significant diuretic responses after furosemide injection and are more severe. These results indicate that the Yin deficiency Yang excess type is closely related to high renin level and is corresponding to renin-dependent hypertension, whereas the Qi-Yin deficiency type clearly appears to have water retention and is corresponding to volume-dependent hypertension.