高血压病患者动脉弹性及中医辨证分型相关性探究.docVIP

高血压病患者动脉弹性及中医辨证分型相关性探究 　【摘要】 　　目的探讨高血压病患者动脉弹性与中医辨证的相关性及其对治疗、预后的价值。 方法采用HDI CV Profilor DO－2020无创动脉功能检测仪（美国HDI公司）对342例高血压病患者进行大、小动脉弹性指数（C1，C2）测定，同时采集病史，查体及作有关血生化指标。结果与肝火上炎组、痰湿壅盛组比较，阴虚阳亢、阴阳两虚组的C1，C2均明显降低（Plt;0.05）。结论动脉弹性检查可为高血压病患者病情判断，辨证论治提供客观证据，对中医临床辨证分型有一定价值。 【关键词】 原发性高血压； 动脉弹性； 大小动脉弹性； 辨证 　　Abstract：ObjectiveTo inquire into the relationship between arterial compliance and TCM syndrome differentiation and discuss the indicative values of treatment and prognosis. MethodsUsing non-invasively obtained radial pulse contour analysis (HDI CV Profilor DO－2020), large and small arterial compliance (C1 and C2) of 342 patients with primary hypertension were measured. Meanwhile, the medical history, physical exam and biochemistry variables were collected. ResultsCompared with patients group with flaming-up of the liver fire syndrome and patient group with accumulation of phlegm-damp syndrome,the C1,C2 of patients group with hyperactivity of Yang due to Yin deficiency syndrome and Patients group with Yin-yang deficiency syndrome were significantly decreased (P＜0.05）.ConclusionThe examination of arterial elasticity is one of the objective evidence for judging state of illness and syndrome differentiation based on treatment in patients with essential hypertension. Thus, it shows definite referential importance to the TCM syndrome typing. 　　Key words：Essential hypertension; Arterial elasticity; Large and small arterial elasticity (C1 and C2); Syndrome differentiation 　　近年来随着对高血压病研究的深入，越来越多的证据表明动脉的弹性是关于动脉缓冲系统的最佳临床指标，人们逐渐认识到高血压病患者存在着动脉结构与功能的改变。各种心血管危险因素如高血压病、糖尿病和高脂血症等导致机体并发症发生的最终途径都是通过血管的损害。动脉弹性下降预示着将发生心血管事件的危险因子，与冠心病、脑卒中的发生和死亡密切相关，同时对心血管病治疗的疗效及预后的评价也具有重要价值，动脉弹性指数（C1，C2）是评价动脉弹性的重要指标［1～2］。本研究采用HDI CV Profilor DO－2020型无创动脉功能检测仪同期测定342例不同中医证型高血压病患者的大、小动脉弹性指数（C1，C2），旨在揭示高血压病中医辨证的实质，更好地指导中医临床辨证。 　　1 一般资料 　　选择2006-01～2007-09在广东省中医院、北京大学人民医院高血压科门诊和住院的原发性高血压病患者342例，原发性高血压病诊断符合《1999年WHO/ISH高血压治疗指南》标准（血压≥140/90mmHg者）并进行血压分级。所有患者均为初诊或停用降压药物或影响心率药物3 d以上的高血压患者，经实验室和临床检查排外继发性高血压、严重心血管并发症以及糖代