H型高血压中西医研究简况  

General Situation of H-type Hypertension in Traditional Chinese and Western Medicin

作　　者：李涛[1] 张晶晶[2] 

机构地区：[1]贵阳中医学院第二附属医院心内科,贵阳550001 [2]贵阳中医学院第一附属医院肾内科,贵阳550001

出　　处：《实用中医内科杂志》2017年第5期82-84,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：H型高血压为原发性高血压伴有高血同型半胱氨酸(Hcy),高Hcy也是冠心病危险因素,高Hcy加重动脉粥样硬化,损伤血管内皮,增加内皮素分泌,消耗一氧化氮,损害血管组织,引起血管狭窄或闭塞,加重心肌梗死。高血压和高Hcy水平是脑血管危险因素。H型高血压可能是我国人群特有现象,且与脑卒中有密切关系。Hcy在血液中被氧化产生大量自由基,损伤血管内皮细胞,损伤肾小球则增加其通透性,出现微蛋白尿。血Hcy列为影响高血压患者预后重要因素。治疗降压和降Hcy兼用,降低同型半胱氨酸最有效方法是补充叶酸,能使Hcy下降>20%,使脑卒中风险下降25%,减少心脑血管事件发生。依那普利叶酸联合制剂有良好疗效,血管紧张素转化酶抑制剂类药物和叶酸在降低心脑血管事件发病风险上具有显著协同作用。高同型半胱氨酸血症多与痰浊、血瘀密切相关。中医证型以阴虚阳亢为主,黄连温胆汤不仅具有降压作用,且具有降Hcy及调脂作用。益肾活血胶囊可明显降低血浆同型半胱氨酸。未来应进一步加强中西医研究,多中心、大规模临床试验和循证医学研究进一步证实有效性和安全性,确定新的治疗靶向。Primary hypertension with hyperhomocysteinemia is defined as H-type hypertension. High hey is also a risk factor for coronary heart disease, High Hey increased atherosclerosis, Injury of vascular endothelium, increased endothelin secretion, consumption of nitric oxide, damage to vascular tissue,causing vascular stenosis or occlusion, increased myocardial infarction. Hypertension and high hey levels are risk factors for cerebrovascular disease. H-type hypertension may be unique to our population phenomenon, and has a close relationship with stroke. Hey is oxidized in the blood to produce a large number of free radicals, damage vascular endothelial cells, damage the glomerulus is to increase its permeability, there microalbuminnria. Blood hey as an important factor in the prognosis of patients with hypertension, treatment of antihypertensive and lowering hey. The most effective way to reduce homocysteine is to add folie acid, can reduce hey〉20%, so that the risk of stroke decreased by 25%, reduce cardiovascular and cerebrovascular events. Enalapril folio ac.id combined with a good effect, angiotensin converting enzyme inhibitor drugs and fi）lic acid in reducing the risk of cardiovascular and cerebrovaseular events have a significant synergistic effect. Hyperhomocysteinemia and phlegm, blood stasis is closely related. TCM syndrome type is based hyperactivity of yin deficiency and yang excess, Huanglian Wendan doup not only has antihypertensive effect, and has reduced hey and lipid-regulating effect. Yishenhuoxue capsule can significantly reduce plasma homocysteine. The future should be further strengthened in traditional Chinese medicine and western research, muhi-eenter, large-scale clinical trials and evidence-based medical research to further confirm the effectiveness and safety, to determine the new therapeutic target.

关 键 词：H型高血压 同型半胱氨酸 冠心病 脑卒中 微蛋白尿 叶酸 依那普利 血管紧张素转化酶抑制剂 痰浊 血瘀 阴虚阳亢 黄连温胆汤 相关研究 综述 

分 类 号：R544.1[医药卫生—心血管疾病]