高同型半胱氨酸血症与原发性高血压中医证型关联分析  

Analysis of correlation between hyperhomocysteine and traditional Chinese medicine syndromes in patients with essential hypertension

作　　者：吕娟 刘玲[1] 张婷[1] 张建平[1] LYU Juan;LIU Ling;ZHANG Ting;ZHANG Jian-ping(Department of Emergency Medicine,Gansu Hospital of Traditional Chinese Medicine,Lanzhou 730000,P.R.China)

机构地区：[1]甘肃省中医院急诊科,甘肃兰州730000

出　　处：《社区医学杂志》2020年第23期1604-1607,共4页Journal Of Community Medicine

摘　　要：目的中老年人是高血压病高发人群,高血压病是一种常见慢性疾病,高同型半胱氨酸血症与高血压病有协同作用,西医治疗后心脑血管事件率仍持续高发,而中医治疗取得一定疗效。本研究探讨高同型半胱氨酸血症与原发性高血压中医证型的相关性,以指导临床诊疗与预防高血压病的发生和发展。方法选取2012-03-01-2017-12-31甘肃省中医院收治的630例原发性高血压伴高同型半胱氨酸血症患者为研究对象,分为中年组(40~49岁)305例和老年组(≥50岁)325例。对所有患者进行中医辨证分型,同时检测血浆同型半胱氨酸水平,分析比较各中医证型之间患高血压病的例数及血浆同型半胱氨酸水平。结果中年组无典型证65例(21.3%),肝火亢盛证44例(14.4%),阴虚阳亢证48例(15.7%),阴阳两虚证54例(17.7%),脾虚痰湿证94例(30.8%);老年组无典型证60例(18.5%),肝火亢盛证75例(23.1%),阴虚阳亢证100例(30.8%),阴阳两虚证72例(22.1%),脾虚痰湿证18例(5.5%)。患者中医证型分布比较,差异有统计学意义,χ^(2)=80.135,P<0.01。中年组各证型之间血浆同型半胱氨酸水平比较,差异有统计学意义,F=8.268,P<0.01,组间两两比较,中年组其余证型与脾虚痰湿证相比,血浆同型半胱氨酸水平差异均有统计学意义,均P<0.01。老年组各证型之间血浆同型半胱氨酸水平比较,差异有统计学意义,F=5.903,P<0.05,老年组其余证型与阴虚阳亢证相比,血浆同型半胱氨酸水平差异均有统计学意义,均P<0.05。结论原发性高血压病患者不同中医证型血浆同型半胱氨酸水平不同,脾虚痰湿型、阴虚阳亢型分别是中、老年人高同型半胱氨酸血症的高危证型,提示中年从痰论治、老年从阴虚论治是中医防治高同型半胱氨酸血症的有效措施。OBJECTIVE Middle aged and elderly people are high incidence of hypertension,which is a common chronic disease.Hyperhomocysteinemia has synergistic effect with hypertension.After western medicine treatment,the incidence of cardiovascular and cerebrovascular events is still high,and traditional Chinese medicine(TCM)treatment of hypertension has achieved certain curative effect.This study explored the correlation between hyperhomocysteinemia and TCM syndrome types of essential hypertension,so as to guide clinical diagnosis and treatment and prevent the occurrence and development of hypertension.METHODS A total of 630 patients with essential hypertension and hyperhomocysteine admitted to our hospital from March 1,2012 to December 31,2017 were selected as the study subjects.The patients were divided into middle age group(40-49 years old)which included 305 cases and old age group(over 50 years old)which included 325 cases.All patients were classified according to TCM syndromes differentiation,and the plasma homocysteine levels were also measured.The number of cases of hypertension and plasma homocysteine levels between different TCM syndromes were compared.RESULTS In the middle aged group,there were 65 cases(21.3%)without typical syndrome,44 cases(14.4%)with irascibility syndrome,48 cases(15.7%)with Yin deficiency and Yang hyperactivity syndrome,54 cases(17.7%)with Yin and Yang deficiency syndrome,and 94 cases(30.8%)with spleen deficiency and phlegmdampness syndrome.In the elderly group,there were 60 cases(18.5%)without typical TCM classification,75 cases(23.1%)of irascibility-hyperactivity syndrome,100 cases(30.8%)of Yin deficiency and Yang hyperactivity syndrome,72 cases(22.1%)of Yin deficiency and Yin deficiency,and 18 cases(5.5%)of spleen deficiency and phlegm-dampness syndrome.The distribution of TCM syndromes in patients was statistically significant,χ^(2)=80.135,P<0.01.There were statistically significant differences in plasma homocysteine level between the middle-aged group and each syndrome type,F=8.268,P<0.0

关 键 词：高同型半胱氨酸血症 原发性高血压 中医证型 

分 类 号：R544.1[医药卫生—心血管疾病]