高血压及其合并糖尿病/糖耐量减低动脉硬化评价及与中医证型相关性研究

摘要

Objective To analyze the correlation of hypertension complicated with diabetes/impaired glucose tolerance (IGT) arteriosclerosis evaluation and TCM syndrome type by clinical investigation. Methods Thirty-six cases of patients with hypertension, 38 cases of hypertension patients complicated with diabetes or IGT and 30 cases of control group were involved, and their heart rate, 24 h ambulatory blood pressure, AASI, fasting glucose or OGTT experiment and TCM syndrome type were determined and analyzed with SPSS 17.0 statistical software. Results Compared with the normal group, AASI were statistically different in hypertension complicated with diabetes or IGT group and hypertension group (P< 0.01), and there was statistical different between the two groups (P<0.05). AASI in cardiovascular disease and stroke had statistically significance compared with the normal group (P<0.01). AASI had positive relation with age, blood pressure, blood glucose, TC, 24 h average SBP and daytime average blood pressure (P<0.05), and negative relation with 24 h average DBP (P<0.05). In hypertention patients, the distribution of TCM syndrome type was blood stasis >excessive accumulation of phlegm-dampness >yin deficiency and yang hyperactivity>liver-fire hyperactivity. AASI of blood stasis syndrome had statistical difference compared with the control group (P<0.05). Conclusion Arteriosclerosis in hypertension patients complicated with diabetes or IGT is more severe than hypertension group and control group. In TCM syndrome type, AASI is more closely related with blood stasis type.%目的 通过临床病例,分析高血压及其合并糖尿病/糖耐量减低动脉硬化评价及与中医证型相关性.方法 测定36例高血压患者,38例高血压合并糖尿病(DM)/糖耐量减低(IGT)患者及30例对照组的24 h血压、动态动脉硬化指数(AASI)、空腹血糖或口服葡萄糖耐量试验及中医分型等数据,并进行统计分析.结果 与正常组比较,高血压组和高血压合并DM/IGT组的AASI差异均有统计学意义(P＜0.01),且2组之间比较差异有统计学意义(P＜0.05);AASI在心血管疾病与卒中疾病上与对照组比较差异有统计学意义(P＜0.01)；AASI与年龄、血压、血糖、胆固醇、24 h平均收缩压、日间平均血压均呈正相关(P＜0.05),与24 h平均舒张压呈负相关(P＜0.05).高血压患者中医证型分布依次为瘀血型＞阴阳两虚型＞痰湿壅盛型＞阴虚阳亢型＞肝火亢盛型；各型与对照组比较,瘀血型AASI差异有统计学意义(P＜0.05).结论 高血压合并糖尿病、糖耐量减低患者动脉硬化程度高于高血压患者及对照组.AASI在中医辨证分型上与瘀血型关系最密切.