高血压中医证型与血脂紊乱及心脏舒缩功能损害的相关性研究

【作者】 张云飞；

【导师】 赵莺；

【作者基本信息】 成都中医药大学 ， 中医诊断学， 2005， 硕士

【摘要】 目的:探讨高血压病中医证型与血脂紊乱及心脏舒缩功能损害的相关性,旨在探索高血压病不同中医证型的辨证客观化指标;同时把高血压病不同证型与血脂紊乱情况结合起来,预测其并发动脉粥样硬化(AS)和冠心病(CHD)的危险性。方法:1、设计调查表,准确填写临床资料。2、以20名健康人作为对照组。3、请两名中级以上职称的医师根据上述临床资料并参照《中药新药临床研究指导原则(试行)》2002版有关高血压病的中医证候诊断标准进行辨证,得出证候结论。4、采用SPSS13.0统计软件包,用单因素方差分析方法,对试验组不同证型之间及试验组与对照组进行比较。结果:1、在试验组各证型之间血脂的比较中,痰湿壅盛型高密度脂蛋白(HDL-C)降低最明显,与其他三型比较有统计学差异;阴阳两虚型低密度脂蛋白(LDL-C)升高明显,与肝火亢盛型比较有统计学差异。2、在试验组各证型之间心功能的比较中,阴阳两虚型射血分数(EF值)较其他三组降低,但无统计学意义,与阴虚阳亢型比较则有统计学差异;痰湿壅盛型E/A下降不明显,与其他三型比较有显著差异。3、试验组与对照组比较,存在明显的血脂紊乱,尤以胆固醇(TC)升高和HDL-C降低最明显,并有统计学差异;高血压病患者普遍存在E/A值降低。结论:1、甘油三酯(TG)升高和HDL-C降低可以作为痰湿壅盛型辨证的客观化指标。2、LDL-C升高和EF值降低可以作为阴阳两虚型辨证的客观化指标。3、E/A值也可以作为痰湿壅盛型辨证的客观化指标。4、试验组各证型中,痰湿壅盛型患者患动脉粥样硬化(AS)和冠心病(CHD)的风险性最高。更多还原

【Abstract】 Objective: Discuss the correlation between different TCM syndromes of primary hypertension and the blood fat disorder and vasomotor harm of heart, in order to find subjective index for TCM syndrome differentiation of hypertension, meanwhile try to correlate the syndromes with blood fat disorder , and predict the risk of occurrence of coronary artery heart disease and atherosclerosis;Methods: 1.Design research form in TCM syndromes of hypertension according to the Guide Book of New TCM Pharmaceutic Clinical Research(2002 edition), fill in precise clinical materials. 2. Take 20 normal people as control group. 3. Two doctors in medium-grade or higher professional title make out syndrome differentiation according to the clinical materials. 4. Apply the SPSS13.0 software and the approaches of single factor variance analysis for the comparison among different syndromes of hypertension and between hypertension group and control group.Results: 1. The comparison among different syndromes of hypertension shows that the decrease of HDL-C is most obvious in the syndrome of excessive phlegm-dampness, having statistic difference compared with the other three groups.the increase of LDL-C is obvious in the syndrome of yin-yang deficiency, having statistic difference compared with the syndrome of liver-fire hyperactivity.2.The research of hypertension syndromes and heart function shows that the EF in the syndrome of yin-yang deficiency decreases more than the other three groups,having statistic difference compared with the syndrome of yin deficiency and yang hyperactivity; the decrease of E/A is not obvious in the syndrome of excessive phlegm-dampness, having obvious difference compared with the other three syndromes.3.Blood fat disorder,especially the increase of cholesterol and the decrease of HDL-C, is obvious in the hypertension group compared with the control group ,having statistic difference; The decrease of E/A is common in the hypertension group. Conclusion: 1.The increase of TG and the decrease of HDL-C can be applied as the subjective index for the syndrome of excessive phlegm-dampness.2.The increase of LDL-C and the decrease of EF can be applied as subjective index for the syndrome of yin-yang deficiency.3.E/A can also be applied as subjective index for the syndrome of excessive phlegm-dampnessAAmong different syndromes of hypertention,the syndrome of excessive phlegm-dampness risks highest to get coronary artery heart disease and atherosclerosis.更多还原