老年高血压病中医辨证分型的客观化研究

目的 探讨老年高血压病中医辨证分型的客观指标.方法 选阴虚阳亢与阴阳两虚证的老年高血压痛患者各30例,检测偶测和动态血压参数、血栓前状态指标、靶器官损害指标(左室质量指数、颈动脉内膜-中层厚度、尿微量白蛋白).结果 阴阳两虚型中夜间平均收缩压、夜间平均舒张压、血小板α-颗粒膜蛋白-140、血管性血友病因子、纤维蛋白原降解产物、左室质量指数、颈动脉内膜-中层厚度和尿微量白蛋白高于阴虚阳亢型(P<0.01),而在平均收缩压夜间下降率、平均舒张压夜间下降率方面却低于阴虚阳亢型(P<0.01).平均收缩压夜间下降率和尿徽量白蛋白指标与两证型均有关.结论 血压参数、血栓前状态与靶器官损害指标的单因素分析结果可作为两型辨证的基础.平均收缩压夜间下降率和尿微量白蛋白指标有助于判别阴虚阳亢与阴阳两虚证.

Objectiveness of TCM Syndrome Differentiation for Senile Hypertension

Objective Abstract To approaching objective index of TCM syndrome differentiation in senile hypertension.Methods Parameters of casual and ambulatory blood pressure(PBP),pre-thrombotic states(PTS),the index of target organ damage(TOD) including left ventricular mass index(LVMI),carotid arterial intima media thickness(IMT) and microalbuminuria(MA) were tested in 60 senile patients(pts) with hypertension.Pts were divided into the syndrome of hyperactivity of Yang due to Yin deficiency(HYYD,n=30) and deficiency of Yin and Yang(DYY,n=30).Results Night mean systolic pressure(NMSP),night mean diastolic pressure(NMDP),the granule membrane protein-140(GMP-140),von Willebrand factor(vWF),fibrinogen degradation products(FDP),LVMI,IMT and MA in syndrome of DYY were significantly higher than that in HYYD(P<0.01),but night declining rate of mean systolic pressure(NDRMSP) and night declining rate of mean diastolic pressure(NDRMDP) were significantly lower than that in HYYD(P<0.01).TCM syndromes were correlated with NDRMSP and MA.Conclusion The PBP,PTS and TOD was the basis for differentiation of type.NDRMSP and MA were related to discrimination of HYYD and DYY.