摘要
目的观察代谢综合征(MetS)与非代谢综合征(no-MetS)高血压患者动态血压及中医证候的差异。方法选择2011年12月1日~2015年1月31日上海中医药大学附属龙华医院肾病科、上海中医药大学附属岳阳中西医结合医院高血压专科门诊收治的符合原发性高血压并伴MetS的患者59例(MetS组),原发性高血压不伴MetS患者60例(no-MetS组)。测量两组的形体学指标[体重、体重指数、腰围、腰臀比、胰岛素抵抗指数(HOMA-IR)]、糖代谢指标[空腹血糖(FPG)、空腹胰岛素(FPI)、糖化血红蛋白(HbA1c)、餐后2h血糖(2h PPG)]、血脂指标[胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]及各个时段[24h、白昼(d)和夜间(n)]的舒张压(DBP)、收缩压(SBP)、平均动脉压(MAP)及其变异性(v)血压指标等,并对中医证候评分进行统计。结果 MetS组患者的形体学指标显著高于no-MetS组,差异有统计学意义(P<0.01)。MetS组患者的FPG、2h PPG、HbA1c、FPI水平均显著高于no-MetS组,HDL-C水平显著低于no-MetS组,差异有统计学意义(P<0.01);MetS组患者的TC、TG、LDL-C水平均高于no-MetS组,差异有统计学意义(P<0.05)。MetS组患者的24h MAP、dDBP、dMAP、nDBP均高于no-MetS组,差异有统计学意义(P<0.05);两组患者的24h SBP、24h DBP、dSBP、n SBP、nMAP比较,差异无统计学意义(P>0.05)。MetS组患者的nDBPv高于no-MetS组,差异有统计学意义(P<0.05);两组患者的其他血压变异性指标比较,差异无明显差异(P>0.05)。MetS高血压患者中医证候以气虚兼郁热、痰湿、血瘀等积聚表现为主,病位在脾,与肝肾有关。结论MetS高血压患者较no-MetS高血压患者呈现更严重的心血管风险,重视中医益气健脾化聚论治是一种有效的干预途径。
Objective To observe the difference of ambulatory blood pressure and traditional Chinese medicine (TCM) syndrome between patients with metabolic syndrome (MetS) and non-metabolic syndrome (no-MetS) hypertension. Methods From December 1,2011 to January 31,2015,59 patients with essential hypertension complicated with MetS (MetS group) and 60 patients with essential hypertension but without complications of MetS (no-MetS group) from the Department of Nephrology in Longhua Hospital,Shanghai University of Traditional Chinese Medicine,and the Department of Hypertension Specialist,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine were enrolled. The physiology indexes (body weight,body mass index,waist circumference,waist-to-hip ratio,homeostatic model assessment for insulin resistance [HOMA-IR]),glucose metabolism indexes (fasting blood glucose [FPG],fasting insulin [FPI],glycosylated hemoglobin [HbA1c],2 hours postprandial blood glucose [2 h PPG]),blood lipid indicators (cholesterol [TC],triglyceride [TG],high density lipoprotein cholesterol [HDL-C],low density lipoprotein cholesterol [LDL-C]) and diastolic blood pressure (DBP),systolic blood pressure (SBP),mean arterial pressure (MAP) at various time periods (24 h,day [d],and night [n]) and variability (v) blood pressure indicators of the two groups were measured. The TCM syndrome scores were counted. Results The physiology index of the patients in the MetS group was significantly higher than that in the no-MetS group,and the difference was statistically significant (P<0.01). The levels of FPG,2 h PPG,HbA1c and FPI in the MetS group were significantly higher than those in the no-MetS group,and the HDL-C level was significantly lower than that in the no-MetS group,with statistically significant differences (P<0.01). The levels of TC,TG and LDL-C in the MetS group were higher than those in the no-MetS group,and the differences were statistically significant (P<0.05). The 24 h MAP,dDBP,dMAP and nDB
作者
陈熤
邓跃毅
符德玉
王文健
CHEN Yi;DENG Yue-yi;FU De-yu;WANG Wen-jian(Department of Nephrology,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Department of Cardiology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Department of Integrated Traditional Chinese and Western Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China)
出处
《中国当代医药》
2019年第14期185-189,共5页
China Modern Medicine
基金
上海中医药大学附属龙华医院爱建捐赠基金资助项目(AJ006)
国家中医临床研究基地业务建设科研专项课题(JDZX2015097)
关键词
代谢综合征
中医证候
胰岛素抵抗
益气健脾
24H动态血压监测
血瘀
原发性高血压
Metabolic syndrome
TCM syndrome
Insulin resistance
Boosting qi and fortifying the spleen
24 h ambulatory blood pressure monitoring
Blood stasis
Essential hypertension
