高血压病患者胰岛素抵抗与中医辨证分型的相关性研究

作者	单位
刘惠文	Liu Huiwen, Zhang Tiezhong, Li Guangwei, et al China Japan Friendship Hospital, Beijing (100029
张铁忠	Liu Huiwen, Zhang Tiezhong, Li Guangwei, et al China Japan Friendship Hospital, Beijing (100029
李光伟	Liu Huiwen, Zhang Tiezhong, Li Guangwei, et al China Japan Friendship Hospital, Beijing (100029
姜亚云	Liu Huiwen, Zhang Tiezhong, Li Guangwei, et al China Japan Friendship Hospital, Beijing (100029

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中文摘要:

目的：探讨高血压病患者胰岛素抵抗与中医辨证分型之间的内在联系。方法：在大庆地区高血压监测人群中严格筛选出无心、脑、肾等并发症的早期高血压病患者２０９例，按照中医辨证分型标准分为肝火亢盛型、痰湿壅盛型、阴虚阳亢型及阴阳两虚型４型，并与健康对照组作胰岛素敏感性比较。结果：（１）高血压病各证型与健康对照组比较均存在明显的胰岛素抵抗（Ｐ＜００５），若将健康对照组的胰岛素敏感性定为１００，则肝火亢盛型、痰湿壅盛型、阴虚阳亢型、阴阳两虚型的胰岛素敏感性分别为：０５４、０５８、０６５、０８０；（２）肝火亢盛型、痰湿壅盛型、阴虚阳亢型３型间胰岛素敏感性比较，其差别无统计学意义（Ｐ＞００５），而与阴阳两虚型比较胰岛素敏感性均显著降低（Ｐ＜００５），阴阳两虚型与健康对照组最接近；（３）将肝火亢盛型、痰湿壅盛型、阴虚阳亢型３型合并，称为非阴阳两虚型，与阴阳两虚型进行比较，发现非阴阳两虚型空腹血胰岛素明显升高（Ｐ＝００００１），胰岛素敏感性明显降低（Ｐ＝００００１）；（４）通过逐步回归分析选择有意义的变量，进行多因素回归分析，在排除了性别、年龄、体重指数的影响后，胰岛素敏感性与中医分型密切相关（Ｐ＝００００１?

英文摘要:

Objective: To find the relationship between insulin resistance and Syndrome Differentiation typing (SDT) in hypertensive patients. Methods: Two hundred and nine patients of early stage hypertension with no complication of heart, brain or kidney were selected and classified into 4 types according to SDT, the Liver Fire exuberant type (A), the Phlegm Dampness abundant type (B), the Yin Deficiency and Yang Excess type (C) and the both Yin Yang Deficiency type (D). Their insulin sensitivity were examined and compared with that of 40 healthy subjects. Results: (1)Compared with healthy subjects, all hypertensive patients had apparent insulin resistance (P<0 05). If the insulin sensitivity of healthy subjects was defined as 1, that of patients of type A,B,C and D were 0.54, 0.58, 0.65 and 0.80 respectively. (2)Comparison between the insulin sensitivity of type A, B and C showed no significant difference, while they were compared with type D, the difference was significant (P<0 05), that is, the insulin sensitivity of type D was close to that of healthy subjects. (3) The fasting blood insulin of type D was obviously lower and the insulin sensitivity of type D was obviously higher than that of the other three types (P=0.0001). (4)After adjusting age, sex and body mass indexes, multivariate regression analysis demonstrated that insulin sensitivity was closely correlated with SDT (P=0.0001). Conclusion: Insulin resistance is one of the pathological basis for SDT in hypertension.

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