摘要
目的探讨高血压对脑卒中高危人群颈动脉粥样硬化形成的影响及其病机,为中医药防治脑卒中提供依据。方法选择既往无糖尿病及血脂异常病史的1 073例脑卒中高危人群,分为高血压组775例和无高血压组298例,采用颈动脉超声观察颈动脉内膜中层厚度及斑块发生情况。将高血压组分为高血压不伴颈动脉粥样硬化组和高血压伴颈动脉粥样硬化组,观察比较2组的中医症状。结果高血压组颈动脉内膜增厚及斑块发生检出率高(P<0.05);随高血压病程的进展,颈动脉内膜增厚和斑块发生检出率均增加(P<0.01)。高血压伴颈动脉粥样硬化组口唇紫暗、口舌生疮、气短、乏力、潮热盗汗、夜尿频多、苔黄、脉沉、面色晦暗及苔腻等症状出现率同高血压不伴颈动脉粥样硬化组比较差异有统计学意义(P<0.05或P<0.01)。结论高血压病程与颈动脉内膜增厚及斑块发生有关,随高血压病程的进展,颈动脉内膜增厚及斑块发生逐渐增高;高血压伴颈动脉粥样硬化以虚实夹杂证为主,是在气阴两虚尤以气虚为主的基础上,痰浊与瘀血的交互作用下形成的,火热在此过程中亦有一定的影响。
Objective To investigate the effect of hypertension on carotid atherosclerosis （CAS） for high-risk group of stroke and discuss its pathogenesis, so as to provide the basis for prevention and treatment of traditional Chinese medicine （TCM）. Methods 1 073 cases of high-risk group of stroke without the history of diabetes or dyslipidemia were divided into a group with hypertension （Group H, n=775） and a group without hypertension （Group N, n=298）. Carotid artery ultrasound was applied to observe the intima-media thickness （IMT） and atherosclerotie plaque. Further the Group H was divided into a group with CAS （Group A） and a group without CAS （Group B）. And TCM symptoms were observed to compare. Results The occurrence rates of IMT and atherosclerotie plaque in Group H were significantly higher （P 〈0.05）; and which were increased as the progression of hypertension （P 〈0.01）. The Group A had a significant difference in the appearance rate of symptoms, ineluding dark purple lips, mouth sores, shortness of breath, lack in strength, tidal fever and night sweating, nocturia, yellow fur, sunken pulse, gloomy complexion, slimy fur and so on, when compared with the Group B （P 〈0.05 or P 〈0.01）. Conclusion There is a positive relationship between the progression of hypertension and the incidence rate of IMT and atherosclerotic plaque. The main syndrome of hypertension with CAS is deficiency-excess complex syndrome, which is formed on the basis of the syndrome of dual deficiency of qi and yin, especially the deficiency of qi, and under the interaction of phlegm and blood stasis. Meanwhile fire-heat also plays a certain role in this process.
出处
《北京中医药》
2013年第7期493-496,共4页
Beijing Journal of Traditional Chinese Medicine
基金
十二五"医改重大专项"脑卒中高危人群筛查和干预项目"
北京中医药大学科研创新团队项目(2011-CXTD-23)
关键词
高血压
脑卒中
动脉粥样硬化
颈动脉内膜
颈动脉斑块
病机
hypertension
stroke
atherosclerosis
intima-media thickness
atherosclerotic plaque
pathogenesis
