基于血脉病理论对高血压合并脑梗死病因病机证候的探讨

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1、提要目的：分析高血压合并脑梗死的危险因素及其证候分布特点，以血管病变为切入点，提出“血脉病”理论，探求高血压合并脑梗死的病因病机，为临床早期干预血管危险因素、预防脑梗死提供理论基础。方法：通过临床采集高血压及高血压合并脑梗死患者的相关信息，运用统计学方法，分析两组危险因素的差异及其证候分布规律，初步探求高血压脑梗死的证候演变规律及其因果联系。结果：高龄、绝经期女性、吸烟、打鼾、嗜咸、性情急躁易怒与高血压脑梗死密切相关（P＜0.05）。高血压脑梗死组颈动脉粥样硬化程度更为严重（P＜0.05）。两组证候分布无显著差异（P＞0.05），证候分布以阴虚阳亢证所占比例最大(47.8%)，其次为肝

2、阳上亢证(27.3%)、痰湿壅盛证(19.3%)、阴阳两虚证(5.6%)。高血压脑梗死组膝软、目赤、健忘、食少、气短评分大于高血压组（P＜0.05），高血压组失眠评分较高（P＜0.05）。结论：血脉病变是高血压脑梗死发病的中间病理机制。火热为主要病理因素。火热灼津、灼血、灼脉，凝痰成瘀，积着人迎，脉闭不通是高血压脑梗死的基本病机。关键词高血压；脑梗死；血脉病；证候；病因病机Etiology,pathogenesisandsyndromeofhypertensioncomplicatedwithcerebralinfarctionbasedonthetheoryofhemo-vascul

3、ar-pathySpeciality：:theclinicalstudyofneuro-medicaldiseaseofTCMAuthor：ChenRuTutor：prof.DingYuanqingAbstractObjective：Toanalyzeriskfactors,syndromedistributionsandcharacteristicsofhypertensioncomplicatedwithcerebralinfarction.Onthisbasis，tofurtherexploretheetiologyandpathogenesisofthediseasebased

4、onthetheoryofhemo-vascular-pathytakingthevasculardysfunctionasthebreakthroughpoint.Toprovidethetheoreticalbasisforinterveningvascularriskfactorsearlyandpreventingcerebralinfarctioneffectively.Methods：Bycollectinginformationofpatientswithsimplehypertensionandhypertensioncomplicatedwithcerebralinf

5、arction,analyzingthedifferencesbetweenthetwogroupsofriskfactorsandsyndromedistributionlawsbyusingstatisticalmethods,preliminaryexplorethesyndromeevolutivelawandthecausalrelationshipbetweenhypertensionandcerebralinfarction.Results：Olderage,menopausalwomen,smoking,snoring,eosinophilicsaltyandtempe

6、ramentirritablearecloselyrelatedtohypertensionwithcerebralinfarction（P＜0.05）.ThedegreeofCarotidArteryAtherosclerosisismoreseriousinhypertensionpatientscomplicatedwithcerebralinfarctionthanwithout（P＜0.05）.Thesyndromedistributionsbetweentwogroupsareofnosignificantdifference,showingthatyin-asthenia

7、andyang-hyperactivityoccupiesthelargestproportion(47.8%),followedbyLiverYangrising(27.3%),phlegmywetandwarmcard(19.3%)andYinandYangtwodeficiencysyndrome(5.6%).Thescoresoflegsoft,redeyes,forgetfulness,eatingless,shortnessofbr