北京市丰台区中老年人群代谢综合征中医证候特点研究
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摘要
目的分析北京市丰台区40～90岁人群代谢综合征(MS)的中医证候要素特点。方法对2012-2015年北京市丰台区常住人口进行多中心、大规模横断面研究,共筛查40～90岁居民10920名,采集人口基本信息、病史资料、中医四诊信息及相关检查结果,分析MS患者的人口学特征及四诊信息,并采用因子分析提取MS患者的中医证候要素。结果本筛查共计10920人,MS患者6046例,检出率为55.4%。MS高发于60～80岁人群,>50岁的女性MS发病率高于男性,口味偏油可增加MS患病率,常食水果、奶制品可降低MS患病率。中医证候要素研究显示,MS与气虚、阴虚、火、痰湿相关性较高,病位以脾、肝、肾、心为主,常见证型为气虚型、阴虚火旺型和痰湿型。结论 MS的发病或与年龄、性别、饮食特点有关,防治MS应益气化痰、健脾除湿,并重视从肝论治,应舒畅情志,清淡饮食,适当增加水果和奶制品摄入。
Objective To analyze characteristics of TCM syndrome elements of metabolic syndrome(MS) in residents aged 40–90 at Fengtai District in Beijing. Methods The data came from a multi-center, large-scale cross-sectional study of 10920 residents aged 40–90 at Fengtai District in Beijing in 2012–2015. The basic population information, medical history, TCM four-diagnostic information and related inspection results were collected.Demographic characteristics and four-diagnostic information of MS patients were analyzed, and factor analysis was used to extract TCM syndrome elements of MS patients. Results Totally 10920 people were screened, and 6046 patients met MS diagnosis, with the detection rate of 55.4%. The morbidity of MS was high in residents aged 60–80.The morbidity of MS in women >50 years old was higher than that in men. The preference of oil could increase the morbidity of MS. Regular consumption of fruit, dairy products could reduce the morbidity of MS. The study of TCM syndrome elements showed that MS had a high correlation with qi deficiency, yin deficiency, fire and phlegm. The disease positions were mainly spleen, liver, kidney and heart. The common syndromes were qi deficiency type, yin deficiency fire hyperactvity type and phlegm dampness type. Conclusion The morbidity of MS may be related to age,gender and dietary characteristics. The prevention and treatment of MS should not only improve qi and phlegm,strengthen spleen and dehumidification, but also pay more attention to treating MS from liver. Patients should keep balance and peace in psychology, eat a light diet, and increase the intake of fruits and dairy products.
Objective To analyze characteristics of TCM syndrome elements of metabolic syndrome(MS) in residents aged 40–90 at Fengtai District in Beijing. Methods The data came from a multi-center, large-scale cross-sectional study of 10920 residents aged 40–90 at Fengtai District in Beijing in 2012–2015. The basic population information, medical history, TCM four-diagnostic information and related inspection results were collected.Demographic characteristics and four-diagnostic information of MS patients were analyzed, and factor analysis was used to extract TCM syndrome elements of MS patients. Results Totally 10920 people were screened, and 6046 patients met MS diagnosis, with the detection rate of 55.4%. The morbidity of MS was high in residents aged 60–80.The morbidity of MS in women >50 years old was higher than that in men. The preference of oil could increase the morbidity of MS. Regular consumption of fruit, dairy products could reduce the morbidity of MS. The study of TCM syndrome elements showed that MS had a high correlation with qi deficiency, yin deficiency, fire and phlegm. The disease positions were mainly spleen, liver, kidney and heart. The common syndromes were qi deficiency type, yin deficiency fire hyperactvity type and phlegm dampness type. Conclusion The morbidity of MS may be related to age,gender and dietary characteristics. The prevention and treatment of MS should not only improve qi and phlegm,strengthen spleen and dehumidification, but also pay more attention to treating MS from liver. Patients should keep balance and peace in psychology, eat a light diet, and increase the intake of fruits and dairy products.
引文
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[17]龚勇珍,孙少卫,廖端芳.细胞炎症反应与脂质代谢的相互作用及调节[J].中国动脉硬化杂志,2017,25(6):623-629.
[18]陈全福,杨荣源,叶焕文.从肝主疏泄论治代谢综合征[J].新中医,2016,48(8):289-291.
[2]田雨,麦劲壮,李莹,等.代谢综合征与心脑血管病关系的前瞻性研究[J].中国预防医学杂志,2013,14(4):241-245.
[3]GRUNDY S M,CLEEMAN J I,DANIELS S R,et al.Diagnosis and management of the metabolic syndrome:an American Heart Association/National Heart,Lung,and Blood institute scientific statement[J].Circulation,2005,112(17):2735-2752.
[4]赵海,王岩.520名社区居民脑卒中筛查情况分析[J].中国医药导刊,2011,13(9):1623.
[5]杜万良,孙海欣,贾茜,等.美国心脏协会/美国卒中协会卒中一级预防指南(第一部分)[J].中国卒中杂志,2011,6(8):659-664.
[6]杜万良,孙海欣,贾茜,等.美国心脏协会/美国卒中协会卒中一级预防指南(第二部分)[J].中国卒中杂志,2011,6(9):727-755.
[7]杜万良,孙海欣,贾茜,等.美国心脏协会/美国卒中协会卒中一级预防指南(第三部分)[J].中国卒中杂志,2011,6(10):809-831.
[8]中华中医药学会中医诊断学分会.中医常见证诊断标准(上)[J].湖南中医药大学学报,2008,28(5):3-8,20.
[9]中华中医药学会中医诊断学分会.中医常见证诊断标准(下)[J].湖南中医药大学学报,2008,28(6):3-10.
[10]国家中医药管理局脑病急症科研组.中风病辨证诊断标准(试行)[J].北京中医药大学学报,1994,17(3):64-66.
[11]王陇德.脑卒中筛查与防治工程:关注动脉硬化的高危因素--探求尽快降低我国脑卒中发病、死亡和伤残之策[J].中国医学前沿杂志(电子版),2011,3(3):1-3.
[12]季绍良,成肇智.中医诊断学[M].北京:人民卫生出版社,2002:99-163.
[13]吴勉华,王新月.中医内科学[M].北京:中国中医药出版社,2012:9-52.
[14]孙树凯,翟玉娥,赵鹏,等.雌激素受体基因多态性与绝经后女性代谢综合征的相关性研究[J].中国实验诊断学,2014,18(10):1652-1657.
[15]侯瑞芳,陶枫,陆灏,等.肥胖的中医治疗进展[J].中华中医药学刊,2015,33(8):1959-1962.
[16]王椿野,郭蓉娟.肝郁化火证的研究进展[J].环球中医药,2012,5(2):138-142.
[17]龚勇珍,孙少卫,廖端芳.细胞炎症反应与脂质代谢的相互作用及调节[J].中国动脉硬化杂志,2017,25(6):623-629.
[18]陈全福,杨荣源,叶焕文.从肝主疏泄论治代谢综合征[J].新中医,2016,48(8):289-291.
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