冠心病稳定型心绞痛痰瘀互结证中医证候量表与生化指标相关性
|
摘要
目的:对严格筛选冠心病稳定型心绞痛痰瘀互结证患者的中医证候量表和生化指标进行分析,探究中医证候与临床生化指标之间的相关性。方法:本试验采用了多中心、小样本、精细化的研究方法收集38例冠心病稳定型心绞痛痰瘀互结证患者,对患者0、8、12周中医证候以及各时点的生化指标进行相关性分析。结果:①冠心病痰瘀互结证因子分析结果:第0周主成分一以脂代谢相关指标为主,主成分二、三、四以炎性因子为主,主成分五以凝血功能为主,主成分六到十以临床症状和部分炎性因子为主。经过治疗后,第8周及第12周中医证候逐渐以血瘀和炎性因子为主,痰浊症状及脂代谢相关指标逐渐减少。②冠心病痰瘀互结证聚类结果:第0周聚为10类,其中第一、二类以炎性因子为主,第三、四类以脂代谢相关为主,第五类以凝血功能为主,第六至十类以中医证候为主。结论:冠心病痰瘀互结证主要症状以舌质紫暗、舌下络脉青紫、舌有瘀斑瘀点、身重和口黏腻为主,主要表现在炎性因子、血脂、凝血功能三方面,其中痰和瘀的相互作用可能与炎性因子的高表达有关。
Objective: To analyze the TCM Syndrome Scale and biochemical indexes of patients with stable angina pectoris and syndrome of intermin-gled phlegm and blood stasis, and to explore the correlation between TCM syndromes and clinical biochemical indexes. Methods: Thirty-eight patients with stable angina pectoris and syndrome of intermingled phlegm and blood stasis were collected by multi center, small sample and fine method. The correlation analysis was made on the TCM Syndromes of 0 th, 8 th and 12 th weeks and the biochemical indexes at each time point. Results: ①The result of the syndrome factor analysis of syndrome of intermin-gled phlegm and blood stasis of coronary heart disease:the main components of the main component were lipid metabolism related indexes in 0 th weeks, the main components were two or three and four with inflammatory factors, five of the main components were coagulant function, and the main components were six to ten with clinical symptoms and some inflammatory factors. After treatment, at 8 th and 12 th week, TCM syndrome gradually increased with blood stasis and inflammatory factors, and phlegm symptoms and lipid metabolism related indicators gradually decreased. ②Cluster results of phlegm and stasis syndrome of coronary heart disease: at 0 th week there were 10 types, of which first, second were mainly inflammatory factors, the third, fourth groups were mainly lipid metabolism, the fifth was mainly coagulation function, and sixth to ten were mainly TCM syndromes.Conclusion: The main syndrome of intermin-gled phlegm and blood stasis of coronary heart disease include three aspects of inflammatory factors, blood lipids and blood clotting function, including purple dark dark tongue, sublingual purplish, tongue ecchymosis, body weight and mouth sticky. The interaction of the phlegm and blood stasis is related to the highly expressed inflammatory factors.
Objective: To analyze the TCM Syndrome Scale and biochemical indexes of patients with stable angina pectoris and syndrome of intermin-gled phlegm and blood stasis, and to explore the correlation between TCM syndromes and clinical biochemical indexes. Methods: Thirty-eight patients with stable angina pectoris and syndrome of intermingled phlegm and blood stasis were collected by multi center, small sample and fine method. The correlation analysis was made on the TCM Syndromes of 0 th, 8 th and 12 th weeks and the biochemical indexes at each time point. Results: ①The result of the syndrome factor analysis of syndrome of intermin-gled phlegm and blood stasis of coronary heart disease:the main components of the main component were lipid metabolism related indexes in 0 th weeks, the main components were two or three and four with inflammatory factors, five of the main components were coagulant function, and the main components were six to ten with clinical symptoms and some inflammatory factors. After treatment, at 8 th and 12 th week, TCM syndrome gradually increased with blood stasis and inflammatory factors, and phlegm symptoms and lipid metabolism related indicators gradually decreased. ②Cluster results of phlegm and stasis syndrome of coronary heart disease: at 0 th week there were 10 types, of which first, second were mainly inflammatory factors, the third, fourth groups were mainly lipid metabolism, the fifth was mainly coagulation function, and sixth to ten were mainly TCM syndromes.Conclusion: The main syndrome of intermin-gled phlegm and blood stasis of coronary heart disease include three aspects of inflammatory factors, blood lipids and blood clotting function, including purple dark dark tongue, sublingual purplish, tongue ecchymosis, body weight and mouth sticky. The interaction of the phlegm and blood stasis is related to the highly expressed inflammatory factors.
引文
[1]毛静远,牛子长,张伯礼.近40年冠心病中医证候特征研究文献分析.中医杂志,2011,52(11):958-961
[2]Mack M,Gopal A.Epidemiology, traditional and novel risk factors in coronary artery disease.Cardiology Clinics,2014,32(3):323-332
[3]Go A S,Mozaffarian D,Roger V L,et al.Executive summary:Heart disease and stroke statistics-2014 update:A report from the American Heart Association.Circulation,2014,129:399-410
[4]Go A S,Mozaffarian D,Roger V L,et al.Heart disease and stroke statistics-2014 update:A report from the American Heart Association.Circulation,2014,129:e28-e292
[5]曹洪欣,张华敏.痰瘀互结与冠心病发病机理辨识.中华中医药学刊,2001,19(6):544-546
[6]徐一兰,高杉,许慧愚,等.冠心病稳定性心绞痛痰瘀互结证多中心、小样本、精细化临床研究方案.天津中医药,2018,35(2):86-90
[7]Brown G,Albers J J,Fisher L D,et al.Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B.New England Journal of Medicine,1990,323(19):1289-1298
[8]Toth P P,Barylski M,Nikolic D,et al.Should low high-density lipoprotein TCholesterol(HDL-C)be treated?.Best Practice&Research Clinical Endocrinology&Metabolism,2014,28(3):353-368
[9]张红栓,贾钰华,华何与,等.冠心病心绞痛痰浊证、血瘀证的血浆代谢组学研究.新中医,2010,42(6):12-14
[10]闻莉,刘松林,梅国强.高脂血症的中医临床证型分布及辨证规律研究.中国中医基础医学杂志,2008,14(3):220-221
[11]徐达,吴颢昕.从痰瘀互结论治冠心病的研究进展.中华中医药杂志,2018,33(6):2503-2506
[12]张继东,乔云,武传龙,等.冠心病患者胰岛素抵抗与中医辨证分型及纤溶系统活性的相关性研究.中国中西医结合杂志,2004,24(5):408-410
[13]张菀桐,褚瑜光,胡元会,等.冠心病血瘀证与凝血功能及血小板参数相关性分析.中医杂志,2015,56(16):1390-1393
[14]洪永敦,黄衍寿,吴辉,等.冠心病中医证候与炎症因子关系的临床研究.广州中医药大学学报,2005,22(2):81-86
[2]Mack M,Gopal A.Epidemiology, traditional and novel risk factors in coronary artery disease.Cardiology Clinics,2014,32(3):323-332
[3]Go A S,Mozaffarian D,Roger V L,et al.Executive summary:Heart disease and stroke statistics-2014 update:A report from the American Heart Association.Circulation,2014,129:399-410
[4]Go A S,Mozaffarian D,Roger V L,et al.Heart disease and stroke statistics-2014 update:A report from the American Heart Association.Circulation,2014,129:e28-e292
[5]曹洪欣,张华敏.痰瘀互结与冠心病发病机理辨识.中华中医药学刊,2001,19(6):544-546
[6]徐一兰,高杉,许慧愚,等.冠心病稳定性心绞痛痰瘀互结证多中心、小样本、精细化临床研究方案.天津中医药,2018,35(2):86-90
[7]Brown G,Albers J J,Fisher L D,et al.Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B.New England Journal of Medicine,1990,323(19):1289-1298
[8]Toth P P,Barylski M,Nikolic D,et al.Should low high-density lipoprotein TCholesterol(HDL-C)be treated?.Best Practice&Research Clinical Endocrinology&Metabolism,2014,28(3):353-368
[9]张红栓,贾钰华,华何与,等.冠心病心绞痛痰浊证、血瘀证的血浆代谢组学研究.新中医,2010,42(6):12-14
[10]闻莉,刘松林,梅国强.高脂血症的中医临床证型分布及辨证规律研究.中国中医基础医学杂志,2008,14(3):220-221
[11]徐达,吴颢昕.从痰瘀互结论治冠心病的研究进展.中华中医药杂志,2018,33(6):2503-2506
[12]张继东,乔云,武传龙,等.冠心病患者胰岛素抵抗与中医辨证分型及纤溶系统活性的相关性研究.中国中西医结合杂志,2004,24(5):408-410
[13]张菀桐,褚瑜光,胡元会,等.冠心病血瘀证与凝血功能及血小板参数相关性分析.中医杂志,2015,56(16):1390-1393
[14]洪永敦,黄衍寿,吴辉,等.冠心病中医证候与炎症因子关系的临床研究.广州中医药大学学报,2005,22(2):81-86