血脂异常患者证素季节分布的相关性研究
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摘要
目的分析血脂异常患者中医证素与季节变化的相关性。方法根据《证素辨证学》中证候辨证常见证量表制作四诊信息诊断量表,于1年时间内收集符合血脂异常诊断标准的临床病例528例,以24节气立春、立夏、立秋、立冬为节点,按收取病例时间分为春、夏、秋、冬四组,判定中医证素,分析血脂异常患者中医证素与季节变化的关系。结果研究中共出现病位证素19个,常见病位证素为肝、肾、脾、心。共出现病位证素22个,常见实证病性证素为湿、气滞、阳亢、血瘀;常见虚症病性证素主要为阴虚、气虚、血虚、阳虚、精亏。病位证素为脾、肝、胃、表、肌肤、经络、心神,病性证素为风、寒、燥、水停、气虚、阳虚、阳浮、阴虚、津液亏、精亏、动风在不同季节发生率有差异,且差异具有统计学意义(P<0.05)。病位证素肝、肾、肌肤、筋骨,病性证素气滞、气虚、血虚、阳虚、阴虚的证素贡献度分值在四季分布不全相同,差异具有统计学意义(P<0.05)。结论血脂异常患者中医病位证素脾、肝、胃、表、肌肤、经络、心神,病性证素风、寒、燥、水停、气虚、阳虚、阳浮、阴虚、津液亏、精亏、动风在不同季节发生率不同。病位证素肝、肾、肌肤、筋骨,病性证素气滞、气虚、血虚、阳虚、阴虚的证素发展程度有季节差异。
Objective To analyze the correlation between TCM syndrome elements and seasonal changes in patients with dyslipidemia. Methods Based on the common syndrome scale in the Syndrome Elements and Syndrome Differentiation, the diagnostic scale of four diagnostic information was made. A total of 528 clinical cases which met the dyslipidemia diagnostic standard were collected within 1-year time. Taking the beginnings of spring, summer, autumn and winter in the 24 solar terms as nodes, the cases were divided into 4 groups: spring, summer, autumn and winter, according to the admission time. The TCM syndrome elements were determined and their relationship with seasonal changes in patients with dyslipidemia was analyzed. Results There were 19 syndrome elements of disease location in total, and the common ones were liver, kidney, spleen and heart. There were 22 syndrome elements of disease nature in total, and the common ones in excess syndrome were dampness, qi stagnation, yang hyperactivity and blood stasis. The common ones in deficient syndrome were yin deficiency, qi deficiency, blood deficiency, yang deficiency and. The incidences of syndrome elements of disease location like spleen, liver, stomach, exterior, skin, meridians and heart spirit as well as syndrome elements of disease nature like wind, cold, dryness, water retention, qi deficiency, yang deficiency, yang floating, yin deficiency, fluid deficiency, essence deficiency and stirring wind were different in different seasons, and the differences were statistically significant(P<0.05). The distributions of the contribution scores in syndrome elements of disease location like liver, kidney, skin, sinews and bones were different in the four seasons(P<0.05). Conclusion In the patients with dyslipidemia, the incidences of TCM syndrome elements are different in different seasons, such as the syndrome elements of disease location like spleen, liver, stomach, exterior, skin, meridians and heart spirit, as well as the syndrome elements of disease nature like wind, cold, dryness, water retention, qi deficiency, yang deficiency, yang floating, yin deficiency, fluid deficiency, essence deficiency and stirring wind. There are seasonal differences in the development degree of syndrome elements, such as the syndrome elements of disease location like liver, kidney, skin, sinews and bones, as well as the syndrome elements of disease nature like qi stagnation, qi deficiency, blood deficiency, yang deficiency and yin deficiency.
Objective To analyze the correlation between TCM syndrome elements and seasonal changes in patients with dyslipidemia. Methods Based on the common syndrome scale in the Syndrome Elements and Syndrome Differentiation, the diagnostic scale of four diagnostic information was made. A total of 528 clinical cases which met the dyslipidemia diagnostic standard were collected within 1-year time. Taking the beginnings of spring, summer, autumn and winter in the 24 solar terms as nodes, the cases were divided into 4 groups: spring, summer, autumn and winter, according to the admission time. The TCM syndrome elements were determined and their relationship with seasonal changes in patients with dyslipidemia was analyzed. Results There were 19 syndrome elements of disease location in total, and the common ones were liver, kidney, spleen and heart. There were 22 syndrome elements of disease nature in total, and the common ones in excess syndrome were dampness, qi stagnation, yang hyperactivity and blood stasis. The common ones in deficient syndrome were yin deficiency, qi deficiency, blood deficiency, yang deficiency and. The incidences of syndrome elements of disease location like spleen, liver, stomach, exterior, skin, meridians and heart spirit as well as syndrome elements of disease nature like wind, cold, dryness, water retention, qi deficiency, yang deficiency, yang floating, yin deficiency, fluid deficiency, essence deficiency and stirring wind were different in different seasons, and the differences were statistically significant(P<0.05). The distributions of the contribution scores in syndrome elements of disease location like liver, kidney, skin, sinews and bones were different in the four seasons(P<0.05). Conclusion In the patients with dyslipidemia, the incidences of TCM syndrome elements are different in different seasons, such as the syndrome elements of disease location like spleen, liver, stomach, exterior, skin, meridians and heart spirit, as well as the syndrome elements of disease nature like wind, cold, dryness, water retention, qi deficiency, yang deficiency, yang floating, yin deficiency, fluid deficiency, essence deficiency and stirring wind. There are seasonal differences in the development degree of syndrome elements, such as the syndrome elements of disease location like liver, kidney, skin, sinews and bones, as well as the syndrome elements of disease nature like qi stagnation, qi deficiency, blood deficiency, yang deficiency and yin deficiency.
引文
[1] 中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中华心血管病杂志,2016,44(10):833-853.
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[4] 王臬,陈平,洪钰芳,等.中医治疗高脂血症研究进展[J].实用中医药杂志,2019,35(2):247-249.
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[6] 杨莹骊,王亚红,王斌.郭维琴教授从脾胃论治高脂血症临床经验[J].现代中医临床,2016,23(5):1-4.
[7] 原萌谦,刘志诚,徐斌.1584例不同性别肥胖并发高脂血症患者证候证素特点的临床研究[J].时珍国医国药,2016,27(9):2178-2180.
[2] 朱文锋.证素辨证学[M].北京:人民卫生出版社,2008.
[3] 邢峰丽,封若雨,封小强,等.浅议高脂血症的中医辨证分型[J].环球中医药,2016,9(9):1073-1074.
[4] 王臬,陈平,洪钰芳,等.中医治疗高脂血症研究进展[J].实用中医药杂志,2019,35(2):247-249.
[5] 王新陆.论“血浊”与“治未病”[J].天津中医药,2008,25(3):177-180.
[6] 杨莹骊,王亚红,王斌.郭维琴教授从脾胃论治高脂血症临床经验[J].现代中医临床,2016,23(5):1-4.
[7] 原萌谦,刘志诚,徐斌.1584例不同性别肥胖并发高脂血症患者证候证素特点的临床研究[J].时珍国医国药,2016,27(9):2178-2180.