精神分裂症血脂异常患者中医体质类型及与血脂指标的相关性研究

Correlation Between Traditional Chinese Medicine Physical Constitution Types and Blood Lipid Indexes in Schizophrenic Patients with Dyslipidemia

【目的】了解精神分裂症血脂异常患者的中医体质分布,探讨中医体质与各血脂指标的相关性。【方法】选取100例住院治疗的符合精神分裂症血脂异常诊断的患者。根据《中医体质分类与判定》电子量表,确定体质类型,观察体质分布情况。测定血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、体质量指数(BMI)、腰臀比(WHR),比较不同体质患者的血脂水平、BMI及WHR,观察BMI与血脂指标的相关性。【结果】(1)中医体质分布方面,以偏颇体质为主(占91.0%),平和质较少(占9.0%)。而偏颇体质中,以气虚质所占比例最高(占26.0%),其他从高到低依次为痰湿质(占23.0%)、阳虚质(占12.0%)、气郁质(占10.0%)、血瘀质和湿热质(各占7.0%),最少为阴虚质(占6.0%)。(2)BMI和WHR方面,痰湿质患者的BMI、WHR明显高于其他体质类型的患者,差异有统计学意义(P<0.05)。(3)血脂水平方面,痰湿质和气虚质患者的TC、LDL-C水平明显高于其他体质类型的患者,差异有统计学意义(P<0.05);而各体质类型患者的TG、HDL-C、ApoA1、ApoB水平比较,差异均无统计学意义(P>0.05)。(4)BMI与血脂水平的关系方面,超重组和肥胖组的HDL-C、ApoA1水平均明显低于正常组,差异均有统计学意义(P<0.05);而3组间TC、TG、LDL-C、ApoB水平比较,差异均无统计学意义(P>0.05)。【结论】精神分裂症血脂异常患者以气虚质和痰湿质为主,且气虚质和痰湿质患者的TC、LDL-C水平明显高于其他体质类型的患者。

Objective To investigate the distribution of traditional Chinese medicine(TCM)physical constitution types in schizophrenic patients with dyslipidemia,and to study the correlation of TCM constitution types with the blood lipid indexes.Methods One hundred schizophrenic inpatients with dyslipidemia were selected and their constitution types were determined according to the electronic scale of Classification and Judgment of Constitution of Traditional Chinese Medicine.And then the characteristics of the distribution of constitution types were observed.The levels of blood lipid indicators such as total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),apolipoprotein A1(ApoA1),and apolipoprotein B(ApoB),body mass index(BMI),and waist-hip ratio(WHR)in schizophrenic patients with various constitution types were measured and compared,and then the correlation of BMI with the blood lipid indexes was evaluated.Results(1)Schizophrenic patients with dyslipidemia had high incidence of biased constitution types(91.0%),but had low incidence of balanced constitution(9.0%).Among the biased constitution types,qi deficiency constitution accounted for 26.0%,phlegm-damp constitution accounted for 23.0%,yang deficiency constitution accounted for 12.0%,qi stagnation constitution accounted for 10.0%,blood stasis constitution and damp-heat constitution accounted for 7.0%,and yin deficiency constitution accounted for 6.0%.(2)BMI and WHR in the schizophrenic patients with phlegm-damp constitution type were higher than those in the patients with other constitution types,and the difference was statistically significant(P<0.05).(3)In respect of the blood lipid levels,TC and LDL-C in the schizophrenic patients with phlegm-damp constitution and qi deficiency constitution were higher than those in the patients with other constitution types,and the difference was statistically significant(P<0.05).However,the differences of TG,HDL-C,ApoA1,and ApoB levels in various constitution types were insignificant(P>0.05).(4)For the correlation of BMI with blood lipid levels,the overweight and obese schizophrenic patients had lower HDL-C and ApoA1 levels than the normal group,and the differences were statistically significant(P<0.05).However,the differences of TC,TG,LDL-C,and ApoB levels among the overweight group,obese group,and normal group were not statistically significant(P>0.05).Conclusion The schizophrenic patients with dyslipidemia are dominated by qi deficiency constitution and phlegmdamp constitution,and the patients with qi deficiency constitution and phlegm-damp constitution have higher TC and LDL-C levels than the patients with other constitution types.