同型半胱氨酸与冠心病痰瘀证相关性研究

The Association between Homocysteine and Phlegm and Stasis Syndrome of Coronary Heart Disease:A Systematic Review and Meta-analysis

目的评价同型半胱氨酸(Homocysteine,Hcy)在冠心病痰瘀证中的分布规律,寻找冠心病痰瘀证的客观生化指标。方法检索CNKI、WANFANG、VIP、CBM、PubMed、Embase、Medline和Wed of Science等数据库。检索时间从建库至2021年02月26日。检索对象为研究Hcy与冠心病痰瘀证(包括单元证——痰浊痹阻证、心血瘀阻证;复合证——痰瘀互结证)关系的病例对照研究和横断面研究。结果冠心病痰瘀证(痰浊痹阻证、心血瘀阻证)血Hcy均高于非痰非瘀证(气阴两虚证、寒凝心脉证)(P<0.05);冠心病痰瘀证组间比较,Hcy在痰浊痹阻证与心血瘀阻证间的分布无明显统计学差异(P>0.05),而痰瘀互结证组Hcy则高于痰浊痹阻证、心血瘀阻证组(P<0.05)。结论(1)Hcy在冠心病痰瘀证中的分布较非痰非瘀证更多,高Hcy或许可以成为冠心病痰瘀证的客观生化指标;(2)痰瘀互结证组Hcy高于痰浊痹阻、心血瘀阻证组,说明随着单一证演变为复合证时,Hcy水平呈正相关上升,提示Hcy水平与冠心病痰瘀证的发生发展存在一定的相关性。

Objective To assess the distribution of homocysteine(Hcy)in phlegm and blood stasis syndrome of coronary heart disease(CHD)in order to provide reference for phlegm and blood stasis syndrome indexes of CHD.Methods CNKI,WANFANG,VIP,CBM,PubMed,Embase,Medline and Wed of Science were retrieval from the establishment of the database to 26th February,2021 with the key words of Hcy,phlegm and blood stasis syndrome of CHD(including phlegm syndrome,blood stasis syndrome and intermingled phlegm and blood stasis syndrome).Results The levels of Hcy in patients with phlegm and blood stasis syndrome(phlegm syndrome and blood stasis syndrome)were higher than those CHD patients with non-phlegm and non-blood stasis syndrome(Qi and yin deficiency and cold coagulation)(P<0.05);There was no significant difference between phlegm group and blood stasis group(P>0.05),but Hcy in intermingled phlegm and blood stasis syndrome group was higher than that in phlegm group and blood stasis syndrome group(P<0.05).Conclusion(1)The distribution of Hcy in phlegm and blood stasis syndrome is more than that in nonphlegm and non-blood stasis syndrome.(2)Hcy in the intermingled phlegm and blood stasis syndrome group was higher than that in the phlegm group and blood stasis syndrome group which suggests that Hcy of phlegm and blood stasis has an increasing trend when developing from single syndrome into complex syndrome.