不同中医证型冠心病心绞痛患者脂代谢、凝血功能及冠状动脉病变分析

Analysis ofIipid Metabolism,Coagulation Function and Coronary Artery Lesions in Patients with Angina Pectoris of Coronary Heart Disease of Different TCM Syndrome Types

目的:探究冠心病心绞痛患者脂代谢、凝血功能及冠状动脉病变与中医证型的关系。方法:以2020年1月~2022年5月77例冠心病心绞痛患者为研究对象,根据中医证型的不同将其分为心血瘀阻证、寒凝心脉证、痰浊内阻证、心气虚弱证、心肾阴虚证、心肾阳虚证。比较不同中医证型冠心病心绞痛患者心功能指标、脂代谢指标、凝血功能及冠状动脉病变程度。结果:77例冠心病心绞痛患者中存在心血瘀阻证23例、寒凝心脉证4例、痰浊内阻证18例、心气虚弱证13例、心肾阴虚证2例、心肾阳虚证17例。心血瘀阻证、痰浊内阻证、心气虚弱证及心肾阳虚证患者心功能指标及高密度脂蛋白(HDL)、载脂蛋白A(ApoA)水平水平对比无明显差异(P>0.05);痰浊内阻证患者的胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白(LDL)水平均高于其他三种证型患者(P<0.05);四组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及凝血酶时间(TT)对比无明显差异(P>0.05);心血瘀阻证患者的纤维蛋白(FIB)水平高于其他三种证型患者(P<0.05);四种证型患者的冠状动脉狭窄程度及病变血管支数对比无明显差异(P>0.05)。结论:冠心病心绞痛患者脂代谢、凝血功能与中医证型有关,痰浊内阻证患者的血脂水平较高,心血瘀阻证患者的凝血功能较差。

Objective:To explore the relationship of lipid metabolism,coagulation function and coronary artery lesions with TCM syndrome types in patients with angina pectoris of coronary heart disease.Methods:77 patients with angina pectoris of coronary heart disease from January 2020 to May 2022 were selected as the research subjects.According to the different TCM syndrome types,the patients were divided into heart blood stasis syndrome,cold congealing the heart vessels syndrome,phlegm turbidity internal blockage syndrome,heart qi weakness syndrome,heart-kidney yin deficiency syndrome and heart-kidney yang deficiency syndrome.Cardiac function indicators,lipid metabolism indicators,coagulation function and severity of coronary artery lesions were compared among patients with angina pectoris of coronary heart disease of different TCM syndrome types.Results:Among the 77 patients with angina pectoris of coronary heart disease,there were 23 cases of heart blood stasis syndrome,4 cases of cold congealing the heart vessels syndrome,18 cases of phlegm turbidity internal blockage syndrome,13 cases of heart qi deficiency syndrome,2 cases of heart-kidney yin deficiency syndrome,and 17 cases of heart-kidney yang deficiency syndrome.There were no significant differences in cardiac function indicators and high-density lipoprotein(HDL)and apolipoprotein A(ApoA)among patients with heart blood stasis syndrome,phlegm turbidity internal blockage syndrome,heart qi deficiency syndrome and heart-kidney yang deficiency syndrome(P>0.05).The levels of total cholesterol(TC),triglyceride(TG)and lowdensity lipoprotein(LDL)in patients with phlegm turbidity internal blockage syndrome were higher than those in patients with other three syndromes(P<0.05).There were no significant differences in prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)among the four groups(P>0.05).The level of fibrinogen(FIB)in patients with heart blood stasis syndrome was higher than that in patients with the other three syndromes(P<0.05).The differences in the degree of coronary artery stenosis and the number of diseased vessels among the four syndrome types(P>0.05).Conclusion:Lipid metabolism and coagulation function in patients with angina pectoris of coronary heart disease are related to TCM syndrome types.The blood lipids levels of patients with phlegm turbidity internal blockage syndrome are higher,and the coagulation function of patients with heart blood stasis syndrome is poor.