代谢综合征常见中医证型与高敏C反应蛋白及颈动脉内中膜厚度的相关研究

Research on the Relationship between CRP, IMT and TCM Syndrome Types of MS

目的研究代谢综合征(MS)患者常见中医证型与高敏C反应蛋白(Hs-CRP)及颈动脉内中膜厚度(IMT)的关系,为其分型及防治提供依据。方法选择80例MS患者,中医辨证分为肝火亢盛型、痰湿壅盛型、气阴两虚型、阴阳两虚型、痰瘀互结型;另设正常对照组20例。入院当日测定空腹血糖(FPG)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、空腹血清Hs-CRP、血清胰岛素(FINS),计算胰岛素敏感指数(ISI),并测定身高、体重、腰围、血压,计算体重指数(BMI)。采用多普勒超声诊断仪扫查双侧颈总动脉、颈内动脉,测量血管内径及IMT。结果MS各证型患者Hs-CRP显著高于正常对照组(P<0.01),其程度依次为:气阴两虚>阴阳两虚>痰瘀互结>痰湿壅盛>肝火亢盛。MS患者颈动脉IMT显著高于正常对照组(P<0.05),其升高程度在中医各证型中依次为阴阳两虚>气阴两虚>痰瘀互结>痰湿壅盛>肝火亢盛。结论Hs-CRP、IMT水平可作为MS中医辨证分型的重要指标。

Objective To research the value of CRP and IMT in each TCM type of MS, and provide the basis for classification and treatment. Method Eighty cases of MS were divided into five Chinese medicine syndrome groups including liver fire exuberant syndrome, phlegm dampness abundant syndrome, deficiency syndrome of Qi and Yin, deficiency syndrome of Yin and Yang, phlegm accumulation and blood stasis syndrome. Twenty healthy people were taken as normal control group： FPG, TG, HDL-C, FINS, Hs-CRP were detected and ISI was calculated. Height, weight, waistline, blood pressure and BMI were measured. The inner diameter of the common carotidartery （CCA） and infima-media thickness （IMT） of the CCA were measured by Color Doppler ultrasonography. Result Hs-CRP in MS group was higher than the control group （P〈0.01）, the rate of Hs-CRP went up by liver fire exuberant syndrome 〈 phlegm dampness abundant syndrome 〈 phiegm accumulation and blood stasis syndrome 〈 deficiency syndrome of Yin and Yang 〈 deficiency syndrome of Qi and Yin. IMT in MS group was higher than the control group （P 〈 0.05）, the heightening level of IMT was deficiency syndrome of Yin and Yang 〉 deficiency syndrome of Qi and Yin 〉 phlegm accumulation and blood stasis syndrome 〉 phlegm dampness abundant syndrome 〉 liver fire exuberant syndrome. Conclusion Hs-CRP and IMT can be used as important indexes of TCM syndrome differentiation of MS.