代谢综合征痰瘀互结型与胰岛素、C-反应蛋白、肿瘤坏死因子等关系研究

Study on relationship between levels of serum insulin,C reactive protein (CRP),Tumor Necrosis Factor (TNF-α) and phlegm-stagnation stasis syndrome of metabolic syndrome

目的:研究代谢综合征(MS)痰瘀互结证与胰岛素、C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、胰岛素抵抗指数(HOMA-IR)、血脂等指标之间的关系,以探讨痰瘀互结证在代谢综合征辨证施治中的重要性,为中医辨证代谢综合征寻找客观依据。方法:共收集代谢综合征患者54例,根据辨证分为痰瘀互结型(25例)和非痰瘀互结型(29例)两组,测定两组患者的胰岛素、CRP、TNF-α、血脂等,分析上述指标与MS痰瘀互结辨证之间的关系。结果:两组血清胰岛素、CRP、TNF-α均高于对照组,差异有统计学意义(P<0.05或P<0.01)。代谢综合征患者两组比较,痰瘀互结组的空腹胰岛素(FIns)、CRP、HOMA-IR均高于非痰瘀互结型,差异有统计学意义(P<0.05或P<0.01)。结论:代谢综合征痰瘀互结证与FIns、HOMA-IR、CRP、TNF-α、TG之间有直接相关关系。

Objective： To study the relationship between the levels of serum insulin, C-reactive protein （CRP）, Tumor Necrosis Factor （TNF- α ）, insulin resistance index, blood fat, and phlegm-stagnation stasis syndrome of metabolic syndrome（MS）, so as to discuss the significance of phlegm-stagnation stasis syndrome in treatment based on syndrome differentiation of MS, in order to find the objective evidence of differentiation of symptoms and signs of TCM of MS. Methods： In this study, 54 cases with MS were divided into groups of phlegm-stagnation stasis syndrome and non- phlegm-stagnation stasis syndrome according to the clinical symptoms, tongue demonstration and pulse tracings. There were 25 cases in phlegm-stagnation stasis group, 29 cases in non- phlegm-stagnation stasis group. The levels of serum insulin, CRP, TNF- α, blood fat were checked, the insulin resistance index was calculated. Results： The levels of serum insulin, CRP, TNF- α of the two groups of metabolic syndrome were significantly higher than those of the healthy persons （ P〈0.05 or P〈0.01 ） . The levels of fasting insulin , CRP, insulin resistance index, systolic blood pressure of the phlegm-stagnation stasis group are significantly higher than that of the nonphlegm-stagnation stasis group （ P〈0.05 or P〈0.01 ） . Conclusion ： This study found that there were high levels of serum insulin, CRP, TNF- α in the patients with MS. Phlegm-stagnation stasis syndrome was significant in the differentiation of symptoms and signs of TCM in MS. There was direct relationship between phlegm-stagnation stasis syndrome in MS and fasting insulin, insulin resistance index, CRP, TNF- α, TG.