冠心病血瘀证与痰浊证辨证客观化的研究

Clinical Study on the Differentiation of the Phlegm Syndrome and the Blood Statsis Syndrome in Coronary Heart Disease

目的观察冠心病(CHD)血瘀证与痰浊证患者血液中内皮素(ET)、一氧化氮(NO)、过氧化脂质(LPO)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、脂联素(ADPN)、瘦素(LPT)、游离脂肪酸(FFA)及血脂水平[TG(甘油三酯)、TC(总胆固醇)、LDL-C(低密度脂蛋白胆固醇)、HDL-C(高密度脂蛋白胆固醇)、apo-A(载脂蛋白A)、apo-B(载脂蛋白B)]的变化,探讨其在CHD血瘀证及痰浊证辨证分型中的作用。方法检测40例痰浊证CHD患者(T组),43例血瘀证CHD患者(X组)及20例健康志愿者(N组)血液中ET、NO、LPO、MDA、SOD、GSH-PX、ADPN、LPT、FFA及血脂(TG、TC、LDL-C、HDL-C、apo-A、apo-B)水平。结果 (1)X组及T组ET、LPO、MDA、FFA、TG、TC、LDL-C水平较N组显著增高,其中X组ET、LPO、MDA水平较T组增高明显,其余则为T组增高较明显。(2)X组及T组NO、SOD、GSH-PX、ADPN、LPT、HDL-C、apo-A/apo-B水平较N组显著降低,其中X组NO、SOD、GSH-PX水平较T组降低明显,其余为T组降低明显。结论 CHD血瘀证与痰浊证在ET、NO、LPO、MDA、SOD、GSH-PX、ADPN、LPT、FFA及血脂(TG、TC、LDL-C、HDL-C、apo-A/apo-B)变化方面有显著性差异,这些实验指标可以作为CHD痰浊证及血瘀证辨证分型的客观依据。

Objective： To observe the variation of blood level of endothelin（ET）,nitric oxide（NO）,malondi-aldehyde（MDA）,superoxide dismutase（SOD）,glutathione peroxidase（GSH-PX）,adiponectin（ADPN）,leptin（LPT）,free fatty acid（FFA） and blood lipids level（TG,TC,LDL-C,HDL-C,apo-A and apo-B） in coronary heart disease（CHD） patients between the blood stasis syndrome and the phlegm syndrome in Traditional Chinese Medicine（TCM） and to investigate the effect of the above factors in syndrome differentiation of CHD.Methods： 83 CHD patients were divided into T and X group.Meanwhile,20 healthy persons were the N group.The contents including ET,NO,MDA,SOD,GSH-PX,ADPN,LPT,FFA and blood-fat level（TG,TC,LDL-C,HDL-C,apo-A and apo-B） of above groups were observed and compared in 3 groups.Results：（1） Compared with N group,there were some remarkable increases in the X group and the T group such as ET,LPO,MDA,FFA,TG,TC,LDL-C.Compared with T group,there were some significant increases in the X group including ET,LPO and MDA.（2） Compared with N group,there were some obvious decreases in the X group and the T group including NO,SOD,GSH-PX,ADPN,LPT,HDL-C,apo-A and apo-B.Compared with T group,there were some remarkable reductions in the X group such as NO,SOD and GSH-PX.Conclusion： There are significant variations of blood levels including ET,NO,MDA,SOD,GSH-PX,ADPN,LPT,FFA and blood-fat level（TG,TC,LDL-C,HDL-C,apo-A and apo-B）,which could be used to be the objective criterion of the syndrome differentiation in CHD of TCM.