胆石症中医证型与糖脂代谢及血钙水平的相关性研究

Cholelithiasis Syndromes and Glucose Metabolism,Lipid Metabolism,Blood Calcium Level of Correlation

目的:研究胆石症(Cholelithiasis)患者中医不同证型与糖脂代谢以及血钙水平之间的相关性。方法:选择胆石症患者128例,其中中医辨证属肝胆湿热证54例,肝郁气滞证30例,瘀血阻滞证28例,胆腑郁热证16例。所有受试者均行肝胆B超、血钙、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LD-LC)、高密度脂蛋白(HDLC)、载脂蛋白A1(Apo-A1)、载脂蛋白B(Apo-B)、空腹血糖(FBS)等检查。结果:①胆石症患者的中医辨证分型中以肝胆湿热证为主,其次为肝郁气滞证、肝阴不足证,瘀血阻滞证最少;②胆石症糖脂代谢异常以肝胆湿热证最为明显;③胆石症四种中医证型血钙水平相互比较无明显差异(P>0.05)。结论:胆石症患者中医证型中以肝胆湿热证多见,湿热证患者糖脂代谢异常现象明显,湿热证与糖脂代谢/血钙等理化指标可作为胆石症易发因素的客观指标;糖脂代谢参与胆石症形成的病理生理过程,其水平可作为胆石症中医辨证分型辅助客观指标。

Objective：Cholelithiasis in patients with different syndromes of traditional Chinese medicine and lipid metabolism and the correlation between the serum calcium level.Methods：To choose the 128 patients with cholelithiasis,in which TCM is a liver and gallbladder damp-heat syndrome in 54 cases,30 cases of qi stagnation,blood stasis evidence in 28 cases,biliary organs Yu heat of 16 cases.All subjects underwent B-bile,calcium,cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDLC）,high density lipoprotein（HDLC）,apolipoprotein A1（Apo-A1）,apolipoprotein B（Apo-B）,fasting blood glucose（FBS） and other tests.Results：Cholelithiasis in patients with syndrome differentiation type in the liver and gallbladder damp-heat syndrome,followed by the qi stagnation,liver and lack of evidence,blood stasis card minimum;Cholelithiasis,abnormal glucose and lipid metabolism in the liver and gallbladder damp-heat syndrome is most evident;Cholelithiasis four kinds of syndromes between serum calcium level was no significant difference（P0.05）.Conclusion：Syndromes in gallstone patients with liver and gallbladder damp-heat syndrome more common,damp abnormal glucose and lipid metabolism in patients with clear damp-heat syndrome and lipid metabolism / calcium and other physical and chemical indicators as a gallstone-prone elements of the objective indicators;glucose and lipid metabolism involved in the pathophysiology of gallstone formation,the level can be used as cholelithiasis TCM syndrome secondary objective indicators.