冠心病中医证型与血脂及冠脉造影所见的相关性分析

Correlation of TCM Syndrome with Blood Lipid and Coronary Angiographic Observation in Coronary Heart Disease

目的研究冠心病各中医证型与血脂及冠脉造影狭窄支数的相关性,为临床辨证分型提供客观化指标。方法采用流行病学方法调查150例患者,分别检测血脂水平和冠脉造影,应用SPSS13.0软件系统与同期的健康体检者20例(对照组)比较,分析中医证型与血脂和冠脉造影狭窄支数的关系。结果中医证型以心血瘀阻型和痰阻心脉型为主;与对照组相比,冠心病各证型患者的血脂TG、TC、LDL-C均升高,其中心血瘀阻型和痰阻心脉型TG、TC、LDL-C升高更明显(P<0.05);各证型间比较,气滞血瘀型以TC升高为主(P<0.05),阴寒凝滞型以LDL-C升高为主(P<0.05),心血瘀阻型以TC、LDL-C升高为主(P<0.05),痰阻心脉型以TG升高和HDL-C降低为主(P<0.05)。冠脉造影单支狭窄以阴寒凝滞型和气阴两虚型为主,双支狭窄以心血瘀阻型与痰阻心脉型为主,三支狭窄以阳气虚衰型为主。结论冠心病心血瘀阻型和痰阻心脉型脂质代谢紊乱更明显,冠脉造影以双支血管病变为主。

Objective To research the relation between traditional Chinese medicine（TCM） syndrome types and blood lipid and coronary angiography. Methods The lipid levels and coronary angiography were studied in 150 patients （pts）. The relationship be- tween TCM syndrome type and blood fat and coronary angiography were analyzed by SPSS13.0 software system. Results TCM syn- drome types were divided into stasis resistance type and sputum resistance. Compared with the control, triglycerides（TG）, total cho- lesterol（TC）, low- density lipoprotein- cholesterol （LDL- C） were increased in pts with coronary artery disease. TG, TC, LDL- C were increased significantly in pts with stasis resistance type and sputum resistance type（P〈0.05）. TC was increased significantly in stagnancy of qi and blood stasis type（P〈0.05）. LDL - C increased primarily in pts with yin cold stagnate type（P〈0.05）. TC and LDL - C increased in pts with painstaking effort stasis resistance type （P〈 0. 05）. TG increased and high- density lipoprotein cholesterol （HDL- C） reduced in pts with phlegm obstruction heart type（P〈0.05）. TCM syndrome of single coronary stenosis was yin cold stagnate type and deficiency type of qi and yin. That of double coronary stenosis was stasis resistance type and sputum resistance type. That of three branch stenosis was spirit virtual failure type. Conclusion TCM syndromes types of coronary heart disease were stasis resistance type and sputum resistance type with lipid metabolic disturbance.