原发性血脂异常患者情志证素分布规律及与血脂指标相关性研究

Correlation between emotional syndrome factors and blood lipid indexes in patients with primary dyslipidemia

目的探讨原发性血脂异常患者情志证素的分布特点及与血脂指标的相关性。方法收集120例原发性血脂异常患者的一般资料、证素相关四诊信息、血脂指标。采用"证素辨证法"理论对证素进行诊断分级,采用SPSS 17.0统计软件进行分析。结果120例原发性血脂异常患者肝证素的诊断率最高,占78%。病位证素肝、肾、脾明显高于其他。病性证素湿、气滞、气虚、阴虚明显高于其他。高密度脂蛋白(HDL-C)、血脂载脂蛋白(ApoA1)均与肾、阴虚证素呈负相关,且随着证素程度加重,HDL-C、ApoA1有减少的趋势。结论原发性血脂异常的中医病位病机主要责之肝,其次为肾、脾。病性特点为虚实夹杂,虚多为阴虚、气虚,实多为湿和气滞。而肝气郁滞、肝肾阴虚考虑是原发性血脂异常中与中医情志相关的主要病机。HDL-C、ApoA1降低,定位在肾,定性为阴虚的可能性大。

Objective To discuss distribution characteristics of emotional syndrome factors in the patients with primary dyslipidemia and the correlations between these factors and blood lipid indexes.MethodsThe general information,information of TCM four examinations related to syndrome factors and blood lipid indexes were collected from the patients（n=120）.The syndrome factors were determined and classified according to the theory of syndrome factors differentiation,and statistically analyzed by applying SPSS 17.0 software.ResultsLiver factor had the highest diagnostic rate（77.5%） in 120 patients.The occurrence frequencies of disease-location factors as liver,kidney and spleen were significantly higher than those of other disease-location factors.The occurrence frequencies of disease-nature factors as dampness,qi stagnation,qi deficiency and yin deficiency were significantly higher than those of other disease-nature factors.The levels of high density lipoprotein-cholesterol（HDL-C） and ApoA1 were negatively related to syndrome factors as kidney and yin deficiency,and the levels of HDL-C and ApoA1 had a descending trend with the aggravation of syndrome factors.ConclusionThe major TCM pathogenesis of disease locations of primary dyslipidemia is liver followed by kidney and spleen.The characteristic of disease nature is a mixture of deficiency and excess.The deficiency syndromes are mainly yin deficiency and qi deficiency,while the excess syndromes are mainly dampness and qi stagnation.Liver qi stagnation and liver-kidney yin deficiency are the main pathogenesis of primary dyslipidemia related to TCM emotional theory.The reductions of HDL-C and ApoA1 levels are most probably related to kidney（location） and yin deficiency（nature）.