160例代谢综合征患者中医证候特点研究

Study on characteristics of traditional Chinese medicine syndrome of 160 patients with metabolism syndrome

目的:应用证素辨证法探讨代谢综合征(MS)症状、证素分布特点及与血脂、身体质量指数(BMI)之间关系,为辨证客观化提供理论依据。方法:选择参加常规体检的160例代谢综合征患者。体检当日采集四诊信息,测量血压、身高,空腹状态下身体质量及腰围,测定空腹血糖(FPG)、胆固醇(TC)、血清甘油三酯(TG)、高密度脂蛋白(HDL-C),应用证素辨证法分析证素积分,症状分布特点及证素特点与性别、年龄、生化指标之间关系。结果:160例代谢综合征患者症状中频次出现较高的是形体肥胖、口渴、脘痞胀、渴欲饮热、倦怠乏力、四肢麻木、口苦、急躁易怒、失眠等症,舌质以舌淡最多见,舌苔以苔白、腻最多见,脉象以弦、细、滑脉最多见。证素分析发现痰积分最高,其次是气滞、肝、湿;40岁以上女性以肝、气滞、痰湿为主,40岁以上男性以脾、痰、热为主;40岁以下女性以脾、痰、气虚为主,40岁以下男性则以脾、痰、热为主。痰证素贯穿于MS全过程,与胆固醇(r=0.364,P=0.013)、LDL-C(r=0.374,P=0.001)、BMI(r=0.410,P=0.003)密切相关。结论:代谢综合征症候群组成多样,证素以痰为主,40岁以上女性多兼杂气滞、湿,男性多兼杂热;40岁以下女性多兼杂气虚,男性多兼杂热,代谢综合征痰证素与血脂异常及BMI有密切关系。

Objective： To disuse the distribution characteristics of symptoms and syndrome elements of metabolic syndrome by using method of syndrome elements differentiation, in order to provide a theoretical foundation for objectification of syndrome differentiation. Methods： 160 patients with metabolic syndrome were selected, and the four diagnostic methods information, blood pressure, stature, body weight and waist circumference in the fasting state, fasting blood-glucose （FPG）, cholesterol （TC）, serum triglyceride （TG） and high-density lipoprotein （HDL-C） were determined on the same day of physical examination, and analyzed the relationship between syndrome elements integral, characteristics of symptoms, syndrome elements and sex, age, biochemical indexes. Results： The high frequency symptoms of 160 patients with metabolic syndrome were obesity, thirst, abdominal fullness and distention, languid, bitter taste, irritable, insomnia and so on. The most common tongue quality was pale tongue, and the most common fur was white fur and greasy fur, while the most common pulse manifestations were stringy pulse, thready pulse and slippery pulse. The analysis of syndrome elements showed that the highest integral syndrome element was phlegm, and the next were qi stagnation, liver and dampness. The most common syndrome elements of women over 40 years old were liver, qi stagnation and phlegm-damp, and the common syndrome elements of men over 40 years old were spleen, phlegm and heat, while the most common syndrome elements of women under 40 years old were spleen, phlegm and qi deficiency, and the most common syndrome elements of men under 40 years old were spleen, phlegm and heat. The syndrome element which through the whole course of metabolic syndrome was phlegm, and there were close relationships between phlegm and cholesterol （r=-0.364, P=0.013）, low density lipoprotein （r=0.374, P=0.001） and body mass index （BMI） （r=-0.410, P=0.003）. Conclusion： The constitution of symptom complex of metabolic syndrome was various, and the most common syndrome element was phlegm. The accompanying symptoms of women over 40 years old were qi stagnation and damp, and the accompanying symptom of women over 40 years old was qi deficiency. The accompanying symptom of men was heat. There was close relationship between syndrome element of metabolic syndrome and blood fat and BMI.