冠心病稳定型心绞痛痰瘀互结证中医证候量表与生化指标相关性

Correlation between TCM Syndrome Scale and biochemical indexes in the syndrome of intermin-gled phlegm and blood stasis of coronary heart disease with stable angina pectoris

目的:对严格筛选冠心病稳定型心绞痛痰瘀互结证患者的中医证候量表和生化指标进行分析,探究中医证候与临床生化指标之间的相关性。方法:本试验采用了多中心、小样本、精细化的研究方法收集38例冠心病稳定型心绞痛痰瘀互结证患者,对患者0、8、12周中医证候以及各时点的生化指标进行相关性分析。结果:①冠心病痰瘀互结证因子分析结果:第0周主成分一以脂代谢相关指标为主,主成分二、三、四以炎性因子为主,主成分五以凝血功能为主,主成分六到十以临床症状和部分炎性因子为主。经过治疗后,第8周及第12周中医证候逐渐以血瘀和炎性因子为主,痰浊症状及脂代谢相关指标逐渐减少。②冠心病痰瘀互结证聚类结果:第0周聚为10类,其中第一、二类以炎性因子为主,第三、四类以脂代谢相关为主,第五类以凝血功能为主,第六至十类以中医证候为主。结论:冠心病痰瘀互结证主要症状以舌质紫暗、舌下络脉青紫、舌有瘀斑瘀点、身重和口黏腻为主,主要表现在炎性因子、血脂、凝血功能三方面,其中痰和瘀的相互作用可能与炎性因子的高表达有关。

Objective:To analyze the TCM Syndrome Scale and biochemical indexes of patients with stable angina pectoris and syndrome of intermin-gled phlegm and blood stasis,and to explore the correlation between TCM syndromes and clinical biochemical indexes.Methods:Thirty-eight patients with stable angina pectoris and syndrome of intermingled phlegm and blood stasis were collected by multi center,small sample and fine method.The correlation analysis was made on the TCM Syndromes of 0 th,8 th and 12 th weeks and the biochemical indexes at each time point.Results:①The result of the syndrome factor analysis of syndrome of intermin-gled phlegm and blood stasis of coronary heart disease:the main components of the main component were lipid metabolism related indexes in 0 th weeks,the main components were two or three and four with inflammatory factors,five of the main components were coagulant function,and the main components were six to ten with clinical symptoms and some inflammatory factors.After treatment,at 8 th and 12 th week,TCM syndrome gradually increased with blood stasis and inflammatory factors,and phlegm symptoms and lipid metabolism related indicators gradually decreased.②Cluster results of phlegm and stasis syndrome of coronary heart disease:at 0 th week there were 10 types,of which first,second were mainly inflammatory factors,the third,fourth groups were mainly lipid metabolism,the fifth was mainly coagulation function,and sixth to ten were mainly TCM syndromes.Conclusion:The main syndrome of intermin-gled phlegm and blood stasis of coronary heart disease include three aspects of inflammatory factors,blood lipids and blood clotting function,including purple dark dark tongue,sublingual purplish,tongue ecchymosis,body weight and mouth sticky.The interaction of the phlegm and blood stasis is related to the highly expressed inflammatory factors.