不同中医证候血脂异常患者凝血功能差异研究

Study on the Differences of Blood Coagulation Function in Patients with Dyslipidemia in Different TCM Syndromes

目的:本研究观察60例不同中医证型血脂异常患者的凝血酶原时间(PT)、凝血酶原国际标准化比值(INR),比较其凝血功能的差异,评估血栓风险的不同,为中医辨证用药提供一定的临床思路。方法:根据2007年中国成人血脂异常防治指南及根据《中药新药临床研究指导原则(试行)》中的血脂异常证候诊断标准制作诊断量表,收集临床病例,判定中医证型,对符合证候的患者入院后第1天早晨空腹,取外周静脉血,血生化检测,记录血凝结果,采用ANOVA单因素方差分析。结果:凝血酶原时间(PT)的结果比较,阴虚阳亢证>脾肾阳虚证>肝肾阴虚证>痰浊阻遏证>气滞血瘀证,凝血酶原国际标准化比值(INR):阴虚阳亢证>脾肾阳虚证>痰浊阻遏证>肝肾阴虚证>气滞血瘀证。结论:气滞血瘀、痰浊阻遏患者的血脂异常患者血液处于高凝状态,具有更高的血栓风险,在临床中治疗血脂异常时注意活血化瘀、化痰去浊。

Objective ： In this study, observation of dyslipidemia in 60 cases of patients with different TCM syndrome type of prothrombin time （ PT ）, prothrombin international normalized ratio （ INR ）, compares the differences between the coagulation function to assess risk of blood clots and TCM drugs provide some clinical thinking. Methods： According to the 2007 China adult lipid prevention and treatment of the abnormal guide and according to the new drug of traditional Chinese medicine clinical research guiding principle （ for trial implementation ） in lipid exception syndrome diagnostic criteria of diagnostic scale, collected clinical cases, determine the TCM syndromes, to conform to the syndrome of the patients admitted to the first day after fasting in the morning, take in peripheral venous blood and blood biochemical; record the results of the blood coagulation; ANOVA single factor variance analysis. Results ： The results of prothrombin time （ PT ） compared syndrome of hyperactivity of Yang due to Yin deficiency〉syndrome of Yang deficiency of spleen and kidney〉syndrome of Yin deficiency of liver and kidney〉phlegm turbidity obstructing〉Qi stagnation and blood stasis syndrome, prothrombin international normalized ratio （ INR ）： syndrome of hyperactivity of Yang due to Yin deficiency〉syndrome of Yang deficiency of spleen and kidney〉phlegm turbidity obstructing〉syndrome of Yin deficiency of liver and kidney〉Qi stagnation and blood stasis type. Conclusion： Qi stagnation and blood stasis, phlegm turbidity obstructing dyslipidemia patients with abnormal blood in hypercoagulable state, with a higher risk of blood clots, in the clinical treatment of dyslipidemia attention to promoting blood circulation to remove blood stasis, phlegm turbidity.