湖南地区中老年冠心病患者中医证型与血浆同型半胱氨酸及血脂水平关系的研究

Study of the Relationship Between Plasma Homocysteine and Lipid Levels with TCM Syndromes in Elderly Patients with Coronary Heart Disease in Hunan

目的通过分析湖南地区中老年冠心病(CHD)患者中医辨证分型与血浆同型半胱氨酸(Hcy)及血脂水平(TC、TG、HDL-C、LDL-C)的相关性,为冠心病辨证分型及临床研究提供参考。方法通过采集299例冠心病患者四诊信息,并按中医辨证论治主要分为心血瘀阻证、痰浊中阻证、气滞心胸证及气阴亏虚、痰热瘀阻证四组,并设置健康对照组300例,分别检测各组的血浆Hcy及血脂水平,统计分析各指标与冠心病中医证型之间的相关性。结果 CHD各证型组血浆Hcy水平整体高于健康对照组(P<0.05),且以气阴亏虚、痰热瘀阻证组为最高(P<0.05)。健康对照组的HDL-C水平高于各证型组(P<0.05)。结论湖南地区中老年冠心病患者中医辨证分型与血浆Hcy水平具有一定的相关性,以气阴亏虚、痰热瘀阻证血浆Hcy水平为最高,CHD各证型组HDL-C水平低于对照组,因此血浆Hcy水平在一定程度上可作为本地区冠心病中医分型临床诊断的重要参考指标。

Objective To provide a reference for traditional Chinese medicine（TCM） syndromes differentiation and clinical study by analyzing the correlation between plasma homocysteine（Hcy） and lipid levels（TC, TG, HDL-C, LDL-C） with TCM syndromes in elderly patients with Coronary Heart Disease（CHD） in Hunan. Methods 299 CHD patients were divided into four groups, stagnation of heart-blood syndrome, phlegm in the resistance syndrome, Qi stagnation in mind syndrome, QiYin deficiency, phlegm-heat stagnation syndrome according to TCM syndrome differentiation. 300 healthy people were collected as control group. Plasma homocysteine（Hcy） and lipid levels（TC,TG, HDL-C, LDL-C） were tested in all subjects to detect the correlation between the indicators in HCD. Results Plasma Hcy（P〈0.05） in case group was higher than that in control group in various CHD patients, in which the Qi-Yin Deficiency and phlegm-heat stagnation syndromes were the highest（P〈0.05）. HDL-C level in control group was higher than that in each disease group（P〈0.05）. Conclusion There is a correlation between syndromes differentiation and plasma Hcy levels in patients with CHD in Hunan. The Hcy level of Qi-Yin deficiency and phlegm stasis syndromes was the highest. HDL-C level in various CHD groups was lower than that in control group. Therefore, plasma Hcy level could be an important reference index in diagnosing the CHD differential syndromes of TCM.