冠心病心绞痛维医证型与血脂相关性及心脏B超指标的变化

The relationship between Uighur medicine syndromes of angina pectoris from CHD and blood lipid, and type-B ultrasonic indexes

目的:通过观察冠心病心绞痛患者血脂(胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、脂蛋白-a、脂蛋白-b)、心脏B超的相关指标,分析其与维医证型的相关性,探讨维医各证型的严重程度,合理干预,为冠心病维医辨证论治提供客观的依据。方法:临床收集符合冠心病心绞痛西医诊断标准的200例患者进行辨证分型,全部行上述指标的检测,经过统计学检验,分析各项指标与冠心病维医证型间的关系。结果:辨证分型结果为:异常血液质型49例,异常黏液质型55例,异常胆液质型47例,异常黑胆质型49例,以异常黏液质型为主。异常黑胆质组CHOL水平明显高于异常血液质组、异常胆液质组(P<0.05),而与异常黏液质组间不存在显著差异(P>0.05)。异常血液质组TG水平明显高于非异常血液质组(P<0.05)。异常血液质组HDLC水平明显低于异常黑胆质组和异常黏液质组(P<0.05)。异常血液质组、异常黑胆质组每分钟搏出量(SV)明显低于异常黏液质组(P<0.05),异常黑胆质组FS水平明显低于异常胆液质组(P<0.05)。结论:冠心病维医异常黑胆质型与CHOL的关系最密切,而异常血液质型与TG、HDLC的关系最密切,可作为反映冠心病异常黑胆质型、异常血液质型的客观依据。异常血液质型,异常黑胆质型患者要注意锻炼、避免感冒和重体力劳动、不抽烟、保持健康体重、预防心衰的发生。通过血脂与冠心病维医证型的相关性研究,为冠心痛维医病机和辨证论治的客观化研究找到新的线索。结果提示我们在冠心病的治疗过程中,不但要注意引起疾病异常体液的性质,同时要进行降血脂、稳斑等相应治疗。

Objective:To observe the relationship between serum lipids(cholesterol,triglyceride,high density lipoprotein,lowdensity lipoprotein,lipoprotein-a,lipoprotein-b)and heart ultrasonography in patients with angina pectoris from CHD.Methods:200patients were collected by dialectical classification.All the above indexes were detected.Results:The results of dialecticalclassification were abnormal hematological type in49cases,abnormal mucus type in55cases,abnormal bile duct type in47cases,abnormal black bile type in49cases,with abnormal mucinous type.The level of CHOL in the abnormal black bile groupwas significantly higher than that in the abnormal hematological group and the abnormal bile duct group(P<0.05);but there wasno significant difference between the abnormal black bile group and the abnormal mucus group(P>0.05).The level of TG in the abnormal hematological group was significantly higher than that in non-abnormal hematological group(P<0.05).The level of HDLCin the abnormal hematological group was significantly lower than that in the abnormal black bile group and abnormal mucus group(P<0.05).The level of SV in the abnormal hematological group and the abnormal black bile group was significantly lower than thatin abnormal mucus group(P<0.05).The level of FS in abnormal black bile group was significantly lower than that in the abnormalmucus group(P<0.05).Conclusion:CHD showed very close relationship with the pathogenesis of CHOL,and abnormal bloodquality and TG,HDLC were most closely related,can be used to reflect abnormal coronary heart disease,abnormal blood quality.Abnormal blood quality,abnormal black bile type patients should pay attention to exercise,to avoid colds,heavy physical labor,donot smoke,to maintain a healthy weight,and prevent from the occurrence of heart failure.