急性冠脉综合征患者中医证型分布及与血清Hcy、HDL-C、TC的关系分析

Distribution of TCM Syndrome Types in Patients with Acute Coronary Syndrome and Its Relationship with Serum Hcy,HDL-C and TC

目的探究急性冠脉综合征(ACS)患者中医证型分布及与血清同型半胱氨酸(Hcy)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)的关系分析。方法以120例ACS患者为研究对象(实证组60例与虚证组60例),分析ACS患者中医证型分布情况。比较实证组及虚证组患者的血清Hcy、HDL-C、TC水平,并分析实证组、虚证组中不同证型患者的血清Hcy、HDL-C、TC水平。结果根据中医证型的不同将ACS患者分为实证组[寒凝血瘀(n=12)、痰结血瘀(n=27)、热毒瘀滞(n=21)]、虚证组[气虚血瘀(n=23)、阴虚血瘀(n=26)、心阳欲脱(n=11)]。实证组中男性比例高于虚证组(P<0.05),实证组及虚证组的年龄、冠心病病程比较,差异无统计学意义(P>0.05);虚证组的血清Hcy、LDL-C、TC、三酰甘油(TAG)水平低于实证组,HDL-C水平高于实证组(P<0.05);实证组中寒凝血瘀证患者的Hcy、LDL-C水平低于痰结血瘀证、热毒瘀滞证患者,HDL-C高于痰结血瘀证患者(P<0.05);痰结血瘀证患者的Hcy、LDL-C、TC、TAG水平高于热毒瘀滞证患者,HDL-C水平低于热毒瘀滞证患者(P<0.05);虚证组中气虚血瘀证患者的Hcy、LDL-C、TC水平高于阴虚血瘀证、心阳欲脱证患者,HDL-C水平低于阴虚血瘀证、心阳欲脱证患者(P<0.05)。结论相比于ACS虚证患者,实证患者的血清Hcy及血脂水平较高,6种中医证型患者中痰结血瘀证患者的血清Hcy及血脂水平最高。

Objective:To explore the distribution of TCM syndrome types in patients with acute coronary syndrome(ACS)and its relationship with serum homocysteine(Hey),high-density lipoprotein cholesterol(HDL-C)and total cholesterol(TC).Methods:A total of 120 patients with ACS were selected as the research subjects(including 60 cases in excess syndrome group and 60 cases in deficiency syndrome group),and the distribution status of TCM syndrome types in patients with ACS were analyzed.The levels of serum Hey,HDL-C and TC of patients in excess syndrome group and deficiency syndrome group were compared,and serum Hey,HDL-C and TC levels were analyzed among patients with different syndrome types in the two groups.Results:According to the different TCM syndrome types,the patients with ACS were divided into excess syndrome group[cold coagulation and blood stasis(n=12),phlegm and blood stasis(n=27),heat toxin stasis(n=21)]and deficiency syndrome group[qi deficiency and blood stasis(n=23),yin deficiency and blood stasis(n=26),heart-yang depletion(n=11)].The proportion of males in excess syndrome group was higher than that in deficiency syndrome group(P<0.05),and there were no significant differences in age and course of coronary heart disease between excess syndrome group and deficiency syndrome group(P>0.05).The levels of serum Hey,LDL-C,TC and TG in deficiency syndrome group were lower,while the level of HDL-C was higher compared to excess syndrome group(P<0.05).In excess syndrome group,the levels of Hey and LDL-C in patients with cold coagulation and blood stasis syndrome were lower than those in patients with phlegm and blood stasis syndrome or heat toxin stasis syndrome,while the HDL-C was higher than that in patients with phlegm and blood stasis syndrome(P<0.05).The levels of Hey,LDL-C,TC and TAG in patients with phlegm and blood stasis syndrome were higher while HDL-C level was lower compared to patients with heat toxin stasis syndrome(P<0.05).The levels of Hey,LDL-C and TC in patients with qi deficiency and blood stasis syndrome in deficiency syndrome group were higher while the HDL-C level was lower than patients with yin deficiency and blood stasis syndrome and patients with heart-yang depletion syndrome(P<0.05).Conclusion:Compared with patients with ACS of deficiency syndrome,patients with excess syndrome have higher serum Hey and blood lipids levels.Among the six TCM syndrome types,patients with phlegm and blood stasis syndrome have the highest levels of serum Hey and blood lipids.