血脂边缘升高人群中医证候特征的回顾性研究

Retrospective study on TCM pattern characteristics of people with elevated blood lipid margins

目的探究血脂边缘升高人群核心病机及中医证候特征,为中医药早期防治血脂异常研究及诊疗提供参考。方法研究对象为2018年12月至2020年12月期间符合标准的1404例血脂边缘升高人群,其中女性720例、男性684例,年龄分布在28~65岁。收集性别、年龄、血压、身高、体重、身体质量指数、空腹血糖、血尿酸、甘油三酯、胆固醇、低密度脂蛋白、高密度脂蛋白及中医症状、体征等信息,建立血脂异常水平数据库。采用频数统计、因子分析、系统聚类探究核心病机及证候特征。结果中医症状、体征出现频次前5位依次是身热不扬、口干、尿清、口苦、肥胖;因子分析共提取7个公因子,分别是脾虚夹瘀证、湿热伤阴证、湿热困脾证、湿热蕴胃证、脾虚痰湿证、痰热伤阴证、胃热脾虚证;系统聚类共分6种中医证候、1种状态,分别是痰湿中阻证、大肠湿热证、气阴两伤挟瘀证、阳气不足证、脾胃虚弱证、三焦湿热证和肥胖。结论血脂边缘升高人群证候分布主要为痰湿中阻证、大肠湿热证、气阴两伤挟瘀证、阳气不足证、脾胃虚弱证、三焦湿热证,以及形体肥胖的状态表现。

Objective To explore the core pathogenesis and TCM pattern characteristics in people with elevated blood lipid margins,and to provide reference for early prevention and treatment of dyslipidemia in TCM.Methods A total of 1404 individuals with elevated blood lipid margins who met the inclusion and exclusion criteria from December 2018 to December 2020 were recruited,including 720 females and 684 males,aged between 28 and 65 years old.Information including gender,age,blood pressure,height,weight,body mass index,fasting blood glucose,blood uric acid,triglycerides,cholesterol,low-density lipoprotein,high-density lipoprotein,as well as other TCM symptoms and signs was collected to establish a database of abnormal blood lipid levels.Frequency statistics,factor analysis,and systematic clustering were employed to explore the core pathogenesis and pattern characteristics.Results The top five TCM symptoms and signs with the highest frequency were tidal fever due to warm dampness,dry mouth,clear urine,bitter taste,and obesity;seven common factors were extracted by factor analysis,namely,spleen deficiency with blood stasis pattern,damp heat damaging yin pattern,damp heat affecting the spleen pattern,damp heat with stomach retention pattern,spleen deficiency with phlegm dampness pattern,phlegm heat damaging yin pattern,and stomach heat with spleen deficiency pattern;systematic clustering was divided into six TCM patterns and one state,namely,phlegm dampness accumulating in the spleen pattern,damp heat in the large intestine pattern,qi-yin injury with blood stasis pattern,yang qi insufficiency pattern,spleen and stomach deficiency pattern,three jiao damp heat pattern,and obesity.Conclusion The pattern distribution in people with elevated blood lipid margins mainly includes phlegm dampness accumulating in the spleen pattern,damp heat in the large intestine pattern,qi-yin injury with blood stasis pattern,yang qi insufficiency pattern,spleen and stomach deficiency pattern,three jiao damp heat pattern,and their manifestation of physical obesity.