不同血脂ApoE基因型急性冠脉综合征患者中医证候分布特征研究

A Study on the Distribution Characteristics of Traditional Chinese Medicine Syndromes in Patients with Acute Coronary Syndrome of Different Lipid ApoE Genotypes

目的观察不同ApoE基因型急性冠脉综合征(ACS)患者的中医证候特征,重点研究ApoE4基因型ACS患者中医证候特征。方法收集249例ACS患者中医证候和ApoE基因型信息,分析不同ApoE基因型ACS患者中医证候特征及差异。结果共纳入ApoE2基因型32例,ApoE3基因型175例,ApoE4基因型42例。其中前3位:1)ApoE2组证素血瘀24例、气虚17例、痰浊15例;证型痰瘀互阻5例、气虚痰浊5例、气虚血瘀3例。2)ApoE3组证素气虚114例、血瘀108例、痰浊61例;证型气虚血瘀38例、痰瘀互阻17例、气阴两虚14例。3)ApoE4组证素气虚30例、痰浊24例、血瘀20例;证型气虚血瘀夹痰浊4例、气虚血瘀3例、气阴两虚3例。结论血脂基因型以ApoE3型多见。ApoE2基因型多见痰瘀互阻证;ApoE3基因型多见气虚血瘀证;ApoE4基因型多见气虚血瘀夹痰浊证,其证素评分中气虚、血瘀、痰浊、热蕴证最高,中医证素多见痰浊、热蕴证,证型以虚实夹杂为主,夹杂痰浊证素较多。

Objective:To observe the traditional Chinese medicine(TCM)syndrome characteristics of patients with different ApoE genotypes of acute coronary syndrome(ACS),focusing on the TCM syndrome characteristics of ApoE4 genotype ACS patients.Methods:Information on TCM syndrome and ApoE genotype of 249 ACS patients was collected,and the TCM syndrome characteristics and differences of ACS patients with different ApoE genotypes were analyzed.Results:A total of 32 cases with the ApoE2 genotype,175 cases with the ApoE3 genotype,and 42 cases with the ApoE4 genotype were included.The top three of syndrome elements and syndrome types in each group:1)ApoE2 group:syndrome elements-blood stasis 24 cases,qi deficiency 17 cases,phlegm turbidity 15 cases;syndrome types-interblocking phlegm and blood stasis 5 cases,qi deficiency with phlegm turbidity 5 cases,qi deficiency with blood stasis 3 cases.2)ApoE3 group:syndrome elements-qi deficiency 114 cases,blood stasis 108 cases,phlegm turbidity 61 cases;patterns-qi deficiency with blood stasis 38 cases,interblocking phlegm and blood stasis 17 cases,deficiency in both qi and yin 14 cases.3)ApoE4 group:syndrome elements-qi deficiency 30 cases,phlegm turbidity 24 cases,blood stasis 20 cases;syndrome types-qi deficiency with blood stasis and phlegm turbidity 4 cases,qi deficiency with blood stasis 3 cases,deficiency in both qi and yin 3 cases.Conclusion:The ApoE3 genotype is the most common among lipid gene types.The ApoE2 genotype is more likely to present with the pattern of interblocking phlegm and blood stasis;the ApoE3 genotype is more likely to present with the pattern of qi deficiency with blood stasis;and the ApoE4 genotype is more likely to present with the pattern of qi deficiency with blood stasis and phlegm turbidity.In the pathogenic factor scoring,qi deficiency,blood stasis,phlegm turbidity,and heat accumulation are the highest.TCM pathogenic factors often include phlegm turbidity and heat accumulation,and the patterns are predominantly mixed,with a high incidence of phlegm turbidity.