老年高脂血症人群血脂指标与中医体质分型的关系研究

Study on the correlation of blood lipid indicators with traditional Chinese medicine constitutions in elderly people with hyperlipemia

目的探讨老年高脂血症(HP)人群的血脂指标水平和中医体质分型的关系,为临床治疗提供依据。方法选取600例老年HP患者,均应用迈瑞BS-830检测仪测定血脂指标,以中医辨证体质分型分类,比较不同中医体质分型患者的基本情况、血脂指标水平,并以二元Logistic回归模型分析HP和中医体质分型的关系。结果通过临床辨证,600例老年HP患者中,平和质60例(10.0%),气虚质135例(22.5%)、阳虚质135例(22.5%)、阴虚质90例(15.0%)、痰湿质75例(12.5%)、湿热质34例(5.7%)、血瘀质51例(8.5%)、气郁质20例(3.3%)、特禀质0例。不同中医体质分型患者的性别、年龄、病程、体质量及吸烟史情况比较差异不具统计学意义(P>0.05)。不同中医体质分型患者的总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)比较差异不具统计学意义(P>0.05);气虚质、阴虚质、湿热质、血瘀质患者的TC分别为(5.14±1.21)、(5.10±1.14)、(5.25±1.12)、(5.45±1.31)mmol/L,LDL-C分别为(2.94±0.66)、(2.95±0.60)、(2.95±0.53)、(3.51±1.03)mmol/L,均高于平和质患者的(4.18±1.20)、(2.60±0.74)mmol/L,差异存在统计学意义(P<0.05);气虚质、阴虚质、痰湿质、湿热质、血瘀质患者的TG分别为(2.26±0.37)、(2.27±0.32)、(1.87±0.45)、(2.03±0.19)、(2.41±0.55)mmol/L,均高于平和质患者的(1.68±0.53)mmol/L,差异存在统计学意义(P<0.05)。以HP为因变量,以中医体质分型为自变量(平和质为参照),进行二元Logistic回归分析,发现气虚质、阴虚质、痰湿质、血瘀质是HP的高危因素(P<0.05)。结论不同中医体质分型的老年HP患者的血脂指标水平有所不同,且临床上以气虚质、阴虚质、痰湿质、血瘀质等体质多见。

Objective To explore the correlation of blood lipid indicators with traditional Chinese medicine constitutions in elderly people with hyperlipemia(HP),so as to provide basis for clinical treatment.Methods 600 elderly patients with HP were selected,and their blood lipid indicators were measured using the Mindray BS-830 detector to classify their traditional Chinese medicine constitutions.The basic conditions and lipid indicators of patients with different traditional Chinese medicine constitutions were compared,and the correlation of HP with traditional Chinese medicine constitutions was analyzed by binary Logistic regression model.Results Through clinical differentiation,among 600 elderly patients with HP,there were 60 cases(10.0%)of peaceful constitution,135 cases(22.5%)of Qi-deficiency constitution,135 cases(22.5%)of Yang-deficiency constitution,90 cases(15.0%)of Yin-deficiency constitution,75 cases(12.5%)of phlegm-damp constitution,34 cases(5.7%)of damp-heat constitution,51 cases(8.5%)of blood-stasis constitution,20 cases(3.3%)of Qi-depression constitution,and 0 cases of special constitution.There were no significant differences in gender,age,course of disease,body mass and smoking history among patients with different traditional Chinese medicine constitutions(P>0.05).The differences in total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were not statistically significant among the patients with different traditional Chinese medicine constitutions(P>0.05).TC of patients with Qi-deficiency,Yin-deficiency,damp-heat and blood-stasis constitutions were(5.14±1.21),(5.10±1.14),(5.25±1.12)and(5.45±1.31)mmol/L,and LDL-C were(2.94±0.66),(2.95±0.60),(2.95±0.53)and(3.51±1.03)mmol/L,which were all higher than(4.18±1.20)and(2.60±0.74)mmol/L of patients with peaceful constitution,and the difference was statistically significant(P<0.05).TG of patients with Qi-deficiency,Yin-deficiency,phlegmdamp,damp-heat,and blood-stasis constitutions were(2.26±0.37),(2.27±0.32),(1.87±0.45),(2.03±0.19),and(2.41±0.55)mmol/L,which were higher than(1.68±0.53)mmol/L of patients with peaceful constitution,and the difference was statistically significant(P<0.05).Binary Logistic regression analysis with HP as the dependent variable and traditional Chinese medicine constitutions as the independent variable(peaceful constitution as the reference)revealed that Qi-deficiency,Yin-deficiency,phlegm-damp,and blood-stasis constitutions are the high-risk factors for HP(P<0.05).Conclusion The blood lipid indicators of the elderly HP patients with different traditional Chinese medicine constitutions are different,and clinically,Qi-deficiency,Yin-deficiency,phlegmdamp,blood stasis and other constitutions are common.