原发性血脂异常的体质类型及其与血脂指标的相关性研究

【作者】 王丽娟；

【导师】 韩丽蓓；

【作者基本信息】 北京中医药大学 ， 中医内科学， 2012， 硕士

【摘要】 研究目的：通过收集原发性血脂异常患者的临床资料,统计分析出原发性血脂异常患者的体质分布特点,进而通过分析体质类型与原发性血脂异常西医化验指标的关系,找到体质类型与血脂指标的相关性,为以化验指标辅助确定体质类型、进而确定证候提供佐证,希望能通过化验指标辅助确定原发性血脂异常患者的体质类型,使中医体质学说更加客观化,进而为丰富辨证的研究提供佐证。研究方法：1.通过调查问卷收集122例原发性血脂异常患者的一般资料、血脂全套的各项指标即总胆固醇(Tc)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白(ApoAl)、载脂蛋白(ApoB);采用王琦的中医体质分类方法,将患者分为9种体质类型即平和质、气虚质、阳虚质、阴虚质、瘀血质、痰湿质、湿热质、气郁质及特禀质。统计并分析原发性血脂异常患者的体质分布特点及其与血脂指标的相关性。2.数据统计：描述统计量采用均数±标准差或构成比表示,体质类型与血脂指标的相关性研究采用有序回归法。所有统计处理都应用SPSS18.0进行,制表软件采用Access2007。研究结果：1.对一般资料的分析表明,原发性血脂异常患者主要分布在60-75岁这一年龄组,两个年龄组中45-59岁这一年龄组TG水平高于60-75岁的年龄组。男性患者TG水平高于女性患者。122例患者中存在不良饮食生活方式的占77.04%。原发性血脂异常患者血脂指标的异常,最多见的是TC、LDL-C都升高。2.原发性血脂异常患者中,气虚质最多(占62.30%),显著高于其它体质类型；其次是痰湿质、阴虚质、气郁质及阳虚质(大于30%),湿热质、血瘀质相对较少(约占20%),而特禀质与平和质人数最少(约占5%)。其中,男性患者以气虚质最多(28例,占51.9%),其次是痰湿质(23例,占42.6%)；而女性患者以气虚质最多(48例,占70.60%),其次是气郁质(30例,占44.10%)。3.对9种体质类型与血脂指标的相关性研究表明,在原发性血脂异常这一特殊群体中当有LDL-C升高时,气虚质与阳虚质的可能性大；当ApoAl降低时,气郁质的可能性大。研究结论：在原发性血脂异常患者的体质分型中,正气虚之体质占主要地位,其中又以气虚质、阴虚质、阳虚质为主；邪气实之体质中,以痰湿质和气郁质为多见。其中,男性患者以气虚质和痰湿质为主,女性患者则以气虚质及气郁质为主。本研究认为,LDL-C与气虚质、阳虚质呈正相关性,ApoAl与气郁质呈负相关性。但由于本研究样本量少,尚不能认为其它体质类型与血脂指标无相关性。更多还原

【Abstract】 Purpose:This study will collect122cases with primary dyslipidemia and analyze their patterns of TCM constitution through the questionnaire method to enrich the content of patterns of TCM constitution. Then we will analyze the relationgship between patterns of TCM constitution and blood fat indexes of primary dyslipidemia in order to find if they have any correlations. The laboratory indexes can help to identify the patterns of TCM constitution with primary dyslipidemia if the result is significative. Therefore, the theory about the patterns of TCM constitution is more objective, which can provide the basis for identifying body constitution objectively.Methods:1. Collection of patients with general information, blood lipids a full range of the indicators that the total cholesterol(TC), triglyceride(TG), high desitylipoprotein,lowdensitylipoprotein, apolipoprotein(ApoAl), apolipoprotei n (ApoB)through questionaire method. Using Chinese medicine physical classification, be divided into nine kinds of physical types:Moderate physical, Qi deficient physical, Yang deficient physical, Yin deficient physical, Ecchymosis physical, phlegm Physical, Hot and humid physical, Qi stagnation physical, Special intrinsic physical. Analyze the relationgship between patterns of TCM constitution and blood fat indexes of primary dyslipidemia in order to find if they have any correlations.2. Statistics:to use mean±standard deviation or proportion to describe descriptive statistics, ordinal regression to analyze the correlation between patteren of TCM constitution and blood fat indexes of primary dyslipidemia. All statistics were carried out using SPSS18.0, spreadsheets using Access2007.Results:1. After analysis of the subjects’basal data, we found primary dysl ipidemia was closely correlated with unhealthy diet and life styles and lack of exercise. In primary dyslipidemia patients, the most common abnormal blood fat indexes were increase of both TC and LDL-C.2. In primary dyslipidemia patients, the percent of Qi deficient physical (62.30%) was remarkly higher than the other physical types. Phlegm Physical, Yin deficient physical, Qi deficient physical and Yang deficient physical were also very common in primary dyslipidemia patients, and each of the percent was higher than30%. Hot and humid physical and Ecchymosis physical were relatively less common (almost20%), wh ile pa ti en ts classified to special intrinsic phys ical and to Moderate physical were the fewest (almost5%). There were28male patients were classified to Qi physical, with the highest percent51.9%.23male patients were classified to phlegm Physical, with the second highest percent42.6%.In female patients, the first two most common physical types were Qi physical (48patients,70.60%) and Qi stagnation physical (30patients,44.10%).3. After analysis of the correlation between patterns of TCM constitution and blood fat indexes in primary dyslipidemia patients, we found that when the patients’LDL-C was increased, we should firstly classify them to Qi deficient physical and Yang deficient physical, ApoAl increased classify to Qi stagnation physical.Conclusions:In classification of patterns of TCM constitution to primary dyslipidemia patients, patterns of healthy qi deficiency, in which the mainly patterns were Qi deficient physical and Yang deficient physical, were very common. In patterns of xieqi prevail, the mainly patterns were Phlegm Physical and Qi stagnation Physical. Male patients were commonly classified to Qi deficient Physical and Phlegm Physical, while female to QI deficient and QI stagnation Physical. Our study found that LDL-C had positive correlation with qi stagnation Physical. However, because of limitation of our sample size, we can not deny the correlation between blood fat indexes and the other TCM constitution patterns.更多还原