| 郭志丽,管志敏,谢妹龙,等.痰瘀与颈动脉粥样斑块参数及血管内环境相关性的临床研究[J].浙江中医药大学学报,2023,47(11):1330-1334. |
| 痰瘀与颈动脉粥样斑块参数及血管内环境相关性的临床研究 |
| Clinical Study on the Relationship between Phlegm Stasis and Carotid Atherosclerotic Plaque Parameters and Intravascular Environment |
| DOI：10.16466/j.issn1005-5509.2023.11.016 |
| 中文关键词: 痰瘀 颈动脉粥样斑块 血管内环境 糖脂代谢紊乱 体质辨识 动脉粥样硬化 |
| 英文关键词: phlegm-stasis carotid atherosclerotic plaque endovascular environment glucose lipid metabolism disorder physical identification atherosclerosis |
| 基金项目:浙江省中医药科技计划项目(2023ZL173) |
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| 中文摘要: |
| [目的] 探讨痰瘀与颈动脉粥样斑块生成以及血管内环境包括糖脂代谢紊乱、血压、血液黏稠度等指标的相关性。[方法] 收集浙江中医药大学附属嘉兴中医院健康体检中心522例健康体检者的中医体质辨识健康体检数据，整理体质辨识提示为痰瘀证，颈动脉彩超检查阳性的病例的健康体检临床数据资料，分析比较痰瘀证与非痰瘀证健康体检者的颈动脉彩超指标参数与总胆固醇(total cholesterol，TC)、甘油三酯(triglyceride，TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol，LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol，HDL-C)、血压状况、炎症因子、血液黏稠度、动脉硬化指标、血清葡萄糖等数值的差异，并计算颈动脉粥样斑块状态与血清糖脂代谢水平的相关性。 [结果] 与非痰瘀证健康体检者比较，痰瘀证健康体检者颈动脉粥样斑块彩超阳性率54.3%，明显高于非痰瘀证健康体检者(12.9%)；与非痰瘀证健康体检者比较，痰瘀证健康体检者存在不同程度的脂代谢功能紊乱，TC、TG、LDL-C水平均升高(P<0.01)，HDL-C水平降低(P<0.01)。与非痰瘀证健康体检者比较，痰瘀证健康体检者存在不同程度的糖代谢功能紊乱，糖化血红蛋白水平升高，空腹血糖升高(P<0.01)。与非痰瘀证健康体检者比较，痰瘀证健康体检者血液黏稠度升高，血压升高，动脉硬化指数偏高(P<0.01)。进一步分析颈动脉粥样斑块参数与血清糖脂代谢紊乱水平、血压状态相关性得出，TC与颈动脉内中膜厚度(intima-media thickness，IMT)数值呈正相关，TG与IMT数值呈正相关，LDL-C与IMT数值呈正相关；血糖与IMT数值呈正相关，血压与IMT数值呈正相关。[结论] 痰瘀证健康体检者存在一定程度的糖脂代谢紊乱，并且与颈动脉粥样斑块指数存在相关性；痰瘀证健康体检者还存在一定程度的血管内环境紊乱。证候是健康体检者内环境状态的外在体现，中医通过望闻问切进行体质辨识，对初步判断体质有一定帮助。 |
| 英文摘要: |
| [Objective] To investigate the correlation between phlegm stasis and carotid atherosclerotic plaque formation and vascular environment including glucose and lipid metabolism disorder， blood pressure， blood viscosity and other indicators. [Methods] The physical examination data of 522 patients with traditional Chinese medicine physique identification module in the physical examination center of Jiaxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University were collected， the clinical data of the physical examination of patients with phlegm-stasis syndrome indicated by physique identification and positive carotid artery color Doppler ultrasound were collated， and the parameters of carotid artery color Doppler ultrasound and total cholesterol(TC)， triglyceride(TG)， low density lipoprotein-cholesterol(LDL-C)， high density lipoprotein-cholesterol(HDL-C)， blood pressure status， inflammatory factors， blood viscosity， arteriosclerosis indicators， serum glucose and other values of patients with phlegm-stasis syndrome and without phlegm-stasis syndrome were analyzed and compared. The relationship between carotid atherosclerotic plaque status and serum glucose and lipid metabolism level was calculated. [Results] The positive rate of color ultrasound in patients with phlegm-stasis syndrome was 54.3%， which was significantly higher than that in patients without phlegm-stasis syndrome(12.9%). Compared with patients without phlegm-stasis syndrome， patients with phlegm-stasis syndrome had different degrees of lipid metabolism dysfunction， the levels of TC， TG and LDL-C were all increased(P<0.01)， and HDL-C was decreased(P<0.01). Compared with patients without phlegm-stasis syndrome， patients with phlegm-stasis syndrome had different degrees of dysfunction of glucose metabolism， increased glycocated hemoglobin level and rapid glucose(P<0.01). Compared with patients without phlegm-stasis syndrome， patients with phlegm-stasis syndrome had higher blood viscosity， higher blood pressure and higher arteriosclerosis index(P<0.01). The correlation results of carotid atherosclerotic plaque parameters and serum glucose lipid metabolism disorder level， blood pressure state showed that TC was positively correlated with intima-media thickness(IMT)， TG was positively correlated with IMT， LDL-C was positively correlated with IMT; blood glucose was positively correlated with IMT， and blood pressure was positively correlated with IMT. [Conclusion] Patients with phlegm-stasis syndrome have a certain degree of glucose and lipid metabolism disorder， which is correlated with carotid atherosclerotic plaque index; patients with phlegm-stasis syndrome have a certain degree of vascular environment disorder， including increased blood viscosity， increased blood pressure index and increased inflammatory factors. Syndrome is the external manifestation of the patient’s internal environment. There is a basis for traditional Chinese medicine constitution identification to preliminarily judge the patient’s constitution through observation， listening， questioning and incision. |
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