中老年原发性血脂异常中医体质与颈动脉粥样硬化的相关性研究

发布时间：2018-05-30 21:35

本文选题：中老年 + 原发性血脂异常　；参考：《福建中医药大学》2017年硕士论文

【摘要】：目的:探讨中老年原发性血脂异常患者中医体质分型特点及其与颈动脉粥样硬化的关系,筛选出存在颈动脉粥样硬化高危险性的偏颇体质类型,为从中医体质角度预测、预防颈动脉粥样硬化的发生提供依据。方法:对160例符合中老年原发性血脂异常的诊断标准的患者,进行中医体质及一般情况调查,根据《中医体质分类及判定标准》判定体质类型,选取分布最多的三型体质患者行颈动脉血管超声检查,比较各型体质一般情况、血脂指标、颈动脉内-中膜厚度、颈动脉粥样硬化斑块阳性率、斑块稳定性、血管狭窄、血流动力学情况,结果采用SPSS20软件系统进行数据分析。结果:1、160例中老年原发性血脂异常患者中,痰湿质(22%)最多,其次是气虚质(19%)、阳虚质(17.5%)、血瘀质(14%),阴虚质(12.5%)、平和质(9%)、湿热质(5%)相对较少,气郁质(1%)、特禀质(0%)人数最少。2、三型中老年原发性血脂异常患者分布最多的体质中,痰湿质人群颈动脉内-中膜厚度、颈动脉粥样硬化斑块阳性率均最高,且与气虚质、阳虚质比较差异有统计学意义(P0.05);痰湿质血管狭窄率呈现高于其他体质的趋势,且与阳虚质比较差异有统计学意义(P0.05);余体质两两比较差异无统计学意义(P0.05)。3、三型中医体质左侧颈总动脉PSV比较,差异有统计学意义,痰湿质最低,且与气虚质、阳虚质比较,差异有统计学意义(P0.05);三型体质右侧颈总动脉PSV比较,差异无统计学意义(P0.05);痰湿质左侧RI与阳虚质比较差异有统计学意义(P＜0.05),余体质两两比较差异无统计学意义(P0.05);痰湿质右侧RI与气虚质、阳虚质比较差异有统计学意义(P0.05),气虚质与阳虚质比较差异无统计学意义(P0.05)。4、气虚质人群颈动脉不稳定斑块检出率最高,且与痰湿质、阳虚质比较差异有统计学意义(P0.05);痰湿质与阳虚质比较差异无统计学意义(P0.05)5、三型体质TC、HDL-C、LDL-C比较差异有统计学意义(P0.05);就TC、H DL-C而言,痰湿质与气虚质、阳虚质比较差异有统计学意义(P＜0.05),气虚质与阳虚质比较差异无统计学意义(P0.05);就LDL-C而言,痰湿质与阳虚质比较差异有统计学意义(P0.05),余体质两两比较差异无统计学意义(P0.05);三型体质TG差异无统计学意义(P＞0.05)。结论:1、在中老年原发性血脂异常患者中,偏颇体质以痰湿质、气虚质、阳虚质为主。2、痰湿体质中老年原发性血脂异常患者颈动脉内-中膜增厚明显,颈动脉粥样硬化斑块阳性率、血管狭窄及血流动力学改变较其他体质发生率高。3、气虚质中老年血脂异常患者易形成不稳定型斑块,斑块的严重程度高,易发生斑块脱落导致动脉梗塞的风险。4、痰湿质人群可通过影响血脂代谢水平增加动脉粥样硬化的发病风险。
[Abstract]:Objective: to investigate the characteristics of TCM constitution classification and its relationship with carotid atherosclerosis in middle-aged and elderly patients with primary dyslipidemia, and to screen out the biased constitution types with high risk of carotid atherosclerosis, so as to predict the constitution of TCM from the point of view of TCM constitution. To provide evidence for prevention of carotid atherosclerosis. Methods: 160 patients with primary dyslipidemia in middle and old age were investigated with TCM constitution and general condition, and the types of constitution were determined according to the classification and judgement standard of TCM constitution. Carotid artery ultrasound was performed in the patients with the most distributed type III constitution. The general conditions of different types of constitution were compared, including blood lipid index, carotid intima-media thickness, carotid atherosclerotic plaque positive rate, plaque stability, vascular stenosis, carotid artery atherosclerotic plaque positive rate, carotid artery stenosis, carotid artery atherosclerotic plaque stability, carotid artery stenosis. The results were analyzed by SPSS20 software system. Results among the 1160 middle-aged and aged patients with primary dyslipidemia, phlegm and dampness were the most common, followed by Qi deficiency and Qi deficiency, Yang deficiency and 17.5T, blood stasis 14, Yin deficiency and 12.5U, calming and dampness, and dampness and heat, respectively) were relatively small, and the number of patients with dyslipidemia was 22%, followed by Qi deficiency (19 cases), Yang deficiency (17. 5%), blood stasis (14 cases), Yin deficiency (12. 5%). The number of patients with primary dyslipidemia of middle and old age was the highest in the group of phlegm and dampness. The positive rate of carotid artery intima-media thickness and carotid atherosclerotic plaque was the highest in the group of phlegm-wet substance, and the positive rate was higher than that of deficiency of qi. The difference of Yang deficiency was statistically significant (P 0.05), and the rate of phlegm wet vessel stenosis was higher than that of other physique. The difference was statistically significant compared with that of Yang deficiency (P 0.05), but not significant (P 0.05). The PSV of left common carotid artery in three types of TCM constitution was statistically significant, and the phlegm dampness was the lowest, and compared with Qi deficiency and Yang deficiency. The difference was statistically significant (P 0.05). The PSV of the right common carotid artery in the three types of constitution was compared. There was no significant difference in the left RI of phlegm and dampness (P < 0.05), but there was no significant difference between the remaining physique (P < 0.05), the right side of phlegm dampness (RI) and deficiency of qi (P < 0.05). The difference of Yang deficiency was statistically significant (P 0.05), but there was no significant difference between qi deficiency and yang deficiency (P 0.05). The detection rate of unstable plaque in carotid artery was the highest in the group of deficiency of qi, and it was also associated with phlegm and dampness. There were significant differences in Yang deficiency (P 0.05), phlegm wet (P 0.05) and yang deficiency (P 0.05). There was significant difference in LDL-C (P 0.05) between three types of constitution (TCU HDL-CU). In the case of TCH DL-C, phlegm wet and qi deficiency were not significant. The difference between Yang deficiency and Yang deficiency was statistically significant (P < 0.05), but there was no significant difference between Qi deficiency and Yang deficiency (P < 0.05); as far as LDL-C was concerned, There was significant difference between phlegm dampness and yang deficiency, but there was no significant difference in residual constitution (P 0.05) and no significant difference in TG in three types (P > 0.05). Conclusion in middle and old age patients with primary dyslipidemia, the partial physique is mainly phlegm dampness, qi deficiency, yang deficiency, and phlegm dampness constitution is obviously thickened in carotid artery in elderly patients with primary dyslipidemia. The positive rate of carotid atherosclerotic plaques, vascular stenosis and hemodynamic changes were higher than those of other physique. The senile patients with deficiency of qi were prone to form unstable plaques, and the severity of plaque was high. The risk of artery infarction caused by plaque shedding. 4. Phlegm dampness can increase the risk of atherosclerosis by affecting the level of lipid metabolism.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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