高同型半胱氨酸血症患者中医体质与心脑血管危险因素的相关性研究

发布时间：2018-06-30 17:52

本文选题：同型半胱氨酸 + 体质　；参考：《北京中医药大学》2017年硕士论文

【摘要】：高同型半胱氨酸血症(Hyperhomocysteinemia,HHcy)是指血液中经过还原作用后生成的同型半胱氨酸(Homocysteinemia,Hcy)水平升高,超出血液正常水平的病症。Hcy升高是心脑血管疾病、糖尿病及其并发症、神经系统疾病等发生发展的危险因子,而且Hcy升高可与其他危险因素协同作用于人体,促进疾病的发生与发展。西医目前主要通过口服叶酸、B族维生素、甜菜碱等药物治疗高同型半胱氨酸血症,但由于HHcy的致病因素复杂,这并不能治疗所有的HHcy患者,中医药在治疗HHcy上具有独特的优势。中医体质学认为,体质与疾病具有相关性,体质基础是许多疾病发生的"共同土壤",人群的体质状态决定是否发病及发病的倾向性,通过调整患者体质能实现对疾病的防治,充分改善临床症状,防止疾病的发生发展。目的:本课题拟探讨北京市东城区社区高同型半胱氨酸血症(HHcy)患者中医体质类型的分布情况及其与心脑血管危险因素的相关性。方法:本研究采用横断面研究方法,以中医基本理论和王琦教授的中医体质学说为理论指导思想,参照2009年中华中医药学会《中医体质分类判定表》,对东城区社区人群进行中医体质调查,并进行基本资料的收集(性别、年龄、身高、体重、体重指数、腰围、臀围、腰臀比、吸烟史、饮酒史、既往史)及化验检查(Hcy、血脂、肌酐、尿酸、谷丙转氨酶、血糖),研究HHcy患者中医体质类型的分布情况,以及与心脑血管危险因素的相关性。结果:本研究共收集了 485例HHcy患者:1、人口学特征性别分布上,男性205例,占42.27%,女性280例,占57.73%;年龄分布上,最小的40岁,最大的88岁,中位数为69岁,平均年龄为68.57岁。年龄分布集中在50～79岁之间,60～69、70～79岁最多,50岁以下最少。2、中医体质分布情况:平和质206例(37.8%)、阴虚质123例(22.6%)、气虚质71例(13%)、血瘀质69例(12.7%)、阳虚质61例(11.2%)、痰湿质59例(10.8%)、湿热质28例(5.1%)、气郁质28例(5.1%)、特禀质10例(1.8%);男性与女性在湿热体质存在差异(P=0.042)。3、各检验指标在不同中医体质间差异性比较:甘油三酯在痰湿质和平和质之间存在差异,痰湿质患者中甘油三酯偏高者较多。4、各体质与心脑血管疾病危险因素的相关性:HHcy患者中痰湿质与体重指数呈正相关,痰湿质与高密度脂蛋白呈负相关,气虚质、阳虚质与年龄呈正相关,阳虚质与吸烟呈负相关,血瘀质与冠心病呈正相关。结论:本研究中HHcy患者的主要偏颇体质有阴虚质、气虚质、血瘀质、阳虚质、痰湿质。甘油三酯在痰湿质和平和质之间存在差异,痰湿质患者中甘油三酯偏高者较多。痰湿质与体重指数、高密度脂蛋白有一定的相关性,气虚质、阳虚质与年龄有一定的相关性,血瘀质与冠心病有一定的相关性,对临床诊治有提示意义。
[Abstract]:Hyperhomocysteinemia (Hyperhomocysteinemia, HHcy) is the level of homocysteine (Homocysteinemia, Hcy) produced in the blood after reduction. The increase of.Hcy is a risk factor for cardiovascular disease, diabetes and its complication, nervous system disease, and Hcy, and Hcy The increase can cooperate with other risk factors in the human body to promote the occurrence and development of the disease. Western medicine is currently mainly using oral folic acid, B vitamins, betaine and other drugs to treat hyperhomocysteinemia, but because of the complicated pathogenic factors of HHcy, it can not treat all HHcy patients. Traditional Chinese Medicine is unique in the treatment of HHcy. The physique of traditional Chinese medicine holds that physique and disease have correlation, the physical basis is the "common soil" of many diseases. The constitution of the population determines whether the disease is prone to disease and the tendency of the disease. By adjusting the patient's physique, it can realize the prevention and cure of the disease, improve the symptoms of the bed and prevent the occurrence and development of the disease. To discuss the distribution of the type of physique of Chinese medicine in the patients with hyperhomocysteinemia (HHcy) in Dongcheng District community of Beijing and the correlation with the risk factors of cardiovascular and cerebrovascular diseases. Methods: This study adopted a cross-sectional study method, with the basic theory of Chinese medicine and Professor Wang Qi's theory of Chinese medicine as the theoretical guidance, referring to the Chinese traditional Chinese medicine in 2009. To investigate the constitution of the Chinese medical constitution, to investigate the constitution of Dongcheng District community, and to collect the basic data of Chinese medicine, and collect the basic data (sex, age, height, weight, body mass index, waist circumference, hip circumference, waist hip ratio, smoking history, drinking history, past History) and test (Hcy, blood lipid, creatinine, uric acid, alanine aminotransferase, blood sugar), and study the TCM body of HHcy patients The distribution of mass types and the correlation with cardiovascular risk factors. Results: 485 patients with HHcy were collected in this study: 1, the demographic characteristics of human sex, 205 men, 42.27%, 280 women, 57.73%, the minimum age 40, the maximum 88, the median of 69, and the average age of 68.57 years. Between 50~79 years of age, 60 ~ 69,70 to 79 years of age and under 50 years of age, the distribution of physique of traditional Chinese medicine: 206 cases (37.8%), 123 cases of yin deficiency (22.6%), 71 cases of qi deficiency (13%), 69 cases of blood stasis (12.7%), Yang deficiency and substance 61 cases (11.2%), moisture and heat quality cases, qi stagnation and qualitative cases There is a difference (P=0.042).3 in the damp heat constitution (P=0.042), and the difference of each test index in the physique of different Chinese medicine: there is a difference between the triglyceride in the phlegm and the quality of the dampness and the quality of the phlegm, the high triglyceride in the patients with phlegm dampness is more.4, and the correlation between the physical constitution and the risk factors of cardiovascular and cerebrovascular diseases: the phlegm and body mass index in the patients of HHcy Positive correlation, phlegm and HDL have negative correlation with high density lipoprotein, Qi deficiency, Yang deficiency and age have positive correlation, Yang deficiency is negatively related to smoking, blood stasis is positively related to coronary heart disease. Conclusion: the main bias constitution of HHcy patients in this study are yin deficiency, Qi deficiency, blood stasis, Yang deficiency, phlegm wet quality, and triglyceride in phlegm and wet quality and quality. There are many differences between the phlegm and the hypertriglycerides in the patients with phlegm and humid. There is a certain correlation between the phlegm wet quality and the body mass index, high density lipoprotein, Qi deficiency, Yang deficiency and age, and the correlation between the blood stasis and the coronary heart disease, which is suggestive of the clinical diagnosis and treatment.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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