扩张型心肌病患者中医证素与抗心肌抗体的相关性

发布时间：2018-01-13 22:21

本文关键词：扩张型心肌病患者中医证素与抗心肌抗体的相关性　出处：《中国实验方剂学杂志》2017年18期 　论文类型：期刊论文

【摘要】：目的:分析无锡地区扩张型心肌病(dilated cardiomyopathy,DCM)患者中医证素的分布特点,观察血清中抗腺嘌呤核苷酸(ADP/ATP)转位酶(adenine nucleotide translocase,ANT),抗β1肾上腺素能受体(β1receptor),抗毒蕈碱2(muscarinic receptor 2,M2)受体、抗肌球蛋白重链(myosin heavy chain,MHC)4种自身抗心肌抗体的水平,探讨中医证素和抗心肌抗体两者间的关系,为DCM患者临床诊治提供客观的依据。方法:选取无锡地区2013年5月—2014年12月入住心内科的84例DCM患者,由专职中医师进行临床证候采集与中医证素的评估;随机抽取同期住院的61例非DCM引起的慢性心力衰竭患者作为心衰组,抽取47例健康体检者作为正常组。测定3组患者血清中ant-ANT,ant-β1,ant-M2,ant-MHC的水平。结果:DCM患者中医证素分布特点,84例DCM患者中医证素共出现158次,证素按出现频次高低依次为气虚57次(36.08%)血瘀48次(30.38%)阳虚27次(17.09%)阴虚12次(7.59%)水湿9次(5.70%)痰浊5次(3.16%),其中虚性证素占60.76%,实性证素占39.24%。单证素24例,其中气虚(11例)阳虚(13例);兼夹证素60例,其中气虚血瘀(26例)气虚阴虚(12例)阳虚血瘀(8例)气虚血瘀水湿(5例)阳虚血瘀水湿(4例)气虚血瘀痰浊(3例)阳虚血瘀痰浊(2例)。DCM患者与非DCM心力衰竭患者ant-ANT,ant-β1,ant-M2,ant-MHC的水平比较,DCM组抗心肌抗体ant-β1,antMHC,ant-ANT水平明显高于心衰组(P0.05)。DCM患者中医证素与抗心肌抗体水平的关系,DCM患者中医单证素阳虚患者抗心肌抗体ant-β1,ant-ANT,ant-M2,ant-MHC水平均高于气虚患者(P0.05),DCM患者中医兼夹证素间抗心肌抗体ant-β1,ant-ANT,ant-M2,ant-MHC值从高到低为阳虚血瘀气虚血瘀气虚阴虚。结论:DCM患者中医证素中,气虚所占比例最大,其次为实性证素血瘀,是本病最主要的病理因素之一。DCM患者中医证素与抗心肌抗体水平存在相关性,随着单证素从气虚到阳虚,兼夹证素从气虚阴虚,气虚血瘀到阳虚血瘀的演变,抗心肌抗体水平呈增高趋势。可指导临床应用相应的中西医结合方法治疗DCM。
[Abstract]:Objective: to analyze the distribution of TCM syndromes in patients with dilated cardiomyopathy (DCM) in Wuxi area. Serum adenine nucleotide translocase (ADP / ATP) translocation enzyme (ANT) was observed. Anti 尾 1 receptor (尾 1 receptor, anti muscarinic receptor 2 M 2) receptor. The levels of four autoantibodies against myosin heavy chainchus were studied in order to explore the relationship between TCM syndromes and anti-myocardial antibodies. Methods: 84 DCM patients in Wuxi from May 2013 to December 2014 were selected. To collect clinical syndromes and evaluate TCM syndromes by full-time TCM doctors; Sixty-one patients with chronic heart failure caused by non-#en0# were randomly selected as heart failure group and 47 healthy persons as normal group. The serum ant-ANT was measured in three groups. Results the distribution characteristics of TCM syndromes in 84 patients with DCM were 158times. Syndromes in order of frequency were Qi deficiency 57 times (36.08 times) blood stasis 48 times (30.38 times) Yang deficiency 27 times (n = 27) Yin deficiency 12 times (n = 7. 59)) Water dampness 9 times (. 5.70) phlegm turbidity 5 times and 3.16). Among them, deficiency syndromes accounted for 60.76 and solid syndromes accounted for 39.24.The documentins were found in 24 cases, including 11 cases of Qi deficiency, 13 cases of Yang deficiency. 60 cases were accompanied with syndrome element. Among them, there were 26 cases of Qi deficiency and blood stasis, 12 cases of qi deficiency and yin deficiency, 8 cases of yang deficiency and blood stasis, 5 cases of qi deficiency, blood stasis and water dampness, 4 cases of yang deficiency, blood stasis, water dampness, 3 cases of qi deficiency, blood stasis and phlegm turbid, 2 cases of yang deficiency, blood stasis, phlegm turbid, and 2 cases). Ant-ANT in patients with DCM and patients with non-DCM heart failure. The level of ant- 尾 1 ant-M2 ant-MHC was compared with that of ant- 尾 1 antMHC in DCM group. The level of ant-ANT was significantly higher than that of P0.05. DCM in heart failure group. The relationship between TCM syndromes and anti-myocardial antibody level was significantly higher than that in heart failure group. The levels of ant- 尾 1- antant-M2ant-MHC in patients with DCM were higher than those in patients with deficiency of qi (P0.05). In DCM patients, ant- 尾 _ 1 ant- 尾 _ 1 antant-M2 ant-M2. Ant-MHC value from high to low for Yang deficiency blood stasis deficiency of blood stasis qi deficiency yin deficiency. Conclusion the proportion of qi deficiency is the largest in Chinese medicine syndrome factors and the second is solid syndrome element blood stasis. DCM is one of the most important pathological factors. There is a correlation between TCM syndromes and anti-myocardial antibody levels, with the document element from Qi deficiency to Yang deficiency, and from Qi deficiency to Yin deficiency. The evolution of qi deficiency and blood stasis to yang deficiency and blood stasis, the level of anti-myocardial antibody is increasing, which can guide clinical application of the corresponding combination of traditional Chinese and western medicine in the treatment of DCM.
【作者单位】：南京中医药大学无锡附属医院;
【基金】：江苏省中医药领军人才项目无锡市医院管理中心科研项目(YGZXM14047)
【分类号】：R259
【正文快照】： [网络出版地址]http://kns.cnki.net/kcms/detail/11.3495.R.20170628.1622.034.html[网络出版时间]2017-06-28 16:22扩张型心肌病(DCM)是一种以左心室、右心室或双侧心腔扩大、心脏收缩功能障碍为主要表现的心肌疾病,其临床表现的基本特征以逐渐进展的心力衰竭、心律失常、血

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