从治未病探讨高同型半胱氨酸血症中医体质管理

目的:观察四川省自贡地区高同型半胱氨酸血症(homocysteine,HCY)人群的中医体质分布、中医体质与心血管危险因素的相关性,为建立治未病同健康管理相结合的模式干预高同型半胱氨酸血症提供依据。方法:通过调查514例高同型半胱氨酸血症人群填写的《中医体质分类与判定表》的情况,搜集基本信息及实验室检查,探讨中医体质分布和危险因素的相关性。结果:514例高HCY血症人群中,主要以痰湿质(28.2%)、血瘀质(17.1%)、湿热质(14.8%)、阴虚质(12.3%)为主,男性体质分布以痰湿质(32.2%)、血瘀质(16.9%)、湿热质(14.2%)、气虚质(11.2%)为主,女性体质分布以痰湿质(23.9%)、血瘀质(17.4%)、湿热质(15.4%)、阴虚质(14.6%)为主。痰湿质、血瘀质、湿热质、阴虚质的年龄、舒张压、三酰甘油水平比较,差异有统计学意义(P<0.05),其中,痰湿质年龄水平高于其他3种体质,湿热质年龄水平最低(P<0.05);血瘀质舒张压高于其他3种体质(P<0.05),湿热质三酰甘油含量高于其他3种体质(P<0.05)。痰湿质、血瘀质高HCY人群与饮酒有显著相关性(P<0.05),湿热质高HCY人群与高血压有显著相关性(P<0.05),痰湿质、阴虚质高HCY人群与血脂异常有显著相关性(P<0.05)。结论:痰湿质、血瘀质、湿热质、阴虚质是高同型半胱氨酸血症的主要体质,男女体质分布有差异,不同体质相关的危险因素不同。

Discussion About TCM Constitution Management for Homocysteine Based on Prevention of Disease

Objective:To observe the distribution of TCM constitution and the correlation between TCM constitution and cardiovascular risk factors in the population of homocysteine(HCY) in Zigong Area of Sichuan Province,so as to provide the basis for the establishment of the model of combination of disease prevention and health management to intervene HCY.Methods:Based on the investigation of 514 patients with HCY who filled in the "TCM Constitution Classification and Judgment Form",the basic information and laboratory examination indexes were collected to explore the correlation between TCM constitution distribution and risk factors.Results:Among 514 patients with HCY,the main constitution distribution included phlegm dampness(28.2%),blood stasis(17.1%),damp heat(14.8%),and yin deficiency(12.3%).The constitution distribution of males mainly included phlegm dampness(32.2%),blood stasis(16.9%),damp heat(14.2%),and qi deficiency(11.2%),while that of females mainly included phlegm dampness(23.9%),blood stasis(17.4%),damp heat(15.4%) and yin deficiency(14.6%).There were statistically significant differences in age,diastolic pressure and triacylglycerol levels among phlegm dampness constitution,blood stasis constitution,damp heat constitution and yin deficiency constitution(P<0.05).Among them,phlegm dampness constitution levels were higher than those of other three constitutions,and those of damp heat constitution were the lowest(P<0.05).The diastolic pressure of blood stasis constitution was higher than those of other three constitutions(P<0.05),and damp heat the triacylglycerol content of damp heat constitution was higher than those of other three constitutions(P<0.05).There was a significant correlation between HCY with blood stasis and drinking(P<0.05).There was a significant correlation between HCY with damp heat and hypertension(P<0.05).There was a significant correlation between HCY with with phlegm dampness and yin deficiency had a significant correlation with dyslipidemia(P<0.05).Conclusion:phlegm dampness,blood stasis,damp heat,and yin deficiency are the main constitution of HCY.There are differences in the distribution of constitution between men and women,and the risk factors related to different constitutions are also different.