冠心病病人血脂改变与中医证型关系的临床研究

目的探讨冠心病病人血脂改变与中医证型的关系,为临床治疗提供指导。方法通过冠状动脉造影术（CAG）,观察冠心病病人血脂改变情况与中医证型、CAG结果之间的关系。结果总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）等脂代谢异常指标在痰、瘀证中有不同程度升高;高密度脂蛋白（HDL）则相反,在痰、瘀证中有不同程度降低;其中痰瘀相兼证与非痰非瘀证之间差异有统计学意义（P〈0.05）。TC、TG、LDL及载脂蛋白（a）[Lp（a）]的水平随着冠状动脉狭窄程度的加重而增高,且重度狭窄与轻度狭窄比较有统计学意义（P〈0.05）;各组间HDL水平随冠状动脉狭窄的加重而降低,重度狭窄与轻度狭窄比较亦有统计学意义（P〈0.05）。单支病变、双支病变、多支病变病人TC、TG逐渐升高,但各组间差异无统计学意义（P〉0.05）;LDL逐渐升高,多支病变与单支病变、双支病变比较有统计学意义（P〈0.05）,但单支病变、双支病变之间无统计学意义（P〉0.05）;HDL逐渐降低,各组间差异无统计学意义（P〉0.05）;不同病变支数之间Lp（a）差异有统计学意义（P〈0.05）。结论冠心病病人血脂改变与中医证型之间有一定关系。

Relationship between Blood Lipid Level and TCM Syndrome Types in Coronary Heart Disease

Objective To study the relationship between blood lipid level and traditional Chinese medicine（TCM） syndrome types in patients （pts） with coronary heart disease（CHD）.Methods Three hundreds and six-eight pts with CHD diagnosed by coronary angiography （CAG） were collected,and the blood lipid were observed.The TCM syndromes were divided into 4 types.The relations between the blood lipids,TCM syndrome types,and CAG in pts with CHD were analyzed.Results The levels of total cholesterol（TC）,triglyceride（TG）,and low density lipoprotein （LDL） in pts with phlegm syndrome and stasis syndrome were increased while the levels of high density lipoprotein（HDL） were reduced.There were obvious difference in phlegm and blood stasis syndrome and non-phlegm non-stasis syndrome（P0.05）.The levels of TC,TG,LDL and apolipoprotein（a） were increased with the increase of severity of coronary artery stenosis,and there were statistical difference in severe stenosis compared with mild stenosis（P0.05）.The levels of TC and TG were elevated gradually in pts with single vessel disease,two vessel disease,and multi-vessel disease,but there were no significant difference （P0.05）.The levels of LDL was elevated gradually,multi-vessel disease has statistical significant difference compared with single vessel disease and two vessel disease（P0.05）.The levels of HDL were reduced gradually.The levels of apolipoprotein（a） in pts with single vessel disease,two vessel disease and multi-vessel disease were obviously different（P0.05） Conclusion The blood lipids had some relations with TCM syndrome types in pts with CHD.