冠心病心绞痛患者血浆同型半胱氨酸水平与 中医证候要素痰、瘀的回归性研究

目的 研究冠心病心绞痛患者血浆同型半胱氨酸水平与中医证候要素痰、瘀的回归性。方法 收集冠心病心绞痛患者共227例，检测血浆同型半胱氨酸，采集四诊信息并按中医证候要素痰、瘀进行辨证积分分类，并对四组指标采用2×2析因分析及线性回归分析。结果 冠心病患者各证候要素组间Hcy水平依次为:痰瘀互结组＞血瘀组＞痰浊组＞无痰无瘀组；以Hcy为应变量，痰证积分（≥20部分）为自变量做一元线性回归可知，冠心病患者血浆Hcy水平与痰证积分≥20的部分呈线性相关；以Hcy为应变量，瘀证积分为自变量做一元线性回归可知，冠心病患者血浆Hcy水平与瘀证积分成线性相关，即瘀证积分越高，Hcy水平越高。结论 Hcy水平与中医证素“痰”“瘀”皆存在线性相关，Hcy可作为评估冠心病患者“痰”证严重程度的客观化指标，并可作为中医冠心病中医“瘀”证辨证的客观化指标。

A Regression Study of Plasma Homocysteine Level and Phlegm and Blood Stasis in Patients with Angina Pectoris of Coronary Heart Disease

Abstract:Objective To do the regression study on plasma homocysteine level and TCM syndrome factors phlegm and blood stasis in patients with coronary heart disease and angina pectoris.Methods 227 patients with angina pectoris of coronary heart disease were collected, plasma homocysteine was detected,the information of four diagnoses was collected and made a dialectical score classification according to phlegm and blood stasis of TCM syndromes,and 2×2 factorial analysis and linear regression analysis were used for the four groups of indexes.Results The levels of Hcy among the syndromes of patients with coronary heart disease were as follows:phlegm and blood stasis group>blood stasis group>phlegm turbidity group>no phlegm and blood stasis group.Taking Hcy as the dependent variable and the integral of phlegm syndrome(≥20 parts)as independent variables,we made a linear regression analysis,the plasma Hcy level in patients with coronary heart disease is linearly related to the level of phlegm syndrome score≥20.Taking Hcy as the dependent variable and the integral of stasis syndrome as independent variable,we made a linear regression analysis.The plasma Hcy level in patients with coronary heart disease is linearly related to the integral of stasis syndrome,that is,the higher the stasis syndrome score is,the higher the Hcy level is.Conclusion The level of Hcy is linearly related to the TCM syndrome"phlegm"and "blood stasis".Hcy can be used as an objective index to evaluate the severity of phlegm syndrome in patients with coronary heart disease,and can be used as an objective index for syndrome differentiation of TCM"stasis"syndrome of coronary heart disease.