胆石症中医证型与糖脂代谢及血钙水平的相关性研究

目的:研究胆石症(Cholelithiasis)患者中医不同证型与糖脂代谢以及血钙水平之间的相关性。方法:选择胆石症患者128例,其中中医辨证属肝胆湿热证54例,肝郁气滞证30例,瘀血阻滞证28例,胆腑郁热证16例。所有受试者均行肝胆B超、血钙、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LD-LC)、高密度脂蛋白(HDLC)、载脂蛋白A1(Apo-A1)、载脂蛋白B(Apo-B)、空腹血糖(FBS)等检查。结果:①胆石症患者的中医辨证分型中以肝胆湿热证为主,其次为肝郁气滞证、肝阴不足证,瘀血阻滞证最少;②胆石症糖脂代谢异常以肝胆湿热证最为明显;③胆石症四种中医证型血钙水平相互比较无明显差异(P>0.05)。结论:胆石症患者中医证型中以肝胆湿热证多见,湿热证患者糖脂代谢异常现象明显,湿热证与糖脂代谢/血钙等理化指标可作为胆石症易发因素的客观指标;糖脂代谢参与胆石症形成的病理生理过程,其水平可作为胆石症中医辨证分型辅助客观指标。

Cholelithiasis Syndromes and Glucose Metabolism,Lipid Metabolism,Blood Calcium Level of Correlation

Objective：Cholelithiasis in patients with different syndromes of traditional Chinese medicine and lipid metabolism and the correlation between the serum calcium level.Methods：To choose the 128 patients with cholelithiasis,in which TCM is a liver and gallbladder damp-heat syndrome in 54 cases,30 cases of qi stagnation,blood stasis evidence in 28 cases,biliary organs Yu heat of 16 cases.All subjects underwent B-bile,calcium,cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDLC）,high density lipoprotein（HDLC）,apolipoprotein A1（Apo-A1）,apolipoprotein B（Apo-B）,fasting blood glucose（FBS） and other tests.Results：Cholelithiasis in patients with syndrome differentiation type in the liver and gallbladder damp-heat syndrome,followed by the qi stagnation,liver and lack of evidence,blood stasis card minimum;Cholelithiasis,abnormal glucose and lipid metabolism in the liver and gallbladder damp-heat syndrome is most evident;Cholelithiasis four kinds of syndromes between serum calcium level was no significant difference（P0.05）.Conclusion：Syndromes in gallstone patients with liver and gallbladder damp-heat syndrome more common,damp abnormal glucose and lipid metabolism in patients with clear damp-heat syndrome and lipid metabolism / calcium and other physical and chemical indicators as a gallstone-prone elements of the objective indicators;glucose and lipid metabolism involved in the pathophysiology of gallstone formation,the level can be used as cholelithiasis TCM syndrome secondary objective indicators.