冠心病不稳定性心绞痛患者气滞血瘀证和气虚血瘀证的生物学基础比较分析  

Comparative Analysis on the Biological Basis of Blood Stasis Syndrome Induced by Qi-stagnation and Qi-deficiency in Patients with Unstable Angina Pectoris

作　　者：任建勋[1,2] 刘建勋[1] 林成仁[1] 苗阳[1] 陈可远[1] 

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京市中西医结合医院,北京100039

出　　处：《中国中西医结合杂志》2010年第4期352-356,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家重大科技专项经费资助项目(重大新药创制No.2009ZX09502-017);国家自然科学基金重点项目(No.30830118)

摘　　要：目的比较分析临床冠心病不稳定性心绞痛气病致瘀病机演化中不同证候分型的客观特征。方法对冠心病不稳定性心绞痛病机变化属气病致瘀的78名受试者进行气滞血瘀与气虚血瘀辨证分组,并从血压、糖脂代谢、凝血功能、甲状腺功能以及炎症反应变化等方面对气病致瘀不同证候类型进行比较分析。结果在冠心病气病致瘀的病理过程中,气滞血瘀证患者发病年龄、糖化血红蛋白、促甲状腺激素(TSH)、凝血酶原时间、活化部分凝血活酶时间的变化与气虚血瘀证患者比较,差异有统计学意义(P<0.05)。相对于健康受试者,气病致瘀患者肿瘤坏死因子(TNF)α-、层粘连蛋白(LN)表达明显升高(P<0.05),分泌型免疫球蛋白A(sIgA)降低。结论机体的炎性免疫反应可能在血瘀证的病理环节中起重要作用。而由情绪应急刺激引起的下丘脑、垂体、外周激素分泌功能紊乱可能是气滞血瘀证的本质所在。Objective To comparatively analyse the objective characteristics of different syndrome types of qi-disturbance-induced blood stasis syndrome（QDBS） in the pathogenetic evolution of unstable angina coronary heart disease（UA-CHD）.Methods Seventy-eight patients with UA-CHD of QDBS were differentiated into 2 groups： 55 in the qi-deficiency-induced blood-stasis syndrome group（A） and 23 in the qi-stagnation-induced blood-stasis syndrome group（B）.The comparative analysis on them was carried out through comparing their blood pressure,glucose and lipid metabolisms,coagulation function,thyroid function and inflammation reaction changes,etc.Results In the pathogenetic process of qi-disturbance induced blood stasis,the initiating age,levels of HbA1c,TSH,PT and APTT between the two groups were significantly different（P〈0.05）.Levels of TNF-α and LN were higher and levels of sIgA lower in patients than those in healthy subjects（P〈0.05）.Conclusions Inflammation immune reaction may play an important role in the pathogenetic process of blood-stasis syndrome,and the functional disturbance of hypothalamus,pituitary and endocrinal secretion induced by emotional stress is possibly the essence of qi-stagnation induced blood stasis syndrome.

关 键 词：冠心病 气虚血瘀证 气滞血瘀证 生物学基础 临床研究 

分 类 号：R259[医药卫生—中西医结合]