冠心病痰瘀互结证与炎症生物学指标相关性探讨  

Correlation between coronary heart disease with intermingled phlegm-blood stasis syndrome and inflammatory related factors

作　　者：柏冬[1] 胡镜清[2] 马雅銮[3] 陶旭光[3] 陈冰[3] 

机构地区：[1]中国中医科学院中医基础理论研究所方证研究中心,北京100700 [2]中国中医科学院中医基础理论研究所 [3]中国中医科学院中医基础理论研究所生物化学研究室,北京100700

出　　处：《环球中医药》2015年第6期658-662,共5页Global Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)(2014CB542903);国家中医药管理局2013年中医药行业科研专项(201307003);中国中医科学院基本科研业务费自主选题(YZ-1425)

摘　　要：痰瘀互结证是冠心病的主要证候类型。在冠心病发生、发展的全过程中都伴随着炎症反应。既往研究表明,以下13个炎症相关指标与冠心病痰瘀互结证存在一定相关性。分别是:C反应蛋白、同型半胱氨酸、细胞因子(TNF-α、IL-6、IL-18、MMPS、MCP-1、M-CSF)、免疫细胞膜分子(CD4\CD4L、PS\PSL、ICAM-1)和脂蛋白(Apo A-Ⅰ、α1-AT)。其中已被公认为冠心病独立危险因素的C反应蛋白、同型半胱氨酸研究证据最多。另外,冠心病患者血中大部分炎症因子水平随着非痰瘀证→痰证/瘀证→痰瘀互结证依次升高,提示痰瘀互结证患者较其他证候炎症程度增高。这些指标有助于痰瘀互结证的客观评估。Intermingled phlegm-blood stasis syndrome is one of the main syndromes in coronary heart disease（ CHD） with inflammation accompanying CHD throughout the whole process. Previous studies indicated that CHD with intermingled phlegm-blood stasis syndrome correlated to 13 inflammatory factors.These 13 factors are C-reactive protein（ CRP）,homocysteinaemia（ HCY）,tumor necrosis factor-α（ TNF-α）,interleukin-6（ IL-6）,interleukin-18（ IL-18）,matrix metalloproteinases（ MMPs）,monocyte chemoattractant protein-1（ MCP-1）,intercellular adhesion molecule-1（ ICAM-1）,macrophage colony stimulating factor（ M-CSF）,CD40 / CD40 L,PS / PSGL1,Apo A-Ⅰ,and α1-AT. Among them,CRP and HCY,which have widely been considered the independent risk factors of CHD,were more related to CHD with intermingled phlegm-blood stasis syndrome compared with other inflammatory factors. Besides,the serum levels of inflammatory factors in patients with intermingled phlegm-blood stasis syndrome were higher than those with phlegm syndrome or blood stasis syndrome alone,while patients with non-intermingled phlegmblood stasis syndrome revealed the lowest serum levels of inflammatory factors. This result showed that patients with intermingled phlegm-blood stasis syndrome had higher level of inflammation than other types of syndrome. The findings may be of help for objective indicators of intermingled phlegm-blood stasis syndrome.

关 键 词：冠心病 痰瘀互结证 炎症 

分 类 号：R541.4[医药卫生—心血管疾病]