痰瘀舌象在高脂血症中医诊断治疗中的应用价值  

Phlegm and Blood Stasis Tongue in TCM Diagnosis of Hyperlipidemia

作　　者：丰胜利[1] 张学智[1] 张月苗[1] 刘宇[1] 

机构地区：[1]北京大学第一医院中西医结合科,北京100034

出　　处：《辽宁中医杂志》2016年第12期2536-2538,共3页Liaoning Journal of Traditional Chinese Medicine

基　　金：北京市中医药科技发展专项基金资助项目(JJ201454)

摘　　要：目的:评价痰瘀舌象在高脂血症中医诊断治疗中的应用价值。方法:151例高脂血症患者按中医舌象辨证分为痰浊舌象组、血瘀舌象组、气血不足舌象组,比较3组的一般资料(年龄、病程、体重指数)、血脂四项、颈动脉超声的变化;另对83例门诊具有痰浊或/和血瘀舌象高脂血症患者采用自拟调脂饮治疗,观察其治疗效果。结果:在舌象辨证中痰浊舌象及血瘀舌象组占多数(73%)。一般资料痰浊舌象组发病年龄相对年轻,病程最短;而虚证舌象组年龄最大,病程最长;血瘀舌象组在两者之间。进一步实验室指标观察痰浊舌象组以胆固醇(TC)、甘油三酯(TG)升高,尤以TG升高为主(P<0.01);血瘀舌象组表现在低密度脂蛋白(LDL-C)及TC升高为主(P<0.01);而虚证舌象组高密度脂蛋白(HDL-C)明显降低(P<0.01),血瘀舌象组和虚证舌象组颈动脉粥样斑块及内膜增厚的发生率均明显增高(P<0.05)。对83例具有痰浊或/和血瘀舌象高脂血症患者采用自拟调脂饮治疗,患者TC、LDL-C、TG均明显下降(P<0.01),但HDL-C无明显变化。结论:痰瘀舌象在高脂血症中医诊断及治疗中具有重要的临床应用价值。Objective：To investigate the value of phlegm and blood stasis tongue in the diagnosis and treatment of hyperlipidemia with traditional Chinese medicine （TCM）. Methods：A total of 151 cases of outpatients with hyperlipidemia were divided into 3 groups ： phlegm tongue group, blood stasis tongue group and deficiency of blood and Qi tongue group, according to the principle af TCM syndrome differentiation. The differences among the three groups, including the general information （ age, disease duration, body mass index, etc. ）, blood lipids [ total cholesterol （ TC）, triglycerides （ TG）, high - density lipoprotein cholesterol （ HDL -C） and low- density lipoprotein cholesterol（ LDL -C） ] and carotid ultrasound were observed. Eighty -three hyperlipidemia patients with both phlegm and blood stasis tongue were treated with self - designed Tiaozhi Drink to descend the turbid Qi, reduce phlegm and eliminate blood stasis. The changes of their blood lipids before and after the treatment were observed. Results ： Among all types of hyperlipidemia patients, phlegm and blood stasis tongue group took the highest proportion （73%） and the phlegm syndrome tongue group had the lowest average age, the shortest course of disease and the highest body mass index （P 〈 0. 01 ）. Ob- servation of the blood lipids and carotid artery ultrasound showed that phlegm syndrome tongue group elevated TC and TG,especially the TG （P 〈0.01 ） ,while in blood stasis syndrome tongue group,LDL - C and TC increased prominently （P 〈0. 01 ） and in the deficiency syndrome tongue group, HDL - C decreased significantly （ P 〈 0. 01 ）. The incidence of carotid artery intima - media thickness and plaque increased significantly in both blood stasis tongue group and deficiency tongue group （ P 〈 0. 05 ）. The application of self - designed Taozhi Drink significantly lowered TG, TC and LDL - C levels in the 83 cases of hyperlipidemia patients with both phlegm and blood stasis syndrome tongue （P 〈 0. 05

关 键 词：痰瘀证 舌诊 高脂血症 中医诊断治疗 

分 类 号：R589.2[医药卫生—内分泌]