代谢综合征颈动脉内中膜增厚的中医证型和相关因素分析  

Analysis of Traditional Chinese Medicine Syndrome Types and Related Factors of Carotid Intima-Media Thickening in Metabolic Syndrome

作　　者：徐帅 陈恂 卞昊宇 赵玉清 张立平[1] XU Shuai;CHEN Xun;BIAN Haoyu;ZHAO Yuqing;ZHANG Liping(Beijing University of Chinese Medicine,Beijing 100029,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院西苑医院,北京100091

出　　处：《中医药学报》2023年第12期74-79,共6页Acta Chinese Medicine and Pharmacology

基　　金：国家自然科学基金项目(81273695);北京市自然科学基金项目(7212181);北京中医药大学重点攻关项目(2020-JYB-ZDGG-138)。

摘　　要：目的:通过对代谢综合征(MS)伴颈动脉内-中膜(CIMT)增厚患者的回顾性分析,探讨其中医证型特点及相关因素。方法:选取北京中医药大学东方医院于2020年1月—2021年12月收治的319例MS患者为研究对象,对患者的临床资料数据进行统计分析,总结患者的中医证候分布规律。结果:319例患者中年龄60岁以上人群患病率最高,60岁之前男性患者多于女性,60岁之后女性患病率明显上升且高于男性。MS伴CIMT增厚以形成斑块人数最多,不同年龄段间的动脉硬化分级存在差异。MS患者以肝郁脾虚证为主要证型,其他依次为气阴两虚证、痰瘀互结证、气滞湿阻证、脾肾两虚证,与颈动脉硬化分级、年龄、吸烟、BMI、血压、SOD相关(P<0.05)。结论:MS伴CIMT增厚患者以中老年女性为主。年轻且病程较短的患者以肝郁脾虚、气滞湿阻为主要证型,随着疾病进展会出现气阴两虚、痰瘀互结、脾肾两虚。证型分布与年龄、吸烟、体质量指数、血压、SOD较为密切,应密切关注,积极干预。To investigate the characteristics of traditional Chinese medicine(TCM)syndrome types and related factors of metabolic syndrome(MS)accompanied by thickening of the carotid intima media(CIMT)through a retrospective analysis of patients with this disease.Methods:319 MS patients admitted to Dongfang Hospital of Beijing University of Chinese Medicine from January 2020 to December 2021 were selected as research subjects.The clinical data of these patients were analyzed statistically,and the distribution rules of TCM syndromes were summarized.Results:Among 319 patients,the highest prevalence was found in those over 60 years old.More men than women have the disease before the age of 60,while after the age of 60,the prevalence rate of women increased significantly and was higher than that of men.The number of MS with CIMT thickening to form plaque was the most,and the grading of arteriosclerosis was different among different age groups.The main syndrome in MS patients was liver depression and spleen deficiency,followed by syndromes of dual deficiency of qi and yin,phlegm-stasis combination,qi stagnation and damp obstruction,dual deficiency of spleen and kidney,which were correlated with carotid atherosclerosis grade,age,smoking,BMI,blood pressure and SOD(P<0.05).Conclusion:The majority of MS patients with CIMT thickening were middle-aged and elderly women.Liver depression and spleen deficiency,qi stagnation and damp obstruction are the main syndromes in young patients with a short course of disease.As the disease progresses,syndromes of dual deficiency of qi and yin,phlegm-stasis combination,dual deficiency of spleen and kidney appear.The distribution of syndromes was closely related to age,smoking,body mass index,blood pressure and SOD,which should be positively intervened.

关 键 词：代谢综合征 颈动脉内-中膜增厚 中医证型 肝郁脾虚 

分 类 号：R255.4[医药卫生—中医内科学]