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冠心病“痰瘀”证素特征的临床研究(PDF)

《云南中医学院学报》[ISSN:1000-2723/CN:53-1048/R]

期数:
2011年01期
页码:
3-7
栏目:
中医基础理论
出版日期:
2011-02-01

文章信息/Info

Title:
Clinical Study of the Characteristics of the Phlegm and Blood Stasis Syndrome Element on Coronary Heart Disease
作者:
袁肇凯黄献平王丽萍王萍王东生陈清华
湖南中医药大学,湖南长沙410007
Author(s):
YUAN Zhao-kaiHUANG Xian-pingWANG Li-pingWANG PingWANG Dong-shengCHEN Qing-hua
Hunan University of TCM,Changsha Hunan 410007
关键词:
冠心病血瘀证血脂血液流变学血糖胰岛素敏感性指数基因
Keywords:
coronary heart diseaseblood stasis syndromeblood-fatblood rheologyblood glucoseinsulin sensitivity index
分类号:
中图分类号:R2562文献标志码:A
DOI:
-
文献标识码:
A
摘要:
目的:探讨冠心病由“痰凝”至“痰瘀”病性证素变化对冠心病形成的影响。方法:对冠心病痰瘀痹阻证组120例、痰凝心脉证组98例、非痰非瘀证组92例、健康人对照组30例进行血脂、血液流变学、血糖、胰岛素敏感性指数及相关基因表达的检测分析。结果: 冠心病血脂痰凝心脉证组与非痰非瘀证组、正常组均有显著差异(P<001);由非痰非瘀证→痰凝心脉证→痰瘀痹阻证血液流变学各项指标均增加;FINS、ISI值呈健康对照<非痰非瘀证组<痰凝心脉证组<痰瘀痹阻证组递进趋势(均P<001);由非痰非瘀→痰凝心脉→痰瘀痹阻的病理演变中,患者c-myc mRNA和PDGF-AmRNA的表达量均逐渐增加。结论:痰瘀痹阻证血液流变学指标均显著高于非痰非瘀证、痰凝心脉证,提示血液流变学异常是血脉瘀阻的客观指证;IR可能是产生“痰瘀”并由“痰”到“瘀”演变的重要内在生化物质基础;IR与冠状动脉脉病变严重程度呈正相关,提示IR可作为预测冠心病严重程度的参考指标之一;冠心病“痰瘀”证素变化的分子机制与c-myc、PDGF-AmRNA异常表达有关。
Abstract:
Objective:To investigate the effects on coronary heart disease(CHD)for the syndrome element change of the nature of disease from“the Phlegm”to“the Phlegm and Blood Stasis”.Methods:To detect the blood-fat,blood rheology,blood glucose, insulin sensitivity index(ISI)and the expression of related genes from 120 CHD patients with syndrome of blockage of phlegm and blood stasis(Group 1),98 CHD patients with syndrome of stagnation of phlegm in blood vessel(Group 2),92 CHD patients with syndrome of non phlegm and non blood stasis(Group 3)and 30 healthy persons for control group(Controlgroup).Results:Group 2 have significant differences compared with Group 3 and Control group(P<001).All indexs of blood rheology have gradual increase from Group 3,Group 2 to Group 1.Similarly,FINS(Fasting blood insulin)and ISI both have a increased tendency from Control group,Group 3,Group 2 to Group 1 too(P<001).In the process of pathologic evolution,from Group 3, Group 2 to Group 1, the expression amount of c-myc mRNA and PDGF-A mRNA have progressive increase.Conclusion:First,the abnormality of blood rheology is the objective index of stagnation of blood vessel.Second,IR is the important inner biochemistry basic,which produces“the Phlegm and Blood Stasis”,also develops“the Phlegm”to“the Blood Stasis”.Third,there is a positive correlation between IR and pathological changesdegree of coronary artery,which indicates that IR can be used as a indication to predict CHD.Last,the changes of the Phlegm and Blood Stasis syndrome element of CHD relates to abnormal expression of c-myc,PDGF-A mRNA.

参考文献/References

[1]卢化平,张衡达.痰浊瘀血与动脉粥样硬化.欧明.冠心病证治与现代研究[M].青岛:青岛出版社,1994:289-292.
[2]宋剑南.从生物化学角度看痰及痰瘀相关[J].中国中西医结合杂志,2000,6(3):42-43.
[3]贝政平.内科疾病诊断标准[M].北京:科学出版社,2001:49-53.
[4]沈绍功,王承德,闫希军.中医心病诊断疗效标准与用药规范[M].北京:北京出版社,2002:1-179.
[5]李光伟,潘孝红,stephen Lillioja,等.检测人群胰岛素敏感性的一项新指数[J].中华内科杂志,1993,32(10):656-660.
[6]萨姆布鲁克著,金冬雁等译.分子克隆实验指南[M].第二版,北京:科学出版社,1998:343-451.
[7]卢圣栋.现代分子生物学实验技术[M].北京:高等教育出版社,1993:95-154.
[8]鲍军,楼建国,赵永祥,等.54例冠心病血脂15年动态观察及中医辨证治疗相关研究[J]. 中西医结合杂志,1999,(4):206-208.
[9]程小曲.痰浊型冠心病与血脂、脂蛋白、载脂蛋白的关系及疾浊形成机理的探讨[J].新中医,1994,(3):7-9.
[10]朱晓岚,郴免昌,崔志英,等.冠心病中医辨证与甲皱微循环和血液流变学之间的相关性探讨[J].第一军医大学学报,1990,(3):225-227.
[11]黄文权.冠心病气滞血瘀等证型与血粘度等客观指标的相关性探讨[J].实用中西医结合杂志,1990,(5):307-309.
[12]Fujiwara R,Kutsumi Y,Hayashi T,et al. Relation of angiographically definde coronary artery disease and plasma concentrations of insulin,lipid,Lipid ,an apolipoprotein in normolipidemic subjects with varying degrees of glucose tolrance.Am J cardiol,1995,75:122-126.
[13]Shinozak:K,Suzuki M, Ikebuchi M,et al Domonstration of insulin resistance in coronary artery disease documented with angiography,Diabetes Care,1996,19:1-5.
[14]胡兆霆,杨钧国,何勇,等.冠心病患者胰岛素抵抗与血脂、载脂蛋白异常的关系[J].临床心血管病杂志,2000,16(9):387-389.
[15]史卫国,渠莉,王津文,等.葛根素干预冠心病患者胰岛素抵抗的研究[J].中国中西医结合杂志,2002,22(1):21-24.
[16]蔡琳,刘汉雄,燕纯伯,等.胰岛素抵抗与冠状动脉狭窄严重程度的关系[J].中华心血管病杂志,2001,29(9):538-541.
[17]Taubman MR, Rollins RJ,Poon M, ea al. JE mRNA accumulates rapidly in aortic injury and in platelet-Derived growth factor-stimulated vascular smooth muscle cells, Circulation,1992,70:314-317.
[18]Coswami PC, Albee LD, Spitz DR, et al. A Polymerase chain reaction assay for simultaneous detection and quantitation of proto-oncogene and GAPD mRNAS in d:fferent cell growth rates. Cell prolif,1997,30:271-282.
[19]汤键,周爱儒.原癌基因与心血管疾病[M].北京:北京医科大学.中国协和医科大学联合出版社,1990:165-170.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(NO:30973717)收稿日期:2010—11—20作者简介:袁肇凯,男,湖南长沙人,教授,博士生导师,兼职全国高等中医教育研究会中医诊断研究会主任委员,中国中西医结合学会四诊专业委员会副主任委员,中华中医药学会中医诊断学分会委员,全国病理生理学会中医专业委员会委员,享受政府特殊津贴专家,国家级优秀教师,主要研究方向:心病证候本质研究。
更新日期/Last Update: 2011-04-29