本文選題：中老年 + 原發(fā)性血脂異常��； 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討中老年原發(fā)性血脂異�；颊咧嗅t(yī)體質(zhì)分型特點(diǎn)及其與頸動(dòng)脈粥樣硬化的關(guān)系,篩選出存在頸動(dòng)脈粥樣硬化高危險(xiǎn)性的偏頗體質(zhì)類(lèi)型,為從中醫(yī)體質(zhì)角度預(yù)測(cè)、預(yù)防頸動(dòng)脈粥樣硬化的發(fā)生提供依據(jù)。方法:對(duì)160例符合中老年原發(fā)性血脂異常的診斷標(biāo)準(zhǔn)的患者,進(jìn)行中醫(yī)體質(zhì)及一般情況調(diào)查,根據(jù)《中醫(yī)體質(zhì)分類(lèi)及判定標(biāo)準(zhǔn)》判定體質(zhì)類(lèi)型,選取分布最多的三型體質(zhì)患者行頸動(dòng)脈血管超聲檢查,比較各型體質(zhì)一般情況、血脂指標(biāo)、頸動(dòng)脈內(nèi)-中膜厚度、頸動(dòng)脈粥樣硬化斑塊陽(yáng)性率、斑塊穩(wěn)定性、血管狹窄、血流動(dòng)力學(xué)情況,結(jié)果采用SPSS20軟件系統(tǒng)進(jìn)行數(shù)據(jù)分析。結(jié)果:1、160例中老年原發(fā)性血脂異�；颊咧�,痰濕質(zhì)(22%)最多,其次是氣虛質(zhì)(19%)、陽(yáng)虛質(zhì)(17.5%)、血瘀質(zhì)(14%),陰虛質(zhì)(12.5%)、平和質(zhì)(9%)、濕熱質(zhì)(5%)相對(duì)較少,氣郁質(zhì)(1%)、特稟質(zhì)(0%)人數(shù)最少。2、三型中老年原發(fā)性血脂異�；颊叻植甲疃嗟捏w質(zhì)中,痰濕質(zhì)人群頸動(dòng)脈內(nèi)-中膜厚度、頸動(dòng)脈粥樣硬化斑塊陽(yáng)性率均最高,且與氣虛質(zhì)、陽(yáng)虛質(zhì)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);痰濕質(zhì)血管狹窄率呈現(xiàn)高于其他體質(zhì)的趨勢(shì),且與陽(yáng)虛質(zhì)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);余體質(zhì)兩兩比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3、三型中醫(yī)體質(zhì)左側(cè)頸總動(dòng)脈PSV比較,差異有統(tǒng)計(jì)學(xué)意義,痰濕質(zhì)最低,且與氣虛質(zhì)、陽(yáng)虛質(zhì)比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);三型體質(zhì)右側(cè)頸總動(dòng)脈PSV比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);痰濕質(zhì)左側(cè)RI與陽(yáng)虛質(zhì)比較差異有統(tǒng)計(jì)學(xué)意義(P＜0.05),余體質(zhì)兩兩比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);痰濕質(zhì)右側(cè)RI與氣虛質(zhì)、陽(yáng)虛質(zhì)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),氣虛質(zhì)與陽(yáng)虛質(zhì)比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4、氣虛質(zhì)人群頸動(dòng)脈不穩(wěn)定斑塊檢出率最高,且與痰濕質(zhì)、陽(yáng)虛質(zhì)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);痰濕質(zhì)與陽(yáng)虛質(zhì)比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)5、三型體質(zhì)TC、HDL-C、LDL-C比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);就TC、H DL-C而言,痰濕質(zhì)與氣虛質(zhì)、陽(yáng)虛質(zhì)比較差異有統(tǒng)計(jì)學(xué)意義(P＜0.05),氣虛質(zhì)與陽(yáng)虛質(zhì)比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);就LDL-C而言,痰濕質(zhì)與陽(yáng)虛質(zhì)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),余體質(zhì)兩兩比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);三型體質(zhì)TG差異無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。結(jié)論:1、在中老年原發(fā)性血脂異�；颊咧�,偏頗體質(zhì)以痰濕質(zhì)、氣虛質(zhì)、陽(yáng)虛質(zhì)為主。2、痰濕體質(zhì)中老年原發(fā)性血脂異�；颊哳i動(dòng)脈內(nèi)-中膜增厚明顯,頸動(dòng)脈粥樣硬化斑塊陽(yáng)性率、血管狹窄及血流動(dòng)力學(xué)改變較其他體質(zhì)發(fā)生率高。3、氣虛質(zhì)中老年血脂異�；颊咭仔纬刹环�(wěn)定型斑塊,斑塊的嚴(yán)重程度高,易發(fā)生斑塊脫落導(dǎo)致動(dòng)脈梗塞的風(fēng)險(xiǎn)。4、痰濕質(zhì)人群可通過(guò)影響血脂代謝水平增加動(dòng)脈粥樣硬化的發(fā)病風(fēng)險(xiǎn)。
[Abstract]:Objective: to investigate the characteristics of TCM constitution classification and its relationship with carotid atherosclerosis in middle-aged and elderly patients with primary dyslipidemia, and to screen out the biased constitution types with high risk of carotid atherosclerosis, so as to predict the constitution of TCM from the point of view of TCM constitution. To provide evidence for prevention of carotid atherosclerosis. Methods: 160 patients with primary dyslipidemia in middle and old age were investigated with TCM constitution and general condition, and the types of constitution were determined according to the classification and judgement standard of TCM constitution. Carotid artery ultrasound was performed in the patients with the most distributed type III constitution. The general conditions of different types of constitution were compared, including blood lipid index, carotid intima-media thickness, carotid atherosclerotic plaque positive rate, plaque stability, vascular stenosis, carotid artery atherosclerotic plaque positive rate, carotid artery stenosis, carotid artery atherosclerotic plaque stability, carotid artery stenosis. The results were analyzed by SPSS20 software system. Results among the 1160 middle-aged and aged patients with primary dyslipidemia, phlegm and dampness were the most common, followed by Qi deficiency and Qi deficiency, Yang deficiency and 17.5T, blood stasis 14, Yin deficiency and 12.5U, calming and dampness, and dampness and heat, respectively) were relatively small, and the number of patients with dyslipidemia was 22%, followed by Qi deficiency (19 cases), Yang deficiency (17. 5%), blood stasis (14 cases), Yin deficiency (12. 5%). The number of patients with primary dyslipidemia of middle and old age was the highest in the group of phlegm and dampness. The positive rate of carotid artery intima-media thickness and carotid atherosclerotic plaque was the highest in the group of phlegm-wet substance, and the positive rate was higher than that of deficiency of qi. The difference of Yang deficiency was statistically significant (P 0.05), and the rate of phlegm wet vessel stenosis was higher than that of other physique. The difference was statistically significant compared with that of Yang deficiency (P 0.05), but not significant (P 0.05). The PSV of left common carotid artery in three types of TCM constitution was statistically significant, and the phlegm dampness was the lowest, and compared with Qi deficiency and Yang deficiency. The difference was statistically significant (P 0.05). The PSV of the right common carotid artery in the three types of constitution was compared. There was no significant difference in the left RI of phlegm and dampness (P < 0.05), but there was no significant difference between the remaining physique (P < 0.05), the right side of phlegm dampness (RI) and deficiency of qi (P < 0.05). The difference of Yang deficiency was statistically significant (P 0.05), but there was no significant difference between qi deficiency and yang deficiency (P 0.05). The detection rate of unstable plaque in carotid artery was the highest in the group of deficiency of qi, and it was also associated with phlegm and dampness. There were significant differences in Yang deficiency (P 0.05), phlegm wet (P 0.05) and yang deficiency (P 0.05). There was significant difference in LDL-C (P 0.05) between three types of constitution (TCU HDL-CU). In the case of TCH DL-C, phlegm wet and qi deficiency were not significant. The difference between Yang deficiency and Yang deficiency was statistically significant (P < 0.05), but there was no significant difference between Qi deficiency and Yang deficiency (P < 0.05); as far as LDL-C was concerned, There was significant difference between phlegm dampness and yang deficiency, but there was no significant difference in residual constitution (P 0.05) and no significant difference in TG in three types (P > 0.05). Conclusion in middle and old age patients with primary dyslipidemia, the partial physique is mainly phlegm dampness, qi deficiency, yang deficiency, and phlegm dampness constitution is obviously thickened in carotid artery in elderly patients with primary dyslipidemia. The positive rate of carotid atherosclerotic plaques, vascular stenosis and hemodynamic changes were higher than those of other physique. The senile patients with deficiency of qi were prone to form unstable plaques, and the severity of plaque was high. The risk of artery infarction caused by plaque shedding. 4. Phlegm dampness can increase the risk of atherosclerosis by affecting the level of lipid metabolism.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R259

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