發(fā)布時間：2018-06-30 17:52

  本文選題：同型半胱氨酸 + 體質(zhì)��； 參考：《北京中醫(yī)藥大學》2017年碩士論文

【摘要】：高同型半胱氨酸血癥(Hyperhomocysteinemia,HHcy)是指血液中經(jīng)過還原作用后生成的同型半胱氨酸(Homocysteinemia,Hcy)水平升高,超出血液正常水平的病癥。Hcy升高是心腦血管疾病、糖尿病及其并發(fā)癥、神經(jīng)系統(tǒng)疾病等發(fā)生發(fā)展的危險因子,而且Hcy升高可與其他危險因素協(xié)同作用于人體,促進疾病的發(fā)生與發(fā)展。西醫(yī)目前主要通過口服葉酸、B族維生素、甜菜堿等藥物治療高同型半胱氨酸血癥,但由于HHcy的致病因素復雜,這并不能治療所有的HHcy患者,中醫(yī)藥在治療HHcy上具有獨特的優(yōu)勢。中醫(yī)體質(zhì)學認為,體質(zhì)與疾病具有相關性,體質(zhì)基礎是許多疾病發(fā)生的"共同土壤",人群的體質(zhì)狀態(tài)決定是否發(fā)病及發(fā)病的傾向性,通過調(diào)整患者體質(zhì)能實現(xiàn)對疾病的防治,充分改善臨床癥狀,防止疾病的發(fā)生發(fā)展。目的:本課題擬探討北京市東城區(qū)社區(qū)高同型半胱氨酸血癥(HHcy)患者中醫(yī)體質(zhì)類型的分布情況及其與心腦血管危險因素的相關性。方法:本研究采用橫斷面研究方法,以中醫(yī)基本理論和王琦教授的中醫(yī)體質(zhì)學說為理論指導思想,參照2009年中華中醫(yī)藥學會《中醫(yī)體質(zhì)分類判定表》,對東城區(qū)社區(qū)人群進行中醫(yī)體質(zhì)調(diào)查,并進行基本資料的收集(性別、年齡、身高、體重、體重指數(shù)、腰圍、臀圍、腰臀比、吸煙史、飲酒史、既往史)及化驗檢查(Hcy、血脂、肌酐、尿酸、谷丙轉(zhuǎn)氨酶、血糖),研究HHcy患者中醫(yī)體質(zhì)類型的分布情況,以及與心腦血管危險因素的相關性。結(jié)果:本研究共收集了 485例HHcy患者:1、人口學特征性別分布上,男性205例,占42.27%,女性280例,占57.73%;年齡分布上,最小的40歲,最大的88歲,中位數(shù)為69歲,平均年齡為68.57歲。年齡分布集中在50～79歲之間,60～69、70～79歲最多,50歲以下最少。2、中醫(yī)體質(zhì)分布情況:平和質(zhì)206例(37.8%)、陰虛質(zhì)123例(22.6%)、氣虛質(zhì)71例(13%)、血瘀質(zhì)69例(12.7%)、陽虛質(zhì)61例(11.2%)、痰濕質(zhì)59例(10.8%)、濕熱質(zhì)28例(5.1%)、氣郁質(zhì)28例(5.1%)、特稟質(zhì)10例(1.8%);男性與女性在濕熱體質(zhì)存在差異(P=0.042)。3、各檢驗指標在不同中醫(yī)體質(zhì)間差異性比較:甘油三酯在痰濕質(zhì)和平和質(zhì)之間存在差異,痰濕質(zhì)患者中甘油三酯偏高者較多。4、各體質(zhì)與心腦血管疾病危險因素的相關性:HHcy患者中痰濕質(zhì)與體重指數(shù)呈正相關,痰濕質(zhì)與高密度脂蛋白呈負相關,氣虛質(zhì)、陽虛質(zhì)與年齡呈正相關,陽虛質(zhì)與吸煙呈負相關,血瘀質(zhì)與冠心病呈正相關。結(jié)論:本研究中HHcy患者的主要偏頗體質(zhì)有陰虛質(zhì)、氣虛質(zhì)、血瘀質(zhì)、陽虛質(zhì)、痰濕質(zhì)。甘油三酯在痰濕質(zhì)和平和質(zhì)之間存在差異,痰濕質(zhì)患者中甘油三酯偏高者較多。痰濕質(zhì)與體重指數(shù)、高密度脂蛋白有一定的相關性,氣虛質(zhì)、陽虛質(zhì)與年齡有一定的相關性,血瘀質(zhì)與冠心病有一定的相關性,對臨床診治有提示意義。
[Abstract]:Hyperhomocysteinemia (Hyperhomocysteinemia, HHcy) is the level of homocysteine (Homocysteinemia, Hcy) produced in the blood after reduction. The increase of.Hcy is a risk factor for cardiovascular disease, diabetes and its complication, nervous system disease, and Hcy, and Hcy The increase can cooperate with other risk factors in the human body to promote the occurrence and development of the disease. Western medicine is currently mainly using oral folic acid, B vitamins, betaine and other drugs to treat hyperhomocysteinemia, but because of the complicated pathogenic factors of HHcy, it can not treat all HHcy patients. Traditional Chinese Medicine is unique in the treatment of HHcy. The physique of traditional Chinese medicine holds that physique and disease have correlation, the physical basis is the "common soil" of many diseases. The constitution of the population determines whether the disease is prone to disease and the tendency of the disease. By adjusting the patient's physique, it can realize the prevention and cure of the disease, improve the symptoms of the bed and prevent the occurrence and development of the disease. To discuss the distribution of the type of physique of Chinese medicine in the patients with hyperhomocysteinemia (HHcy) in Dongcheng District community of Beijing and the correlation with the risk factors of cardiovascular and cerebrovascular diseases. Methods: This study adopted a cross-sectional study method, with the basic theory of Chinese medicine and Professor Wang Qi's theory of Chinese medicine as the theoretical guidance, referring to the Chinese traditional Chinese medicine in 2009. To investigate the constitution of the Chinese medical constitution, to investigate the constitution of Dongcheng District community, and to collect the basic data of Chinese medicine, and collect the basic data (sex, age, height, weight, body mass index, waist circumference, hip circumference, waist hip ratio, smoking history, drinking history, past History) and test (Hcy, blood lipid, creatinine, uric acid, alanine aminotransferase, blood sugar), and study the TCM body of HHcy patients The distribution of mass types and the correlation with cardiovascular risk factors. Results: 485 patients with HHcy were collected in this study: 1, the demographic characteristics of human sex, 205 men, 42.27%, 280 women, 57.73%, the minimum age 40, the maximum 88, the median of 69, and the average age of 68.57 years. Between 50~79 years of age, 60 ~ 69,70 to 79 years of age and under 50 years of age, the distribution of physique of traditional Chinese medicine: 206 cases (37.8%), 123 cases of yin deficiency (22.6%), 71 cases of qi deficiency (13%), 69 cases of blood stasis (12.7%), Yang deficiency and substance 61 cases (11.2%), moisture and heat quality cases, qi stagnation and qualitative cases There is a difference (P=0.042).3 in the damp heat constitution (P=0.042), and the difference of each test index in the physique of different Chinese medicine: there is a difference between the triglyceride in the phlegm and the quality of the dampness and the quality of the phlegm, the high triglyceride in the patients with phlegm dampness is more.4, and the correlation between the physical constitution and the risk factors of cardiovascular and cerebrovascular diseases: the phlegm and body mass index in the patients of HHcy Positive correlation, phlegm and HDL have negative correlation with high density lipoprotein, Qi deficiency, Yang deficiency and age have positive correlation, Yang deficiency is negatively related to smoking, blood stasis is positively related to coronary heart disease. Conclusion: the main bias constitution of HHcy patients in this study are yin deficiency, Qi deficiency, blood stasis, Yang deficiency, phlegm wet quality, and triglyceride in phlegm and wet quality and quality. There are many differences between the phlegm and the hypertriglycerides in the patients with phlegm and humid. There is a certain correlation between the phlegm wet quality and the body mass index, high density lipoprotein, Qi deficiency, Yang deficiency and age, and the correlation between the blood stasis and the coronary heart disease, which is suggestive of the clinical diagnosis and treatment.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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