本文選題：中醫(yī)證型　切入點(diǎn)：冠心病　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：本研究通過對心血瘀阻、痰阻心脈型胸痹心痛患者行基因測序,觀察MTHFR基因多態(tài)性,分析這兩組證型與MTHFR基因型的相關(guān)性及其在不同基因型中的分布情況,并進(jìn)一步探討中醫(yī)證型、MTHFR基因多態(tài)性對不穩(wěn)定型心絞痛預(yù)后的評估作用。方法：采取前瞻性的調(diào)查研究方法,根據(jù)不穩(wěn)定型心絞痛診斷標(biāo)準(zhǔn),選擇2015年3月至2015年10月期間在南京中醫(yī)藥大學(xué)附屬醫(yī)院(江蘇省中醫(yī)院)心血管內(nèi)科住院行MTHFR基因測序的患者,符合不穩(wěn)定型心絞痛西醫(yī)診斷標(biāo)準(zhǔn)、中醫(yī)辨證屬胸痹心血瘀阻、痰阻心脈,且自愿參加本臨床研究者,總的例數(shù)確定為209例。收集一般資料及出院半年后隨訪的不良心血管事件(MACE)等相關(guān)資料,建立數(shù)據(jù)庫,應(yīng)用SPSS19.0統(tǒng)計(jì)軟件,分析胸痹心血瘀阻、痰阻心脈型與MTHFR基因型之間的相關(guān)性。結(jié)果：1.209例患者中心血瘀阻型為98例,其中基因型為CC者40例,CT者46例,TT者12例；痰阻心脈型為111例,其中基因型為CC者27例,CT者64例,TT者20例。2.胸痹心血瘀阻、痰阻心脈型與血漿同型半胱氨酸水平、MTHFR基因型均具有相關(guān)性(P0.05),MTHFR基因型與血漿同型半胱氨酸水平顯著相關(guān)(P0.01)。3.兩組中醫(yī)證型在CC基因型中的分布有統(tǒng)計(jì)學(xué)差異(P0.05)；兩組中醫(yī)證型在CT、TT基因型中的分布均沒有統(tǒng)計(jì)學(xué)差異(P0.05)。4.本次研究未得出兩組中醫(yī)證型、MTHFR基因型、血漿同型半胱氨酸水平是MACE事件的獨(dú)立相關(guān)因素(P0.05)。結(jié)論：胸痹心血瘀阻、痰阻心脈證型與MTHFR基因型具有相關(guān)性。兩組中醫(yī)證型中,CC基因型更傾向于在心血瘀阻證中表達(dá),CT, TT基因型在兩組中醫(yī)證型中的表達(dá)沒有統(tǒng)計(jì)學(xué)差異。而兩組中醫(yī)證型、MTHFR基因型、血漿同型半胱氨酸水平尚不能夠用于評估短期內(nèi)心血管不良事件的發(fā)生率。
[Abstract]:Objective: to observe the polymorphism of MTHFR gene in patients with heart blood stasis, phlegm obstruction and heart dysmenia, and to analyze the relationship between MTHFR genotype and syndromes in these two groups and their distribution in different genotypes. To further explore the role of MTHFR gene polymorphism in evaluating the prognosis of unstable angina pectoris. Methods: according to the diagnostic criteria of unstable angina pectoris, a prospective investigation method was adopted. Patients with MTHFR gene sequencing were selected from March 2015 to October 2015 in the Department of Cardiovascular Medicine, affiliated Hospital of Nanjing University of traditional Chinese Medicine (Jiangsu Provincial Hospital of traditional Chinese Medicine). The patients met the diagnostic criteria of Western medicine for unstable angina pectoris. Traditional Chinese medicine syndrome differentiation belongs to chest obstruction of heart and blood stasis, phlegm blocking heart vein, and volunteered to participate in this clinical researcher. The total number of cases is 209 cases. Collecting general information and adverse cardiovascular events such as MACEE after half a year of discharge from hospital, and so on, the database was established. SPSS19.0 statistical software was used to analyze the relationship between heart blood stasis, phlegm obstruction and MTHFR genotype. Results 98 cases of heart blood stasis type were found in 1.209 cases, of which 40 cases were CC and 46 cases were TT. There were 111 cases of phlegm blocking heart vein type, including 27 cases with CC genotype, 64 cases with CT and 20 cases with TT. 2. There was a significant correlation between the MTHFR genotype and the plasma homocysteine level. There was a significant correlation between the MTHFR genotype and the plasma homocysteine level. There was no statistical difference in the distribution of TCM syndromes in CTGTT genotypes. 4. The two groups of TCM syndromes were not found to be MTHFR genotypes in this study. Plasma homocysteine level is an independent related factor of MACE events. There was no significant difference in the expression of TT genotype between the two groups, but there was no significant difference in the expression of TT genotype between the two groups. Plasma homocysteine levels are not yet available to assess the incidence of adverse cardiovascular events in the short term.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R256.22

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