血脂異常中醫(yī)證候和2型糖尿病周圍血管病變相關(guān)性的初步探討
發(fā)布時間：2018-12-29 10:24
【摘要】：目的:對220例血脂異�；颊卟v進行回顧性分析,初步探討血脂異常的中醫(yī)證型分布規(guī)律。對其中130例血脂異常合并2型糖尿病周圍血管病變患者,初步分析其血脂、載脂蛋白、CRP等理化因素與頸動脈粥樣硬化的相關(guān)性,以及各中醫(yī)證型中血脂等理化因素與頸總動脈內(nèi)中膜厚度、Crouse斑塊積分的相關(guān)性,探討血脂異常與2型糖尿病周圍血管病變的關(guān)系。為中醫(yī)臨床治療血脂異常和防治2型糖尿病周圍血管病變提供參考。方法:采集患者信息,運用統(tǒng)計學(xué)方法對采集數(shù)據(jù)進行分析,明確血脂異常的各個指標(biāo)與CIMT、Crouse斑塊積分和斑塊等級積分的相關(guān)性,以及這種相關(guān)性在各個中醫(yī)證型中的分布情況。所有數(shù)據(jù)均使用SPSS19.0統(tǒng)計軟件分析。結(jié)果:1.220例血脂異�；颊咧醒惓５闹獣月蕛H為18.63%。2.220例血脂異�；颊咧�,患病人群集中在51-70歲年齡段。3.220例血脂異�；颊吒鱾�中醫(yī)證型中,TG平均水平:脾腎陽虛證組氣滯血瘀證組,痰濁阻遏證組氣滯血瘀證組;TC/HDL-C平均水平:痰濁阻遏證組陰虛陽亢證組。4.130例血脂異常合并2型糖尿病周圍血管病變患者中,TC、LDL-C、TC/HDL-C、Lp(a)與CIMT正相關(guān),HDL-C、ApoA/B與CIMT負相關(guān),ApoB與CIMT、斑塊等級積分正相關(guān),Lp(a)與Crouse斑塊積分正相關(guān)。年齡與Crouse斑塊積分、斑塊等級積分正相關(guān),Hb A1c與斑塊等級積分正相關(guān)。5.130例血脂異常合并2型糖尿病周圍血管病變患者五個中醫(yī)證型中,痰濁阻遏證TC/HDL-C、Lp(a)與CIMT、Crouse斑塊積分正相關(guān);肝腎陰虛證ApoA/B與CIMT負相關(guān);陰虛陽亢證TC、ApoA與Crouse斑塊積分正相關(guān);氣滯血瘀證TC/HDL-C、ApoB與CIMT正相關(guān),LDL-C、ApoB與Crouse斑塊積分正相關(guān)。結(jié)論:1.血脂異�；颊叩闹獣月瘦^低,中老年人群發(fā)病率高。2.血脂異常合并2型糖尿病周圍血管病變患者,年齡、TC、LDL-C、TC/HDL-C、ApoB、Lp(a)、HbA1c水平升高是發(fā)生糖尿病周圍血管病變的危險因素,HDL-C、ApoA/B水平升高是糖尿病周圍血管病變的保護性因素。3.痰濁阻遏型血脂異�；颊�,當(dāng)其合并2型糖尿病時,尤其要關(guān)注TC/HDL-C比值和Lp(a)水平,當(dāng)TC/HDL-C比值升高時,則患者出現(xiàn)糖尿病周圍血管病變的風(fēng)險將增加,Lp(a)與糖尿病周圍血管病變的嚴重程度正相關(guān)。肝腎陰虛型血脂異常患者,當(dāng)其合并2型糖尿病時,其糖尿病周圍血管病變的發(fā)生率隨ApoA/B的升高而降低。陰虛陽亢型血脂異常患者,當(dāng)其合并2型糖尿病時,其糖尿病周圍血管病變的嚴重程度隨TC、ApoA的增加而增加。氣滯血瘀型血脂異�；颊�,當(dāng)其合并2型糖尿病時,其糖尿病周圍血管病變的發(fā)生率與TC/HDL-C比值、ApoB成正相關(guān),LDL-C、ApoB與糖尿病周圍血管病變的嚴重程度成正相關(guān)。
[Abstract]:Objective: to analyze the medical records of 220 patients with dyslipidemia and to explore the distribution of TCM syndromes of dyslipidemia. Among them, 130 cases of dyslipidemia complicated with peripheral vascular disease of type 2 diabetes mellitus were studied. The correlation between the physical and chemical factors such as blood lipid, apolipoprotein, CRP and carotid atherosclerosis was analyzed. The relationship between blood lipids in TCM syndromes and intima media thickness of common carotid artery and plaque score of Crouse was also discussed in order to explore the relationship between dyslipidemia and vascular lesions around type 2 diabetes mellitus. To provide a reference for the clinical treatment of dyslipidemia and the prevention and treatment of type 2 diabetic peripheral vascular disease. Methods: to collect the patient information and analyze the collected data by statistical method to determine the correlation between the indexes of dyslipidemia and CIMT,Crouse plaque score and plaque grade score. And the distribution of this correlation in each TCM syndrome type. All data were analyzed by SPSS19.0 statistical software. Results: among 1.220 patients with dyslipidemia, the awareness rate of dyslipidemia was only 18.63.2.220 cases of dyslipidemia. The patients were concentrated in the age group of 51 to 70 years old. 3.220 cases of dyslipidemia patients had different TCM syndromes. TG average level: spleen and kidney yang deficiency syndrome group qi stagnation and blood stasis syndrome group, phlegm and turbid repressor syndrome group Qi stagnation blood stasis syndrome group; TC/HDL-C mean level: phlegm turbid repressor syndrome group yin deficiency and yang hyperactivity syndrome group. 4.130 cases of dyslipidemia with type 2 diabetic peripheral vascular disease patients, TC,LDL-C,TC/HDL-C,Lp (a) and CIMT positive correlation, HDL-C, ApoA/B was negatively correlated with CIMT, ApoB was positively correlated with CIMT, plaque grade score, Lp (a) was positively correlated with Crouse plaque score. Age was positively correlated with Crouse plaque score and plaque grade score, and Hb A1c was positively correlated with plaque grade score. 5.130 patients with dyslipidemia and peripheral vascular disease of type 2 diabetes mellitus had five TCM syndromes, phlegm turbid repressor syndrome TC/HDL-C, There was a positive correlation between Lp (a) and plaque score of CIMT,Crouse. There was a negative correlation between ApoA/B and CIMT in liver and kidney yin deficiency syndrome, a positive correlation between TC,ApoA and Crouse plaque score in yin deficiency and yang hyperactivity syndrome, a positive correlation between TC/HDL-C,ApoB and CIMT in Qi stagnation and blood stasis syndrome, and a positive correlation between LDL-C,ApoB and Crouse plaque score. Conclusion: 1. The awareness rate of dyslipidemia patients is low, the incidence of middle and old people is high. 2. 2. Age and TC,LDL-C,TC/HDL-C,ApoB,Lp (a), HbA1c were risk factors in patients with dyslipidemia and type 2 diabetic perivascular disease. HDL-C, was a risk factor for diabetic peripheral vascular disease. Elevated ApoA/B level is a protective factor for diabetic peripheral vascular disease. When patients with type 2 diabetes complicated with type 2 diabetes, they should pay particular attention to the ratio of TC/HDL-C and the level of Lp (a). When the ratio of TC/HDL-C increased, the risk of peridiabetic vascular disease would increase. Lp (a) was positively correlated with the severity of peridiabetic vascular disease. The incidence of peripheral vascular lesions in patients with lipids abnormality of liver and kidney yin deficiency type 2 diabetes decreased with the increase of ApoA/B. The severity of peripheral vascular lesions in patients with hyperactivity of yin and yang was increased with the increase of TC,ApoA when they were complicated with type 2 diabetes. In patients with abnormal blood lipids with Qi stagnation and blood stasis, the incidence of peripheral vascular disease was positively correlated with the ratio of TC/HDL-C and ApoB, and that of LDL-C,ApoB was positively correlated with the severity of peripheral vascular disease in patients with type 2 diabetes.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
本文編號：2394718
[Abstract]:Objective: to analyze the medical records of 220 patients with dyslipidemia and to explore the distribution of TCM syndromes of dyslipidemia. Among them, 130 cases of dyslipidemia complicated with peripheral vascular disease of type 2 diabetes mellitus were studied. The correlation between the physical and chemical factors such as blood lipid, apolipoprotein, CRP and carotid atherosclerosis was analyzed. The relationship between blood lipids in TCM syndromes and intima media thickness of common carotid artery and plaque score of Crouse was also discussed in order to explore the relationship between dyslipidemia and vascular lesions around type 2 diabetes mellitus. To provide a reference for the clinical treatment of dyslipidemia and the prevention and treatment of type 2 diabetic peripheral vascular disease. Methods: to collect the patient information and analyze the collected data by statistical method to determine the correlation between the indexes of dyslipidemia and CIMT,Crouse plaque score and plaque grade score. And the distribution of this correlation in each TCM syndrome type. All data were analyzed by SPSS19.0 statistical software. Results: among 1.220 patients with dyslipidemia, the awareness rate of dyslipidemia was only 18.63.2.220 cases of dyslipidemia. The patients were concentrated in the age group of 51 to 70 years old. 3.220 cases of dyslipidemia patients had different TCM syndromes. TG average level: spleen and kidney yang deficiency syndrome group qi stagnation and blood stasis syndrome group, phlegm and turbid repressor syndrome group Qi stagnation blood stasis syndrome group; TC/HDL-C mean level: phlegm turbid repressor syndrome group yin deficiency and yang hyperactivity syndrome group. 4.130 cases of dyslipidemia with type 2 diabetic peripheral vascular disease patients, TC,LDL-C,TC/HDL-C,Lp (a) and CIMT positive correlation, HDL-C, ApoA/B was negatively correlated with CIMT, ApoB was positively correlated with CIMT, plaque grade score, Lp (a) was positively correlated with Crouse plaque score. Age was positively correlated with Crouse plaque score and plaque grade score, and Hb A1c was positively correlated with plaque grade score. 5.130 patients with dyslipidemia and peripheral vascular disease of type 2 diabetes mellitus had five TCM syndromes, phlegm turbid repressor syndrome TC/HDL-C, There was a positive correlation between Lp (a) and plaque score of CIMT,Crouse. There was a negative correlation between ApoA/B and CIMT in liver and kidney yin deficiency syndrome, a positive correlation between TC,ApoA and Crouse plaque score in yin deficiency and yang hyperactivity syndrome, a positive correlation between TC/HDL-C,ApoB and CIMT in Qi stagnation and blood stasis syndrome, and a positive correlation between LDL-C,ApoB and Crouse plaque score. Conclusion: 1. The awareness rate of dyslipidemia patients is low, the incidence of middle and old people is high. 2. 2. Age and TC,LDL-C,TC/HDL-C,ApoB,Lp (a), HbA1c were risk factors in patients with dyslipidemia and type 2 diabetic perivascular disease. HDL-C, was a risk factor for diabetic peripheral vascular disease. Elevated ApoA/B level is a protective factor for diabetic peripheral vascular disease. When patients with type 2 diabetes complicated with type 2 diabetes, they should pay particular attention to the ratio of TC/HDL-C and the level of Lp (a). When the ratio of TC/HDL-C increased, the risk of peridiabetic vascular disease would increase. Lp (a) was positively correlated with the severity of peridiabetic vascular disease. The incidence of peripheral vascular lesions in patients with lipids abnormality of liver and kidney yin deficiency type 2 diabetes decreased with the increase of ApoA/B. The severity of peripheral vascular lesions in patients with hyperactivity of yin and yang was increased with the increase of TC,ApoA when they were complicated with type 2 diabetes. In patients with abnormal blood lipids with Qi stagnation and blood stasis, the incidence of peripheral vascular disease was positively correlated with the ratio of TC/HDL-C and ApoB, and that of LDL-C,ApoB was positively correlated with the severity of peripheral vascular disease in patients with type 2 diabetes.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
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