2022 年第 9 期 第 17 卷

代谢综合征中医证型与其危险因素的相关性分析

Relationship between traditional Chinese medicine syndrome types and risk factors of metabolic syndrome

作者：董新禹1邹国良2韩宇博2韩艺1刘莉2

英文作者：Dong Xinyu1 Zou Guoliang2 Han Yubo2 Han Yi1 Liu Li2

单位：1黑龙江中医药大学，哈尔滨150040；2黑龙江中医药大学附属第一医院心血管科，哈尔滨150040

英文单位：1Heilongjiang University of Chinese Medicine Harbin 150040 China; 2Department of Cardiovascular First Affiliated Hospital Heilongjiang University of Chinese Medicine Harbin 150040 China

关键词：代谢综合征；中医证型；危险因素

英文关键词：Metabolicsyndrome;TraditionalChinesemedicinesyndrometypes;Riskfactors

• 摘要：

• 目的 分析代谢综合征（MS）中医证型与其危险因素的相关性。方法  收集2019年1月至2022年1月于黑龙江中医药大学附属第一医院就诊的350例MS患者的临床资料进行回顾性分析。根据中医辨证分型将患者分为痰瘀互结型组（95例）、气滞湿阻型组（87例）、气阴两虚型组（85例）和脾肾气虚型组（83例）。统计分析4种中医证型与人体参数指标、血压、糖脂代谢等指标之间的相关性。结果  气滞湿阻型组的腹围与体重指数高于痰瘀互结型组、气阴两虚型组、脾肾气虚型组［（99.6±3.4）cm比（92.4±6.5）、（95.6±7.3）、（90.5±2.8）cm，（29.1±4.8）kg/m2比（25.8±2.3）、（25.7±1.9）、（25.5±2.4）kg/m2］，差异均有统计学意义（均P＜0.05）。4组间收缩压、舒张压比较差异均无统计学意义（均P＞0.05）。痰瘀互结型组三酰甘油、低密度脂蛋白胆固醇（LDL-C）水平和三酰甘油/高密度脂蛋白胆固醇（HDL-C）比值明显高于其余3组，HDL-C水平低于其余3组，差异均有统计学意义（均P＜0.05）。气滞湿阻型组总胆固醇水平较高，与痰瘀互结型组、脾肾气虚型组比较，差异均有统计学意义（均P＜0.05）。气阴两虚型组空腹血糖、空腹胰岛素（FINS）、稳态模型胰岛素抵抗指数（HOMA-IR）水平高于其余3组，痰瘀互结型组三酰甘油-葡萄糖指数（TyG指数）高于其余3组，差异均有统计学意义（均P＜0.05）。结论 腹围、体重指数、总胆固醇是气滞湿阻型的危险因素，三酰甘油、HDL-C、LDL-C、TyG指数是痰瘀互结型的危险因素，空腹血糖、FINS、HOMA-IR则是气阴两虚型的危险因素，这些规律可为今后中医防治MS提供客观依据。

• Objective  To analyze the relationship between traditional Chinese medicine(TCM) syndrome types and risk factors of metabolic syndrome(MS). Methods  The clinical data of 350 patients with MS admitted to First Affiliated Hospital, Heilongjiang University of Chinese Medicine from January 2019 to January 2022 were collected and analyzed retrospectively. According to the TCM syndrome differentiation, patients were divided into phlegm and blood stasis type group(95 cases), Qi stagnation and dampness resistance type group(87 cases), Qi-Yin deficiency type group(85 cases), spleen-kidney Qi deficiency type group(83 cases). The relationship between four TCM syndrome types and human body parameters, blood pressure, glucose and lipid metabolism was statistical analyzed. Results  The levels of abdominal circumference and body mass index in the Qi stagnation and dampness resistance type group were higher than those in phlegm and blood stasis type group, Qi-Yin deficiency type group and spleen-kidney Qi deficiency type group［(99.6±3.4)cm vs (92.4±6.5), (95.6±7.3), (90.5±2.8)cm; (29.1±4.8)kg/m2 vs (25.8±2.3), (25.7±1.9), (25.5±2.4)kg/m2］(all P<0.05). There were no significant differences in systolic and diastolic blood pressure among the four groups(all P>0.05). The levels of triacylglycerol, low-density lipoprotein cholesterol(LDL-C) and triacylglycerol/high-density lipoprotein cholesterol(HDL-C) in phlegm and blood stasis type group were significantly higher than those in the other three groups, and the level of HDL-C was lower than that in the other three groups(all P<0.05). The level of total cholesterol in the Qi stagnation and dampness resistance type group was higher, and the difference was statistically significant compared with phlegm and blood stasis type group and spleen-kidney Qi deficiency type group(both P<0.05). The levels of fasting blood glucose, fasting insulin(FINS) and homeostasis model assessment of insulin resistance index(HOMA-IR) in Qi-Yin deficiency type group were higher than those in the other three groups, and the triacylglycerol glucose index(TyG index) in phlegm and blood stasis type group was higher than those in the other three groups(all P<0.05). Conclusions  Abdominal circumference, body mass index and total cholesterol are the risk factors of Qi stagnation and dampness resistance type, triacylglycerol, HDL-C, LDL-C and TyG index are the risk factors of phlegm and blood stasis type, and fasting blood glucose, FINS and HOMA-IR are the risk factors of Qi-Yin deficiency type. These rules provide objective basis for TCM prevention and treatment of MS in the future.