冠心病中医辨证分型与胰岛素抵抗关系的初步研究

作者	单位
毛威	浙江大学医学院附属第一医院心内科
叶武	浙江省中医院心内科
刘强	浙江省中医院心内科
黄兆铨	浙江省中医院心内科
陈申杰	浙江省中医院心内科
秦南屏	浙江省中医院心内科

摘要点击次数: 1297

全文下载次数: 1626

中文摘要:

目的 :观察冠心病 (CHD)中医辨证分型与胰岛素抵抗 (ISR)的关系。方法 :将 5 0例CHD患者辨证分为心血瘀阻、痰浊壅塞和气阴两虚 3型 ,测定 3型患者的空腹血糖 (FBG)、胰岛素 (Ins)浓度和胰岛素抗体 (IAA)、胰岛细胞抗体 (ICA)、谷氨酸脱羧酶抗体 (GAD Ab)及相关的血脂指标 ,计算胰岛素敏感性指数 (ISI) ,并与 2 0名健康对照组的相应指标进行比较。结果 :CHD组FBG、Ins浓度较健康对照组升高 (P <0 0 5 ) ,ISI较健康对照组降低 (P <0 0 1) ,IAA阳性率 (4 0 % )较健康对照组 (5 % )升高 (P <0 0 1) ;心血瘀阻和痰浊壅塞两型的ISI较健康对照组和气阴两虚型降低 (均P <0 0 1) ,IAA阳性率 (5 0 % ,4 7 37% )则较健康对照组 (5 % )和气阴两虚型 (15 38% )增高 (P <0 0 5 ,P <0 0 1) ,而Ins浓度仅在心血瘀阻型增高 (P <0 0 5 ) ;此外 ,CHD及心血瘀阻和痰浊壅塞两型患者同时伴有不同程度的脂质代谢紊乱。结论 :部分CHD患者存在ISR ,且主要与心血瘀阻和痰浊壅塞两型有关 ,其原因部分系血清中存在的IAA所致。

英文摘要:

Objective: To observe the relationsbip between TCM Syndrome type and insulin resistance (ISR) in coronary heart disease (CHD). Methods: Fifty patients were divided into 3 groups according to the Syndrome Differentiation typing in TCM, the Heart blood stasis (HBS) Syndrome group, the Phlegm Turbid stagnation (PTS) Syndrome group and both Qi Yin Deficiency (QYD) Syndrome group. The fasting blood glucose (FBG), fasting blood insulin (Ins), insulin antibody (IAA), islet cell antibody (ICA), glutamic acid decarboxylase antibody (GAD Ab) and related blood lipid parameters in patients were determined and insulin sensitive index (ISI) was calculated simultaneously. Then the above mentioned data were compared with those determined in 20 healthy control subjects. Results: The levels of FBG and Ins in CHD group were higher than those in healthy control group significantly (P<0 05), but ISI level was obviously lower (P<0 01). Moreover, the positive ratio of IAA (40%) was higher in CHD group than that in the control group (5%) significantly (P<0 01). Comparison between the 3 TCM Syndrome type groups and the control group showed that ISI level in HBS and PTS group was obviously lower than that in the control and the QYD (P<0 05) respectively, and the IAA positive ratio in the former 2 groups (50%, 47.37%) was higher than that in the later two (5%,P<0 01 and 15.38%, P<0 05) markedly. While Ins level increased only in the HBS group (P<0 05). Besides, patients of HBS and PTS were accompanied by lipid metabolic disturbance. Conclusion: ISR presents in part of CHD patients particularly in those with HBS and PTS, which was partly due to the existance of IAA in patients serum.

关闭