冠心病稳定期患者中医辨证与超敏C反应蛋白相关性研究

Relationship between Chinese Medicine Syndrome and Serum Level of High-sensitivity C-reactive Protein in Patients with Stable Coronary Heart Disease

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中文关键词: 冠心病中医辨证痰热毒超敏C反应蛋白

英文关键词:coronary heart disease Chinese medicine syndrome phlegm-heat toxin high-sensitivity C-reactive protein

基金项目:国家重点基础研究发展规划(973)项目(No.2006CB504803);国家自然科学基金课题(No.30672751)

作者	单位
郑峰	北京中医药大学
曲丹	北京中医药大学
徐浩	中日友好医院全国中西医结合心血管病中心
陈可冀	中国中医科学院西苑医院心血管病中心

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中文摘要:

目的探讨冠心病稳定期患者中医辨证与超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)的相关性。方法选择经冠脉造影确诊的冠心病且处于症状稳定期的患者346例,测定血清hs-CRP水平,在此基础上分析其中医辨证和血清hs-CRP水平的相关性。结果346例冠心病稳定期患者中,中医辨证以气虚血瘀证、阳虚血瘀证和气虚血瘀痰浊证多见,证候以血瘀证(324例,93.6%)、气虚证(189例,54.6%)、痰浊证(140例,40.5%)居多,各证候之间、复合证型之间hs-CRP水平比较,差异无统计学意义(P>0.05);但痰浊证中偏热组hs-CRP水平[(2.32±2.12)mg/L]明显高于偏寒组[(1.59±1.27)mg/L,P<0.05];血瘀证计分与hs-CRP水平未见明显相关性(Person相关系数为0.069,P=0.203)。结论冠心病稳定期患者中医辨证痰热证与hs-CRP水平升高关系密切;hs-CRP作为炎症标记物,可视作中医"毒"微观指标之一,本研究为"蕴热化毒"这一病机枢转提供了客观依据,值得深入研究。

英文摘要:

Objective To study the relationship between Chinese medicine syndrome and serum level of high-sensitivity C-reactive protein (hs-CRP) in patients with stable coronary heart disease (CHD). Methods Serum hs-CRP level was determined in 346 patients with stable CHD,whose diagnoses were confirmed by coronary angiography,and the correlation between patients′ syndrome and serum hs-CRP level was analyzed. Results In all the CHD patients enrolled,the most commonly encountered Chinese medicine complex syndromes were the qi deficiency and blood-stasis syndrome,the yang deficiency and blood-stasis syndrome,and the qi deficiency with blood-stasis and turbid phlegm syndrome;the dominant syndrome types were blood-stasis,qi deficiency and phlegm-turbidity,which revealed in 324 patients (93.6%),189 patients (54.6%) and 140 patients (40.5%),respectively. Comparisons of hs-CRP level between different complex syndromes and syndrome elements showed no significant difference (P>0.05). However,for patients with phlegm-turbidity syndrome,the hs-CRP level was much higher in patients tended to heat than in those tended to cold (2.23± 2.12 mg/L vs 1.59± 1.27 mg/L,P<0.05). Besides,the score of blood-stasis syndrome showed no correlation with hs-CRP level (Person correlation coefficient: 0.069,P=0.203). Conclusion The elevation of hs-CRP level is closely cor related with phlegm-heat syndrome in stable CHD patients. As an inflammatory biomarker,hs-CRP may be regarded as one of the microcosmic indices of toxin in Chinese medicine,which provides an objective evidence for the pathogenesis hinge of accumulated heat to transform toxin,so it is worthy of further study.

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