作者：刘美之，王俊林，边爱忠，孙爱敏，安香珍

单位：

1.050011河北省石家庄市人民医院中医风湿骨病科　2.053500河北省衡水市，景县中医院中医科

Units：

1.Department of Rheumatology and Orthopedics in Traditional Chinese Medicine, Shijiazhuang People's Hospital,Shijiazhuang 050011, China2.Department of Traditional Chinese Medicine, Jingxian Traditional Chinese Medicine Hospital, Hengshui 053500, China

关键词：

高脂血症；通心络胶囊；痰湿体质；血脂；氧化应激

Keywords：

Hyperlipidemias; Tongxinluo capsule; Phlegm dampness constitution; Blood lipid; Oxidative stress

CLC：

R 589.2

DOI：

10.12114/j.issn.1008-5971.2023.00.273

Funds：

国家自然科学基金青年科学基金项目（81975477）；河北省重点研发计划项目（20377713D）；河北省中医药管理局科研计划项目（2022640）

摘要：

目的　分析高脂血症患者中医体质类型及通心络胶囊对痰湿体质者血脂、氧化应激的影响。方法　收集2021年8月至2022年8月景县中医院收治的高脂血症患者200例为研究对象，评价患者中医体质类型。选取痰湿体质高脂血症患者并采用随机数字表法将其分为痰湿体质对照组和痰湿体质试验组。痰湿体质对照组患者给予阿托伐他汀钙片口服，痰湿体质试验组患者在痰湿体质对照组基础上加用通心络胶囊口服，疗程均为4周。比较平和体质与痰湿体质高脂血症患者一般资料（性别、年龄、BMI）、血脂指标（TC、TG、LDL-C、HDL-C水平）及氧化应激指标〔丙二醛（MDA）含量、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）、过氧化氢酶（CAT）活性〕，比较痰湿体质对照组和痰湿体质试验组治疗前后血脂指标及氧化应激指标。结果 200例高脂血症患者中，痰湿体质55例（27.5%）（痰湿体质对照组27例，痰湿体质试验组28例），气虚体质40例（20.0%），血瘀体质34例（17.0%），阳虚体质19例（9.5%），阴虚体质17例（8.5%），湿热体质13例（6.5%），平和体质10例（5.0%），气郁体质8例（4.0%），特禀体质4例（2.0%）。痰湿体质高脂血症患者TC、TG、LDL-C、HDL-C水平高于平和体质高脂血症患者，SOD活性低于平和体质高脂血症患者（P＜0.05）。治疗后，痰湿体质试验组TC、TG、LDL-C水平低于痰湿体质对照组，HDL-C水平高于痰湿体质对照组（P＜0.05）。治疗后，痰湿体质试验组MDA含量低于痰湿体质对照组，SOD、GSH-Px、CAT活性高于痰湿体质对照组（P＜0.05）。结论　痰湿体质是高脂血症患者的主要中医体质类型，通心络胶囊可改善痰湿体质高脂血症患者的血脂及减轻其氧化应激。

Abstract：

Objective To explore the TCM constitution types of hyperlipidemia patients, and the effect of Tongxinluocapsule on blood lipids and oxidative stress in patients with phlegm dampness constitution. Methods A total of 200 patientswith hyperlipidemia admitted in Jingxian Traditional Chinese Medicine Hospital from August 2021 to August 2022 wereselected as the research subjects. TCM constitution types of patients were evaluated. Hyperlipidemia patients with phlegmdampness constitution were selected and divided into the phlegm dampness constitution control group and the phlegm dampnessconstitution experimental group by random number table method. The patients in the phlegm dampness constitution controlgroup were treated with atorvastatin calcium tablets, the patients in the phlegm dampness constitution experimental group weretreated with Tongxinluo capsules on the basis of the phlegm dampness constitution control group, with a treatment course of 4weeks. The general data (gender, age, BMI) , lipid indicators (TC, TG, LDL-C and HDL-C levels) and oxidative stress indicators[malondialdehyde (MDA) content, superoxide dismutase (SOD) , glutathione peroxidase (GSH-Px) , and catalase (CAT) activity]were compared between hyperlipidemia patients with peaceful constitution and phlegm dampness constitution, the lipid indicatorsand oxidative stress indicators were compared between the phlegm dampness constitution control group and the phlegm dampness constitution experimental group before and after treatment. Results Among 200 patients with hyperlipidemia, there were 55cases of phlegm dampness constitution (27.5%) (27 cases in the phlegm dampness constitution control group and 28 cases inthe phlegm dampness constitution experimental group) , 40 cases of Qi deficiency constitution (20.0%) , 34 cases of blood stasisconstitution (17.0%) , 19 cases of Yang deficiency constitution (9.5%) , 17 cases of Yin deficiency constitution (8.5%) , 13cases of damp heat constitution (6.5%) , 10 cases of peaceful constitution (5.0%) , 8 cases of Qi stagnation constitution (4.0%) ,and 4 cases of intrinsic constitution (2.0%) . The levels of TC, TG, LDL-C and HDL-C in hyperlipidemia patients with phlegmdampness constitution were higher than those in hyperlipidemia patients with peaceful constitution (P < 0.05) . After treatment,the levels of TC, TG and LDL-C in the phlegm dampness constitution experimental group were lower than those in the phlegmdampness constitution control group, and the HDL-C level was higher than that in the phlegm dampness constitution control group(P < 0.05) . After treatment, the MDA content in the phlegm dampness constitution experimental group was lower than that in thephlegm dampness constitution control group, while the activities of SOD, GSH-Px, and CAT were higher than those in the phlegmdampness constitution control group (P < 0.05) . Conclusion Phlegm dampness constitution is the main type of TCM constitutionin patients with hyperlipidemia. Tongxinluo capsule can improve the blood lipids and reduce oxidative stress of hyperlipidemiapatients with phlegm dampness constitution.

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