246例高脂血症患者不同证型客观指标特征研究

Study on Objective Indicator Characteristics of Different Syndrome Types in 246 Hyperlipidemia Patients

摘要: 目的：探讨高脂血症不同中医证型与症状体征和血脂指标的关联性，为中医辨证分型的客观化提供依据。方法：纳入246例高脂血症患者(男142例，女104例)，采集246例高脂血症患者的一般资料、症状体征和血脂指标，比较各证型组间指标特征的差异。结果：246例高脂血症患者最常见的症状体征条目为形体肥胖、倦怠乏力、便溏、失眠、腹胀，中医证型以痰湿阻遏证(28.05%)最为常见。脾肾阳虚证的TG明显高于痰湿阻遏证、阴虚阳亢证和气滞血瘀证(P < 0.05)，脾肾阳虚证的TC和明显高于痰湿阻遏证、肝肾阴虚证、阴虚阳亢证和气滞血瘀证(P < 0.05)。痰湿阻遏证的HDLC和LDL明显低于脾肾阳虚证(P < 0.05)，而Lp(a)、ApoA1、ApoB在几种证型没有明显差异(P > 0.05)。结论：不同中医证型在血脂指标上具有特异性，可为高脂血症证候分型标准化提供客观依据。

Abstract: Objective: To investigate the correlation between different Traditional Chinese Medicine (TCM) syndrome types and clinical manifestations/lipid profiles in hyperlipidemia patients, providing an objective basis for TCM syndrome differentiation. Methods: A total of 246 hyperlipidemia patients (142 males, 104 females) were enrolled. General information, clinical symptoms/signs, and lipid indicators were collected. Differences in characteristic indicators across syndrome groups were analyzed. Results: The most common clinical manifestations included obesity (body mass), fatigue, loose stools, insomnia, and abdominal distension. The predominant TCM syndrome type was phlegm-dampness obstruction syndrome (28.05%). Patients with spleen-kidney yang deficiency syndrome exhibited significantly higher TG levels than those with phlegm-dampness obstruction, yin deficiency with yang hyperactivity, and qi stagnation with blood stasis syndromes (P < 0.05). TC levels in spleen-kidney yang deficiency syndrome were markedly elevated compared to phlegm-dampness obstruction, liver-kidney yin deficiency, yin deficiency with yang hyperactivity, and qi stagnation with blood stasis syndromes (P < 0.05). HDL-C and LDL levels in phlegm-dampness obstruction syndrome were significantly lower than in spleen-kidney yang deficiency syndrome (P < 0.05). No significant differences were observed inLp(a), ApoA1, or ApoB across syndromes (P > 0.05). Conclusion: Distinct TCM syndrome types demonstrate specific lipid profile characteristics, which may serve as objective evidence for standardizing hyperlipidemia syndrome classification.