目的 比较研究古籍中治疗中风及胸痹共用化痰药物的共性及特性,分析其规律,为临床用药提供参考.方法 检索《本草纲目》《丹溪心法》等10本古籍中所有中风或胸痹医案中具有化痰功效的药物,采用列表对比的方法,最终找出中风与胸痹所用化痰药物的重合部分,分析对比,找出规律.结果 二者共用的化痰药物有:桔梗、远志、白附子、天南星、半夏、瓜蒌、石菖蒲、生姜、甘草、杏仁、厚朴、枳实、川贝母、橘红、乌头、雄黄、生白矾、陈皮,共18味.结论 中风及胸痹共用化痰药物中绝大部分属于辛温之品,性寒者亦有,其中性寒者可见于胸痹寒证,而在中风寒证中少见;部分还兼具治未病及调理气机的作用;这些药物涉及多种化痰方法,尚需辨证应用.在临床上治疗痰浊型中风及胸痹时可作为参考.

随着生活节奏的加快,失眠已经成为几乎人人都有过的体验,研究表明,我国失眠的发病率在人群中高达40％.失眠是指经常性入睡困难,或入睡时间不足,睡后易醒,醒后不易再睡,导致不能获得正常睡眠的病症.中医称之为“不寐”“不得眠”“目不暝”等.

目的 探讨中医治疗动脉粥样硬化性心脑血管疾病的用药规律.方法 检索中国知识资源总库(CNKI)和万方数据库,获取2007—2016年中医治疗冠状动脉粥样硬化性心脏病(简称冠心病)、动脉粥样硬化性脑梗死(简称脑梗死)相关文献,使用传承辅助平台(V 2.5)的关联分析法对中药处方进行数据挖掘.结果 筛选出符合纳入标准的文献354篇,经关联规则分析得出治疗冠心病使用频次高的中药是川芎、丹参、甘草,高频中药组合40条;治疗脑梗死频次高的中药是地龙、川芎、当归,高频中药组合107条.2组使用最多的组合均是川芎、当归.冠心病与脑梗死共同高频中药组合21条.结论 中医治疗动脉粥样硬化性心脑血管疾病多使用具有益气补血、活血化瘀、行气止痛、祛痰通络功效的中药.

随着生活水平的提高,我们会发现身边得糖尿病的人越来越多.那么究竟什么是糖尿病呢?糖尿病真的那么可怕吗? 糖尿病是一种全身性内分泌疾病.它的发病原理是体内胰岛素绝对或相对不足,或伴有外周组织对胰岛素不敏感,而引起糖、脂肪、蛋白质代谢的紊乱.最明显的特点是持续性高血糖,主要临床表现为血糖非正常升高、烦渴、多饮、多食、多尿、体重减轻、疲乏等.

动脉粥样硬化在早、中期可无明显症状,而一旦发病可能会导致严重后果,所以对于动脉粥样硬化,应及早检测、预防与治疗. 早预防,常吃这5类食物 谷类食物及粗粮:这些食物中含有大量的膳食纤维,可以促进体内血脂和脂蛋白的代谢,降低血脂浓度和血液粘稠度.

?代谢综合征青睐"苹果型"身材 长久以来,在许多人的观念里,代谢综合征都是胖人的专利,瘦人不会得代谢综合征.事实上,并非所有的胖人会得代谢综合征,瘦人也可能患有代谢综合征. 脂肪堆积的部位有所不同,其危险级别也不同,根据脂肪堆积部位的不同,将肥胖形态分为均匀型肥胖和腹型肥胖.也称为全身性肥胖和向心性肥胖.全身性肥胖脂肪主要堆积在四肢及皮下,向心性肥胖脂肪主要堆积在腹部或躯干部,其中沉积在腹腔内的脂肪又称为内脏脂肪,主要堆积在肝脏、胰腺、胃肠道等器官的周围和内部,内脏脂肪堆积所致的腹型肥胖是代谢异常及胰岛素抵抗最主要的病理生理特征.

Objective To explore the distribution rules of TCM syndrome elements of atherosclerotic cardiovascular diseases.Methods Based on retrospective study, 148 patients who were diagnosed coronary atherosclerotic cardiopathy (CAD) and atherothrombotic cerebral infarction (ATCI)in Dongzhimen Hospital (Jan.2014-Oct.2015) were collected.All the case data were input into computer.SPSS 20.0 software was used to analyze the data and figure out the difference between CAD and ATCI.Results The distribution difference of location element of pattern heart, liver, lung, and nature element of pattern qi stagnation, blood stasis, yang deficiency in both groups were significant (P<0.05).The pattern element frequency of heart, lung, qi stagnation, blood stasis and yang deficiency of CAD were higher than ATCI (P<0.05).Pattern element frequency of liver in ATCI group was higher than CAD patients (P<0.05).The pattern element, chest and diaphragm only appeared in CAD group, while channels and collateral, the wind syndrome appered only in ATCI group.Conclusion There are similarities and differences between coronary atherosclerotic induced heart disease and cerebral infarction.Through analyzing their syndrome regularities could guide clinic.

Objective To explore the distribution rules of TCM syndromes and pattern elements of atherosclerotic cardiovascular diseases.Methods After searching China National Knowledge Infrastruc-ture (CNKI),Wanfang Data and VIP from 2004 to 2013,the literature of coronary atherosclerotic cardi-opathy (CAD)and atherothrombotic cerebral infarction (ATCI)linked to TCM patterns was obtained. From the literature,the raw data quantized were input into computer.Each pattern type was recorded, and from which syndrome elements were extracted.Then the frequency and rate of syndrome type and pattern elements were calculated using SPSS 20.0 Software.Results Altogether 346 articles were eligible and 64810 cases were included.The common syndrome types in both CAD and ATCI were qi deficiency and blood stasis,intermingling of phlegm and blood stasis,qi deficiency,blood stasis,obstruc-tion of phlegm-turbidity,and the common pattern elements were phlegm-turbidity,blood stasis,toxic heat,yang hyperactivity,qi deficiency and yin deficiency,but the distributions of syndrome types or pattern elements in CAD or ATCI were significantly different using Chi-square test.The rate of syndrome of qi deficiency and blood stasis in patients with ATCI was higher than those in patients with CAD (P <0.05),while the rates of syndromes of intermingling of phlegm and blood stasis,qi deficiency,blood stasis,obstruction of phlegm-turbidity in patients with CAD were higher than those in patients with ATCI (P <0.05).The rates of blood stasis,qi deficiency and yin deficiency in CAD were higher than those in ATCI(P <0.05 ),and the rates of phlegm-tuibidity,toxic heat and yang hyperactivity in ATCI were higher than those in CAD (P <0.05 ).The pattern elements of qi stagnation,yang deficiency and congealing of cold were only found in patients with CAD,while the pattern element of wind were only in ATCI.Conclusion The differences and similarities of distribution of syndrome types and pattern elements evolved in cardiac and cerebrovascular diseases due to atherosclerosis,can guide the treatment of different diseases with the same method.

目的 采用系统聚类分析的统计学方法,探讨卒中后抑郁(Post-Stroke Depression,PSD)的中医证候分布规律.方法 对诊断为卒中后抑郁的200例患者的一般资料及中医四诊信息进行调查,使用SPSS 19.0对中医四诊资料进行频数统计和系统聚类分析.结果 卒中后抑郁患者的中医证候分为气虚痰瘀证、肝郁脾虚证、心脾两虚证、肝肾阴虚证、肝郁化火证5类.结论 卒中后抑郁的证候类型不完全等同于单纯的中风或郁证.运用聚类分析的统计学方法,可以对卒中后抑郁进行合理的证候分类.

Objective Observe whether there is an effect of body mass index (MBI) to all ambulatory blood pressure indicators and circadian rhythm of hypertension patients. Methods Ambulatory blood pressure monitoring in 160 cases of patients with high blood pressure, and to measure the height and weight, calculate body mass index. Results Overweight, obese group mean systolic blood pressure, mean arterial pressure, average pulse pressure are higher than that of non overweight group (the difference is statistically significant);overweight, obese and non overweight group in distribution of four ambulatory blood pressure rhythm type has remarkable difference. Conclusion Body mass index can be increased in hypertensive patients with systolic blood pressure, arterial blood pressure, and pulse pressure, meanwhile, it has effects on hypertension ambulatory blood pressure rhythm.

目的 观察高血压患者在不同的体重指数(BMI)组,动态血压表现为不同昼夜节律时,其中医证候特点.方法 测量160例高血压患者的身高、体重,计算BMI并据此分为超重组和非超重组,采用24 h动态血压检测技术进行动态血压监测,分别观察并统计分析全部病例动态血压节律类型、中医证候分型的分布情况.结果 高血压患者动态血压昼夜节律类型不同,中医证候分型分布有显著性差异.肝火亢盛者多表现为杓型,痰瘀内阻者多表现为非杓型.超重组多见痰瘀内阻,非超重组多见肝火亢盛.结论 高血压患者BMI、动态血压节律类型与中医证候分型相关.

Objective To analyse the distribution characteristics of constitutional types and relationship between TCM constitutional types and indexes of blood fat in the patients with primary dyslipidemia.Methods The general materials and indexes of blood fat were collected from 122 patients.All patients were divided into 9 constitutional types by applying Professor WANG Qi ' s method of constitutional classification,and then the data was calculated by using SPSS 18.0 software.Results The constitutional types were mainly qi-deficiency constitution in 122 patients(61.48%),and other types were phlegm-dampness constitution,yin-deficiency constitution,qi-depression constitution and yang-deficiency constitution.In male patients the constitutional types were mainly qi-deficiency constitution,phlegm-dampness constitution,yin-deficiency constitution and damp-heat constitution and in female ones,were mainly qi-deficiency constitution,phlegm-dampness constitution yin-deficiency constitution and qi-depression constitution.The level of low-density lipoprotein-cholesterol(LDL-C) was positively correlated to qi-deficiency constitution and yang-deficiency constitution,and the level of apolipoprotein A1(ApoA1) was negatively correlated to qi-depression constitution.Conclusion Qi-deficiency constitution is the most common constitutional type in the patients with primary dyslipidemia,and constitutional types are correlated to indexes of blood fat.

Objective To analyze the distribution laws of TCM syndrome factors of primary dyslipidemia and type 2 diabetes complicating dyslipidemia,and clinical distribution characteristics of indexes of blood fat.Methods The information of TCM four examinations were collected from the patients with primary dyslipidemia(primary group) and patients with type 2 diabetes complicating dyslipidemia(diabetes group,each n=100).The changes of total cholesterol(TC),triglyceride(TG),low-density lipoprotein-cholesterol(LDL-C) and high-density lipoprotein-cholesterol(HDL-C) were observed.After the data were treated,the syndrome factors from results of factor analysis were studied.The indexes of blood fat were compared and the distribution characteristics were reviewed in two groups.Results The disease locations mainly included spleen,liver and kidney,and especially spleen in the primary group and kidney in the diabetes group.The syndrome factors of disease nature included dampness,phlegm,qi stagnation,blood stasis,heat,qi deficiency,yin deficiency and yang deficiency,and especially dampness,phlegm and blood stasis in the primary group,and yin deficiency and qi deficiency in the diabetes group.The levels of TC,TG,HDL-C and LDL-C were significantly different(P0.05) between two groups.Conclusion ①The TCM syndrome factors of primary dyslipidemia are mainly spleen,liver,kidney,phlegm,dampness,qi stagnation and blood stasis.The therapies are soothing liver and fortifying spleen,resolving phlegm and dispelling dampness,activating blood circulation and regulating qi assisted by replenishing liver and kidney.The TCM syndrome factors of type 2 diabetes complicating dyslipidemia are mainly kidney,liver,spleen,yin deficiency and qi deficiency.The therapies are nourishing liver and kidney,replenishing qi and nourishing yin assisted by resolving phlegm and dispelling dampness.②The increase of TC and LDL-C are mainly changes in primary dyslipidemia,and the increase of TG and decrease of HDL-C are mainly changes in type 2 diabetes complicating dyslipidemia.

Objective To investigate the distribution laws of TCM constitutions,and study the correlation between TCM constitutions and blood fat indexes.Methods The patients with type 2 diabetes combined with hyperlipidemia (n=100) were selected and their constitutional types were decided according to the TCM Constitution Classification and Judgement and the distribution of constitutional types was observed.The blood fat indexes,body mass index (BMI) and waist hip ratio (WHR) were compared,and the correlation between BMI,HbA1c and blood fat indexes was observed in the patients with different constitutional types through detecting total cholesterol (TC),triglyceride (TG),low-density lipoprotein-cholesterol (LDL-C),high-density lipoprotein-cholesterol (HDL-C),apolipoprotein A1 (ApoA1),apolipoprotein B (ApoB),HbA1c,BMI and WHR.Results Among 100 patients,14.0% of them with normal constitution,22.0% with qi-deficiency constitution,16.0% with yang-deficiency constitution,24.0% with yin-deficiency constitution,7.0% with blood-stasis constitution,10.0% with phlegm-damp constitution,5.0% with damp-heat constitution,2.0% with qi-depression constitution,and 0.0% with special constitution.The mean value of TC and LDL-C was the highest in the patients with damp-heat constitution having statistical significance compared with those with normal constitution (P0.05).WHR increased in the patients with phlegm-damp constitution compared with that in the patients with normal constitution (P0.05).The levels of HDL-C and ApoA1 decreased in the overweight group and obesity group compared with the normal group (P0.05).The level of TG increased in the group with good HbA1c and the group with poor HbA1c compared with the group with ideal HbA1c (P0.05).Conclusion The constitutional types are mainly yin-deficiency constitution and qi-deficiency constitution in the patients with type 2 diabetes combined with hyperlipidemia.The levels of TC and LDL-C are the highest in the patients with damp-heat constitution.

Objective To investigate the distribution laws of TCM syndromes of type 2 diabetic dyslipidemia,and correlation between TCM syndromes and blood-lipid changes.Methods The general materials and TCM syndromes in 60 patients with type 2 diabetic dyslipidemia were recorded and the values of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C) were recorded too.Results Among 60 patients 21 with turbid phlegm obstruction syndrome,2 with spleen-kidney yang deficiency syndrome,17 with dual deficiency of qi and yin syndrome,8 with yin deficiency with yang hyperactivity syndrome,5 with qi stagnation and collateral stasis syndrome,and 7 without distinguishing syndromes.In patients with different syndrome types the values of TC,TG,LDL-C and HDL-C had no significant difference.There was a significant difference in weight index between the group of dual deficiency of qi and yin syndrome and group of turbid phlegm obstruction syndrome.There was a significant difference in the numbers of male and female patients with descending HDL-C.Conclusion In the constituent ratio of all syndrome types the proportion of turbid phlegm obstruction syndrome was the highest(35%),and that of spleen-kidney yang deficiency syndrome was the lowest(3.3%).The body index was the highest in the group of turbid phlegm obstruction syndrome and lowest in the group of dual deficiency of qi and yin syndrome.The numbers of male patients with descending HDL-C were higher than those of female patients.

目的 探讨载脂蛋白E(ApoE)基因多态性对高脂血症痰瘀证患者血脂水平及药物调脂疗效的影响.方法 将206例高脂血症痰瘀证患者随机分为试验组和对照组,运用聚合酶链式反应--限制性片段长度多态性技术(PCR-RFLP)检测和分析其ApoE基因分型,同时检测其基线血脂水平,试验组给予益气活血化痰之调脂通脉颗粒治疗,对照组给予血脂康胶囊治疗,4周后再次检测其血脂水平.结果 206例患者基线血脂低密度脂蛋白胆固醇(LDL-C)水平,按照ApoE3/4>E3/3>E2/3的规律逐渐降低,3种基因型比较差异有统计学意义(P<0.01).试验组ApoE3/4基因型患者与ApoE2/3、ApoE3/3基因型患者比较,LDL-C降低改善率最高(P<0.01),ApoE2/3基因型患者与ApoE3/3、ApoE3/4基因型患者比较,高密度脂蛋白胆固醇(HDL-C)升高改善率最大(P<0.05).对照组血脂改善率,3种基因型比较差异无统计学意义(P>0.05).结论 ApoE基因多态性影响高脂血症痰瘀证患者基线血脂水平,并对高脂血症痰瘀证患者所采取的益气活血化痰法调脂治疗反应存在差异.

本课题拟通过初步观察老年性骨量减少和骨质疏松症(OP)的证候特征并比较其异同点,探讨老年性骨量减少至OP的证候演变规律.寻找可引起骨量减少进而引起骨质疏松和骨折的危险证候.为老年性OP的早期干预治疗提供证候学方面的依据.

Objective:To investigate the e ect of apolipoprotein E gene polymorphism on plasma lipid levels of phlegm-blood-stasis syndrome of hyperlipemia.Methods:The genotype of 206 patients with phlegm-blood-stasis of hyperlipemia was detected by the method of PCR-RFLP and the relationship between apolipoprotein E gene polymorphism and the level of total cholesterolTC,triglycerideTG,low density lipoprotein cholesterol(LDL-L) and high density lipoprotein cholesterol(HDL-C)was anaylized.Results The level of low density lipoprotein cholesterol(LDL-L) among the di erent apolipoprotein E genotypes in patients with phlegm-blood-stasis syndrome of hyperlipemia has extremely signi cant di erence(P0.01,P=0.0046) by compare.The regularity is E3/4 E3/3 E2/3.The highest is E3/4 and the lowest is E2/3.The level of total cholesterol TC,triglyceride TGand high density lipoprotein cholesterol(HDL-C) has no signi cant di erence.Conclusion:Apolipoprotein E gene polymorphism in uence on plasma lipids level of hyperlipemia and the LDL-L level of phlegm-blood-stasis syndrome in E4 genotype obsviously heightens.E4 genotype may be one of the main predisposing genes in the phlegm-blood-stasis syndrome of hyperlipemia.

目的研究高脂血症痰瘀证人群载脂蛋白E(apoE)基因型与等位基因频率分布特征。方法运用聚合酶链式反应-限制片段长度多态性(PCR-RFLP)技术检测206例高脂血症痰瘀证患者apoE基因分型,按照频数计数法计算基因频率。结果在206例高脂血症痰瘀证人群中,共检测到5种基因型,以ε3等位基因频率最高,为78.33%,ε2为8.75%,ε4为12.93%,apoE基因型与等位基因频率分布,与北京自然健康人群比较,差异无统计学意义。但ε3等位基因频率仍明显减少,ε4等位基因频率明显增多。结论apoE基因多态性基因频率分布与高脂血症痰瘀证间有一定相关性。

Objective To observe the characteristic of ApoE gene polymorphism and the lipid level in patients with hyperlipidemia and syndrome of phlegm-blood stasis.Methods Ninety-six patients with hyperlipidemia and syndrome of phlegm-blood stasis were detected about their lipid level and ApoE genotype.Results There was not a significant difference in the frequencies of ApoE genotype and allele between patients and natural population in Beijing,and between men and women.The levels of TC and LDL-C were different significantly because of different ApoE genotype: the TC and LDLC levels of patients with E3/4 genotype were higher than that of patients with E3/3 and E2/3 genotype.And HDL-C showed a lower level in patients with E3/4 than in those with E2/3 and E3/3.Conclusion There are not significant differences between hyperlipidemia patients with the syndromes of phlegm-blood stasis and Beijing natural population.There are some relationships between the ApoE gene polymorphism and the lipid level.E3/4 genotype has high relativity with TCM syndrome of phlegm-blood stasis.