[1]申震,董玮,黄雅静,等.不同中医证候膝关节自发性骨坏死患者脂代谢特征的对比研究[J].中医正骨,2022,34(09):1-4.
　SHEN Zhen,DONG Wei,HUANG Yajing,et al.Lipid metabolism characteristics of spontaneous knee osteonecrosis patients with different traditional Chinese medicine syndromes:a comparative study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(09):1-4.
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不同中医证候膝关节自发性骨坏死患者脂代谢特征的对比研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年09期
页码:
1-4
栏目:
临床研究
出版日期:
2022-09-20

文章信息/Info

Title:
Lipid metabolism characteristics of spontaneous knee osteonecrosis patients with different traditional Chinese medicine syndromes:a comparative study
作者:
申震; 董玮; 黄雅静; 雍来清; 郭英; 伍卫新
(昆明市中医医院,云南昆明650051)
Author(s):
SHEN Zhen; DONG Wei; HUANG Yajing; YONG Laiqing; GUO Ying; WU Weixin
Kunming Municipal Hospital of Traditional Chinese Medicine,Kunming 650051,Yunnan,China
关键词:
骨坏死;  膝关节;  证候;  脂类代谢;  临床试验
Keywords:
osteonecrosis;  knee joint;  syndrome complex;  lipid metabolism;  clinical trial
摘要:
目的:比较不同中医证候膝关节自发性骨坏死(spontaneous osteonecrosis of the knee,SONK)患者的脂代谢特征。方法:选取2019年3月至2021年5月收治的56例SONK患者,按照拟定的标准对所有患者进行中医辨证,并抽取外周静脉血测定血清总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、载脂蛋白A1(apolipoprotein-A1,Apo-A1)、载脂蛋白B(apolipoprotein-B,Apo-B)、脂蛋白a(lipoprotein a,LPA)含量。结果:56例SONK患者中痰瘀阻络证27例、肝肾亏虚证18例、气滞血瘀证11例。3种中医证候SONK患者的血清TC、TG、LDL-C含量比较,组间差异均有统计学意义[(4.72±0.96)mmol·L-1,(4.49±0.90)mmol·L-1,(3.97±0.99)mmol·L-1,F=6.989,P=0.003;(2.17±1.35)mmol·L-1,(1.44±0.88)mmol·L-1,(1.78±1.16)mmol·L-1,F=2.927,P=0.039;(3.01±0.99)mmol·L-1,(2.98±0.75)mmol·L-1,(2.45±0.94)mmol·L-1,F=3.356,P=0.030]。痰瘀阻络证患者的血清TC、TG、LDL-C含量均高于气滞血瘀证患者(P=0.026,P=0.036,P=0.022); 肝肾亏虚证患者的血清TC、LDL-C含量均低于痰瘀阻络证患者(P=0.030,P=0.012),但均高于气滞血瘀证患者(P=0.018,P=0.011); 肝肾亏虚证患者的血清TG含量低于痰瘀阻络证和气滞血瘀证患者(P=0.027,P=0.040)。3种中医证候SONK患者的血清 HDL-C、Apo-A1、Apo-B、LPA含量比较,组间差异均无统计学意义[(1.04±0.36)mmol·L-1,(1.18±0.35)mmol·L-1,(0.92±0.40)mmol·L-1,F=0.203,P=0.764;(1.20±0.29)g·L-1,(1.18±0.18)g·L-1,(1.03±0.25)g·L-1,F=0.899,P=0.424;(0.86±0.18)g·L-1,(0.83±0.22)g·L-1,(0.75±0.18)g·L-1,F=0.186,P=0.801;(0.33±0.10)g·L-1,(0.30±0.09)g·L-1,(0.29±0.09)g·L-1,F=0.102,P=0.903]。结论:SONK痰瘀阻络证患者与肝肾亏虚证、气滞血瘀证患者在脂代谢方面存在较大差异,临床治疗SONK痰瘀阻络证患者时应注意纠正脂代谢异常。
Abstract:
Objective:To compare the lipid metabolism characteristics of spontaneous knee osteonecrosis patients with different traditional Chinese medicine(TCM)syndromes.Methods:Fifty-six patients with spontaneous osteonecrosis of the knee(SONK)recruited from March 2019 to May 2021 were selected,and their TCM syndromes were differentiated according to the designed standards.The blood sample was drawn from the peripheral vein,and the serum levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein-A1(Apo-A1),apolipoprotein-B(Apo-B)and lipoprotein a(LPA)were detected by using enzyme linked immunosorbent assay(ELISA).Results:In the 57 SONK patients,the phlegm and blood-stasis blocking collaterals syndrome was found in 27 patients,liver-kidney deficiency syndrome in 18 cases as well as qi-stagnation and blood-stasis syndrome in 11 cases.There was statistical significance in the serum levels of TC,TG and LDL-C between the SONK patients with 3 types of TCM syndrome(4.72±0.96,4.49±0.90,3.97±0.99 mmol/L,F=6.989,P=0.003; 2.17±1.35,1.44±0.88,1.78±1.16 mmol/L,F=2.927,P=0.039; 3.01±0.99,2.98±0.75,2.45±0.94 mmol/L,F=3.356,P=0.030).The serum levels of TC,TG and LDL-C were higher in SONK patients with phlegm and blood-stasis blocking collaterals syndrome compared to SONK patients with qi-stagnation and blood-stasis syndrome(P=0.026,P=0.036,P=0.022).The serum levels of TC and LDL-C were higher in SONK patients with phlegm and blood-stasis blocking collaterals syndrome,while was lower in SONK patients with qi-stagnation and blood-stasis syndrome compared to SONK patients with liver-kidney deficiency syndrome(P=0.030,P=0.012; P=0.018,P=0.011).The serum level of TG was lower in SONK patients with liver-kidney deficiency syndrome compared to SONK patients with phlegm and blood-stasis blocking collaterals syndrome and those with qi-stagnation and blood-stasis syndrome(P=0.027,P=0.040).There was no statistical significance in the serum levels of HDL-C,Apo-A1,Apo-B and LPA between the SONK patients with 3 types of TCM syndrome(1.04±0.36,1.18±0.35,0.92±0.40 mmol/L,F=0.203,P=0.764; 1.20±0.29,1.18±0.18,1.03±0.25 g/L,F=0.899,P=0.424; 0.86±0.18,0.83±0.22,0.75±0.18 g/L,F=0.186,P=0.801; 0.33±0.10,0.30±0.09,0.29±0.09 g/L,F=0.102,P=0.903).Conclusion:There are great differences in lipid metabolism between SONK patients with phlegm and blood-stasis blocking collaterals syndrome and SONK patients with liver-kidney deficiency syndrome as well as between SONK patients with phlegm and blood-stasis blocking collaterals syndrome and SONK patients with qi-stagnation and blood-stasis syndrome,so attention shall be paid to ameliorate the abnormal lipid metabolism in treatment of SONK with phlegm and blood-stasis blocking collaterals syndrome in clinic.

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备注/Memo

备注/Memo:
基金项目:昆明市卫生科技人才培养项目暨“十百千”工程培养计划项目[2020-SW(后备)-52] 通讯作者:伍卫新 E-mail:1029091649@qq.com
更新日期/Last Update: 1900-01-01