不同地域血瘀证患者理化检查结果比较研究
作者：李海霞,王阶,胡元会,何庆勇,郭来,吕光荣,赵凤鸣
【摘要】 目的 为研究不同地域疾病的特点,以血瘀证为切入点,对不同地域血瘀证的理化指标进行研究。方法 收集北京、云南、福建三地三级甲等医院血瘀证患者586例,对不同地域血瘀证的理化指标进行分析,总结不同地域血瘀证理化指标的差异性。结果 在红细胞和血红蛋白方面,云南患者与北京和福建患者比较有显著差异(P<0.05)。在三酰甘油、总胆固醇及高、低密度脂蛋白胆固醇等方面,北京与福建和云南患者比较有显著差异(P<0.01)。北京患者的血压与福建和云南患者比较有极显著差异(P<0.01)。在全血高切、低切粘度方面,北京与云南和福建患者比较有极显著差异(P<0.01),在纤维蛋白原方面,北京与云南和福建患者比较有显著差异(P<0.05)；在红细胞聚集指数、红细胞变形性方面,三地无差异,红细胞压积方面,云南与其他两地比较,有显著差异(P<0.01,P<0.05)；在血小板粘附性、聚集性及血浆粘度方面,北京与其他两地患者比较,有极显著差异(P<0.01)。结论 不同地域患者的客观检查指标有差异。有利于根据不同地域患者的特点指导疾病的预防和治疗,预测疾病的演变和转归。
【关键词】 北京；福建；云南；理化检查；血瘀证
Abstract：Objectives To study the difference of the disease in different places, blood stasis syndrome was taken as an example to study syndromes of the different disease from different place. Methods The blood stasis syndrome patients from north, east and southwest of China were selected to study the laboratory examination of them, then summarize the difference of different place. Results There were significantly difference on erythrocyte and haemoglobin between Yunnan and Beijing, Fujian(P<0.05). There were significant difference on triglyceride, total cholesterol, high-density lipoproteins and low density lipoprotein between Beijing and Fujian, Yunnan (P<0.01). On the aspect of blood pressure, there were significant difference between Beijing and Fujian, Yunnan (P<0.01). On the aspect of blood viscosity, there were significant difference between Beijing and Yunnan, Fujian (P<0.01). On the aspect of fibrinogen, there were significant difference between Beijing and Yunnan, Fujian (P<0.05). On the aspect of the index of erythrocyte aggregation & red blood cell deformation, there were no difference among the three places. On the aspect of hematocrit, there were significant difference between Yunnan and other two place (P<0.01, P<0.05). On the aspect of platelet adhere and platelet aggregation, there were significant difference between Beijing and other two place (P<0.01). Conclusions For the same symptom, there were different lab indexes in patients from different place, which can guide prevention and treatment of disease.
Key words：Beijing；Fujian；Yunnan；laboratory examination；blood stasis syndrome
为研究不同地域疾病的特点,本研究以血瘀证为切入点,对不同地域血瘀证患者的理化指标进行检测和分析,现将结果报道如下。
1 临床资料
1.1 一般资料
选取2004年2月－2005年12月北京西苑医院、云南省中医院、云南省红十字会医院、云南大学医学院附属医院、福建医科大学第一附属医院、福建中医学院第二附属医院、福建军区总医院的血瘀证患者586例,其中北京208例,云南180例,福建198例,包括脑梗死、冠心病心绞痛、肝硬化、月经失调、类风湿性关节炎5种病。不同地域5种疾病分布情况见表1,不同地域血瘀亚型分布情况见表2。表1 不同地域5种疾病分布一般情况(略)表2 血瘀亚型不同地域分布情况(略)
从表1和表2可以看出,北京地区分布的亚型以气虚血瘀、气滞血瘀和痰浊血瘀为主,云南以气滞血瘀和气虚血瘀为主,而福建4种亚型分布较均匀,其中阴虚血瘀较其它证型稍多。
1.2 纳入标准
①年龄<75岁，性别、民族不限；②可以合并其它疾病，但不能存在本课题所选病种的各类急性并发症，并按要求排除合并其它急性疾病的病例；③血瘀证诊断标准：采用中国中西医结合学会活血化瘀专业委员会制订的血瘀证诊断标准（1986年11月，广州）。