冠心病稳定期中医辨证相关因素的研究
摘要
本论文主要包括文献综述和临床研究两个部分。
文献综述:
辨证论治是中医防病治病的特色和优势之一,但如何准确辨证无疑是提高临床疗效的关键。现代医学的飞速发展为拓展和延伸传统中医“四诊”手段、将传统宏观辨证与现代微观辨证的有机结合提供了技术支撑和良好契机。本文从冠状动脉病变、心功能、心电改变、血脂、胰岛素抵抗、同型半胱氨酸、炎症因子、遗传基因等八个方面综述了近5年来冠心病中医辨证相关因素的研究进展,认为今后应采用统一的辨证分型标准,在系统生物学思维指导下进行研究,并加强对冠心病稳定期高危患者的辨证相关因素、微观表征及演变规律的研究。
临床研究:
目的从血脂、超敏C反应蛋白(hsCRP)、Fib等探讨冠心病稳定期患者中医辨证相关因素,为临床辨治提供参考依据和新的思路。
方法对既往有陈旧心梗病史或经冠脉造影检查确诊的346例冠心病稳定期患者进行横断面调查,中医辨证分型参照中国中西医结合学会心血管学会“冠心病中医辨证标准”分为血瘀、痰浊、气滞、寒凝、气虚、阳虚、阴虚7个证候要素。入选时所有患者检测血脂、hsCRP及Fib。采用单因素分析及Logistic多元回归方法,分析冠心病稳定期患者中医辨证与血脂、hsCRP及Fib的相关性。
结果
1、一般资料分析:346例冠心病稳定期患者中,男性254人,女性92人,男女比例大于2:1;平均年龄60.82±9.616岁,以中老年人为主;有冠心病家族史者126人,占36.4%;合并高脂血证患者260人,占75.1%;合并高血压的223人,占64.5%;合并糖尿病的121人,占35.0%;有吸烟史的196人,占56.6%;肥胖患者(体重指数＞28)63人,占18.2%,A型性格278人,占80.3%。
2、中医辨证分型情况:346例冠心病稳定期患者涉及7个证候要素,频率由高至低依次为:血瘀(94.2%)、气虚(45.4%)、痰浊(39.0%)、阳虚(34.4%)、阴虚(15.0%)、气滞(7.2%)、寒凝(0.3%)。
3、中医辨证相关因素的单因素分析:单因素分析显示,TG、HDL-C、TC/HDL-C、ApoB_(100)、ApoA_1/ApoB_(100)、FBG、Fib是辨证痰浊的相关因素;TG、HDL-C、TC/HDL-C、ApoA_1/ApoB_(100)、Lp(a)、Fib、hsCRP是辨证痰热的相关因素;Fib是辨证气滞的相关因素;TG、TC/HDL-C是辨证阳虚的相关因素。
4、中医辨证相关因素的多元Logistic回归分析:以是否辨证某证侯要素为因变量,以上述有显著差异的血清指标为自变量进行多元logistic逐步回归分析,并以性别、年龄、体重指数、高脂血症病史、高血压病史、糖尿病病史、吸烟史进行校正,结果显示,hsCRP、HDL-C、Fib为是否辨证痰热的独立影响因素(P＜0.05),Fib为是否辨证痰浊的独立影响因素(P＜0.05)。
结论冠心病稳定期患者中医辨证痰热证与hs-CRP水平升高、HDL-C降低关系密切;Hs-CRP作为炎症标记物,可视作中医“毒”微观指标之一,本研究为“蕴热化毒”这一病机枢转提供了初步依据,而HDL-C降低则可能是这一转化过程的重要影响因素,值得深入研究。Fib降低作为辨证痰热的独立影响因素,尚有待于进一步扩大样本加以验证。
This paper contains two parts,literature review and clinical research.
Literature review:
Therapy based on syndrome-differentiation is one of the superiorities of traditional Chinese medicino(TCM) in preventing and treating diseases,and how to make an accurate syndrome-differentiation is critical to improve the therapeutic effect.The development of modern medicine expands TCM 'four diagnostic methods' and provides technology,and opportunity for integration of traditional macroscopic and modern microscopic syndrome-differentiation.This paper reviewed the progress on the correlated factors of syndrome-differentiation in coronary heart disease(CHD) according to coronary artery lesion,heart function,electrocardial changes,blood lipid, insulin resistance,homocysteic acid,inflammatory factor and genetic gene and suggest unified criterion of syndrome-differentiation and thought of systematic biology be adopted.Furthermore,the correlated factors of syndrome-differentiation,microscopic exosyndrome and evolving law in high-risk stable CHD patients should be highlighted in the future.
Clinical research:
Objective:From the blood lipid,high-sensitivity C-reactive protein (hsCRP),Fib,etc.to explore in patients with stable coronary heart disease-related factors in TCM,in order to provide reference for the Clinical Diagnosis and Treatment,and new ideas.
Method:Of the past have a history of old myocardial infarction or coronary angiography in 346 cases of diagnosed coronary heart disease in patients with stable cross-sectional survey of TCM Syndrome Types in the light of the Chinese Society of Cardiovascular Institute of Integrated Traditional and Western Medicine "Coronary Heart Disease TCM standards" into the blood stasis,phlegm turbidity,Qi Stagnation,cold coagulation,Qi deficiency,Yang deficiency, Yin deficiency syndrome seven elements.Detection of all patients with selected lipids,hsCRP,and Fib,Single-factor analysis and Logistic regression methods, analysis of patients with stable coronary heart disease and blood lipid TCM, hsCRP and the relevance of Fib.
Results:
1.General data analysis:346 cases of patients with stable coronary heart disease,male 254,female 92,male to female ratio greater than 2:1;the average age of 60.82±9.616 years old,mainly in the elderly;a family history of coronary heart disease 126 people,accounting for 36.4%;the combined 260 patients with blood lipid,accounting for 75.1%;of 223 people with hypertension, accounting for 64.5%;of 121 people with diabetes,accounting for 35.0%;a smoking history of 196,accounting for 56.6%;obese patients(body mass index＞28) 63 people,accounting for 18.2%,A-type character of 278,accounting for 80.3%.
2.The case of TCM Syndrome Types:346 cases of coronary heart disease in patients with stable syndromes involving seven elements,the frequency of high to low as follows:blood stasis(94.2%),Qi-deficiency(45.4%),phlegm turbidity (39.0%),Yang deficiency(34.4%),yin deficiency(15.0%),Qi stagnation(7.2%), cold coagulation(0.3%).
3.TCM-related factors in univariate analysis:single-factor analysis showed that,TG,HDL-C,TC/HDL-C,ApoB100,ApoA1/ApoB100,FBG,Fib is the differentiation of the relevant factors phlegm turbidity;TG,HDL-C,TC/HDL-C, ApoA1/ApoB100,Lp(a),Fib,hsCRP is related to the phlegm-heat differentiation factors;Fib is the differentiation of the relevant factors Qi-deficiency; TG,TC/HDL-C is the differentiation of the relevant factors Yang deficiency.
4 CM-related factors Logistic multiple regression analysis:The syndrome is a differentiation factor as the dependent variable to the above there are significant differences in serum indicator variables for multiple logistic regression analysis,and gender,age,body mass index,fat history of hyperlipidemia,history of hypertension,diabetes history,smoking history corrected results showed that,hsCRP,HDL-C,Fib-heat syndrome differentiation as to whether the independent factors(P＜0.05),Fib differentiation as to whether the independent effects of turbidity factors(P＜0.05).
Conclusion:Patients with stable coronary heart disease TCM heat syndrome and hs-CRP levels,HDL-C lower close;Hs-CRP as a marker of inflammation,may be regarded as traditional Chinese medicine "toxin" one of the micro-indicators, the study as "accumulated heat to transform toxin"to the pathogenesis hub to provide a preliminary basis,and lower HDL-C may be an important transformation process of the influencing factors,it is worth in-depth study.Fib reduce heat as the independent effects of differentiation factors,has yet to be validated to further expand the sample.
文献综述:
辨证论治是中医防病治病的特色和优势之一,但如何准确辨证无疑是提高临床疗效的关键。现代医学的飞速发展为拓展和延伸传统中医“四诊”手段、将传统宏观辨证与现代微观辨证的有机结合提供了技术支撑和良好契机。本文从冠状动脉病变、心功能、心电改变、血脂、胰岛素抵抗、同型半胱氨酸、炎症因子、遗传基因等八个方面综述了近5年来冠心病中医辨证相关因素的研究进展,认为今后应采用统一的辨证分型标准,在系统生物学思维指导下进行研究,并加强对冠心病稳定期高危患者的辨证相关因素、微观表征及演变规律的研究。
临床研究:
目的从血脂、超敏C反应蛋白(hsCRP)、Fib等探讨冠心病稳定期患者中医辨证相关因素,为临床辨治提供参考依据和新的思路。
方法对既往有陈旧心梗病史或经冠脉造影检查确诊的346例冠心病稳定期患者进行横断面调查,中医辨证分型参照中国中西医结合学会心血管学会“冠心病中医辨证标准”分为血瘀、痰浊、气滞、寒凝、气虚、阳虚、阴虚7个证候要素。入选时所有患者检测血脂、hsCRP及Fib。采用单因素分析及Logistic多元回归方法,分析冠心病稳定期患者中医辨证与血脂、hsCRP及Fib的相关性。
结果
1、一般资料分析:346例冠心病稳定期患者中,男性254人,女性92人,男女比例大于2:1;平均年龄60.82±9.616岁,以中老年人为主;有冠心病家族史者126人,占36.4%;合并高脂血证患者260人,占75.1%;合并高血压的223人,占64.5%;合并糖尿病的121人,占35.0%;有吸烟史的196人,占56.6%;肥胖患者(体重指数＞28)63人,占18.2%,A型性格278人,占80.3%。
2、中医辨证分型情况:346例冠心病稳定期患者涉及7个证候要素,频率由高至低依次为:血瘀(94.2%)、气虚(45.4%)、痰浊(39.0%)、阳虚(34.4%)、阴虚(15.0%)、气滞(7.2%)、寒凝(0.3%)。
3、中医辨证相关因素的单因素分析:单因素分析显示,TG、HDL-C、TC/HDL-C、ApoB_(100)、ApoA_1/ApoB_(100)、FBG、Fib是辨证痰浊的相关因素;TG、HDL-C、TC/HDL-C、ApoA_1/ApoB_(100)、Lp(a)、Fib、hsCRP是辨证痰热的相关因素;Fib是辨证气滞的相关因素;TG、TC/HDL-C是辨证阳虚的相关因素。
4、中医辨证相关因素的多元Logistic回归分析:以是否辨证某证侯要素为因变量,以上述有显著差异的血清指标为自变量进行多元logistic逐步回归分析,并以性别、年龄、体重指数、高脂血症病史、高血压病史、糖尿病病史、吸烟史进行校正,结果显示,hsCRP、HDL-C、Fib为是否辨证痰热的独立影响因素(P＜0.05),Fib为是否辨证痰浊的独立影响因素(P＜0.05)。
结论冠心病稳定期患者中医辨证痰热证与hs-CRP水平升高、HDL-C降低关系密切;Hs-CRP作为炎症标记物,可视作中医“毒”微观指标之一,本研究为“蕴热化毒”这一病机枢转提供了初步依据,而HDL-C降低则可能是这一转化过程的重要影响因素,值得深入研究。Fib降低作为辨证痰热的独立影响因素,尚有待于进一步扩大样本加以验证。
This paper contains two parts,literature review and clinical research.
Literature review:
Therapy based on syndrome-differentiation is one of the superiorities of traditional Chinese medicino(TCM) in preventing and treating diseases,and how to make an accurate syndrome-differentiation is critical to improve the therapeutic effect.The development of modern medicine expands TCM 'four diagnostic methods' and provides technology,and opportunity for integration of traditional macroscopic and modern microscopic syndrome-differentiation.This paper reviewed the progress on the correlated factors of syndrome-differentiation in coronary heart disease(CHD) according to coronary artery lesion,heart function,electrocardial changes,blood lipid, insulin resistance,homocysteic acid,inflammatory factor and genetic gene and suggest unified criterion of syndrome-differentiation and thought of systematic biology be adopted.Furthermore,the correlated factors of syndrome-differentiation,microscopic exosyndrome and evolving law in high-risk stable CHD patients should be highlighted in the future.
Clinical research:
Objective:From the blood lipid,high-sensitivity C-reactive protein (hsCRP),Fib,etc.to explore in patients with stable coronary heart disease-related factors in TCM,in order to provide reference for the Clinical Diagnosis and Treatment,and new ideas.
Method:Of the past have a history of old myocardial infarction or coronary angiography in 346 cases of diagnosed coronary heart disease in patients with stable cross-sectional survey of TCM Syndrome Types in the light of the Chinese Society of Cardiovascular Institute of Integrated Traditional and Western Medicine "Coronary Heart Disease TCM standards" into the blood stasis,phlegm turbidity,Qi Stagnation,cold coagulation,Qi deficiency,Yang deficiency, Yin deficiency syndrome seven elements.Detection of all patients with selected lipids,hsCRP,and Fib,Single-factor analysis and Logistic regression methods, analysis of patients with stable coronary heart disease and blood lipid TCM, hsCRP and the relevance of Fib.
Results:
1.General data analysis:346 cases of patients with stable coronary heart disease,male 254,female 92,male to female ratio greater than 2:1;the average age of 60.82±9.616 years old,mainly in the elderly;a family history of coronary heart disease 126 people,accounting for 36.4%;the combined 260 patients with blood lipid,accounting for 75.1%;of 223 people with hypertension, accounting for 64.5%;of 121 people with diabetes,accounting for 35.0%;a smoking history of 196,accounting for 56.6%;obese patients(body mass index＞28) 63 people,accounting for 18.2%,A-type character of 278,accounting for 80.3%.
2.The case of TCM Syndrome Types:346 cases of coronary heart disease in patients with stable syndromes involving seven elements,the frequency of high to low as follows:blood stasis(94.2%),Qi-deficiency(45.4%),phlegm turbidity (39.0%),Yang deficiency(34.4%),yin deficiency(15.0%),Qi stagnation(7.2%), cold coagulation(0.3%).
3.TCM-related factors in univariate analysis:single-factor analysis showed that,TG,HDL-C,TC/HDL-C,ApoB100,ApoA1/ApoB100,FBG,Fib is the differentiation of the relevant factors phlegm turbidity;TG,HDL-C,TC/HDL-C, ApoA1/ApoB100,Lp(a),Fib,hsCRP is related to the phlegm-heat differentiation factors;Fib is the differentiation of the relevant factors Qi-deficiency; TG,TC/HDL-C is the differentiation of the relevant factors Yang deficiency.
4 CM-related factors Logistic multiple regression analysis:The syndrome is a differentiation factor as the dependent variable to the above there are significant differences in serum indicator variables for multiple logistic regression analysis,and gender,age,body mass index,fat history of hyperlipidemia,history of hypertension,diabetes history,smoking history corrected results showed that,hsCRP,HDL-C,Fib-heat syndrome differentiation as to whether the independent factors(P＜0.05),Fib differentiation as to whether the independent effects of turbidity factors(P＜0.05).
Conclusion:Patients with stable coronary heart disease TCM heat syndrome and hs-CRP levels,HDL-C lower close;Hs-CRP as a marker of inflammation,may be regarded as traditional Chinese medicine "toxin" one of the micro-indicators, the study as "accumulated heat to transform toxin"to the pathogenesis hub to provide a preliminary basis,and lower HDL-C may be an important transformation process of the influencing factors,it is worth in-depth study.Fib reduce heat as the independent effects of differentiation factors,has yet to be validated to further expand the sample.
引文
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33 毛以林,袁肇凯,黄献平.冠心病血瘀证与血管紧张素转换酶基因多态性的相关性研究.中国中西医结合杂志2004;24(9):776-780.
34 黄献平,袁肇凯,谭光波,等.冠心病血瘀证患者血管紧张素转换酶基因多态性的检测分析.中医杂志2007;48(1):65-68.
35 黄献平,袁肇凯,毛以林,等.冠心病血瘀证凝血因子Ⅶ基因多态性的检测分析.中西医结合心脑血管病杂志2006;4(2):97-99.
36 李杰,袁肇凯,黄献平,等.湖南汉族人群ACE I/D基因多态性与冠心病血瘀证的遗传流行病学研究.中西医结合心脑血管病杂志2007;5(9):787-789.
37 蔡征宇.冠心病(心绞痛)辨证分型与ACE I/D基因多态性的相关性研究.河南中医2008;28(6):26-28.
38 杨保林,王 阶,姜燕.冠心病血瘀证相关基因b13的筛查和临床验证.中国中医基础医学杂志2007;13(1):69-71.
39 杨保林,王阶,姜燕.应用差异显示筛查冠心病血瘀证相关基因及分析.北京中医药大学学报2006;29(2):132-134,140.
40 薛 梅,陈可冀,殷惠军.汉族人血小板GP Ib HPA-2基因多态性与冠心病血瘀证的相关性研究.中国分子心脏病学杂志2008;8(4):196-202.
41 中国中西医结合学会心血管专业委员会.冠心病中医辨证标准.中国中西医结合杂志1991;11(5):257-258.
42 吴红金,马增春,高月,等.蛋白质组学技术对冠心病血瘀证相关蛋白的研究.中西医结合心脑血管病杂志2005;3(3):189-191.
[1]中国中西医结合学会心血管专业委员会.冠心病中医辨证标准.中西医结合杂志,1991,11(5):257-258.
[2]赵水平.中国成人血脂异常防治指南要点及解读.实用医院临床杂志,2008,5(3):3-6
[3]Conti CR.Updated pathophysiologic concepts in unstable coronary artery disease.Am Heart J 2001;141(2 Suppl):S12-4.
[4]Virmani R,Burke AP,Farb A,et al.Pathology of the vulnerable plaque[J].J Am Coll Cardiol,2006,47(8 Suppl):C13-18.
[5]Goldstein JA,Chandra HR,O'Neill WW.Relation of number of complex coronary lesions to serum C-reactive protein levels and major adverse cardiovascular events at one year[J].Am J Cardiol,2005,96(1):56-60.
[6]杨徐杭,汶医宁,魏敏慧,等.冠心病中医辨证与血清C反应蛋白的相关性研究[J].中医药学刊,2004,22(9):1649-1650.
[7]林超,郭进建,林青,等.高敏C反应蛋白与不稳定型心绞痛中医证型相关性研究[J].中国中医急症,2007,16(10):1221-1223.
[8]易自刚,王强,张双旗.急性冠脉综合征中医证型与IL-18、Hs-CRP的相关性研究[J].江苏中医药,2007,39(12):22-23.
[9]商秀洋,石洁.冠心病中医辨证与血清高敏C反应蛋白的关系研究[J].现代中西医结合杂志,2008,17(6):818-819.
[10]Duffy D,Rader DJ.Emerging therapies targeting high-densitylipoprotein metabolism and reverse cholesterol transport[J].Circulation,2006,113(8):1140-1150.
[11]冯宗忱.脂蛋白与动脉粥样硬化[M].北京:人民卫生出版社,2002:109-136
[12]龚亚驰,陈松,吴传中,等.196例冠状动脉造影患者的血脂分析.齐齐哈尔医学院学报,2008,29(23):2855-2856
[13]李峰,李秀云,王长海.冠心病冠状动脉病变与中医证型关系分析[J].陕西中医,1996,17(9):393.
[14]周明学,徐浩,陈可冀,等.黄连提取物对ApoE基因敲除小鼠主动脉易损斑块Perilipin和PPAR-γ基因表达的影响[J].中国中西医结合杂志,2008,28(6):532-536.
[15]周明学,徐浩,陈可冀,等.活血解毒中药有效部位对ApoE基因敲除小鼠血脂和动脉粥样硬化斑块炎症反应的影响[J].中国中西医结合杂志,2008,28(2):126-130.
[16]徐浩.活血解毒中药抗炎及稳定易损斑块的探索与思考[J].中国中西医结合杂志,2008,28(5):393-394.
[17]徐浩,史大卓,殷惠军,等.“瘀毒致变”与急性心血管事件:假说的提出与临床意义[J].中国中西医结合杂志,2008,28(10):934-938.
2 李静,张继东,刘同涛.冠心病中医证型与冠脉病变的相关性.山东中医药大学学报 2006;30(2):124-125.
3 张鹏,徐伟建.中医证型与冠状动脉病变程度的相关性研究.中西医结合心脑血管病杂志2007:5(2):101-102.
4 刘永明,蒋梅先.259例冠心病患者中医辨证分型与冠脉造影结果的关系研究.北京中医 2005;24(3):131-133.
5 鞠镐,程文立,柯元南,等.冠心病心绞痛病人冠状动脉造影与中医辨证分型关系的研究.中西医结合心脑血管病杂志 2005;3(7):569-571.
6潘宗奇,陈伯钧,冯靖禧,等.冠心病造影结果与中医证型的相关性研究.陕西中医2008;29(6):649-651.
7 徐浩,鹿小燕,陈可冀,等.血瘀证及其兼证与冠脉造影所示病变及介入治疗后再狭窄的相关性研究.中国中西医结合杂志 2007;27(1):8-11.
8 王 阶,何庆勇,马长生,等.基于冠脉造影的冠心病冠脉病变与血瘀证的相关性研究.中国中西医结合杂志2008;28(12):1074-1077.
9 褚田明,顾仁樾.冠心病.阳虚证与心功能减退关系的研究.江苏‘中医药2007;39(6):17-18.
10 陈少芳,黄海.冠心病中医证型与心室舒张功能的相关性研究.福建中医学院学报 2006;16(4):15-16.
11 丁邦晗,周 珂,李俊,等.305例胸痹心痛患者超声心动图改变及其与中医证型韵关系.中国中医药信息杂志2008;15(1):19-21.
12 姜洪茹,郭 勇.超声评价左心室收缩功能与冠心病实证者辨证分型关系初探.中国医药导报2007;4(14):20-21.
13 尚玉红,洪秀芳,吴 鹏,等.冠心病中医辨证与QT和JT离散度的关系.中国中西医结合急救杂志2005;12(2):87-90.
14 周劲松.冠心病中医证型与心率变异性关系的研究.中国中医急症2007;16(6):688-689.
15 刘辛光.冠心病辨证分型与血流动力学流变学变化关系探析.辽宁中医杂志2005;32(10):991-992.
16 曹雪明,张泉.冠心病中医证型与血液流变学相关性探讨.中国中医急症 2006;15(11):1242-1243.
17 王桂玲,王磊,王忠爱,等.冠心病的中医辨证分型与血液流变学指标的关系.实用心电学杂志2007;16(2):124-125.
18 邓奕辉,李定祥,杨军辉.冠心病心绞痛血瘀证四亚型与血脂的相关性研究.湖南中医杂志2008;24(1):59-60.
19 谢海波,陈新宇,石刚,等.冠心病心绞痛中医证型与C-反应蛋白、血脂的相关性研究.湖南中医学院学报2005;25(4):32-34.
20 于顾然,贺燕勤,郭云庚,等.冠心病中医证型与髌岛素抵抗、脂质及红细胞膜ATP 酶关系的临床研究.中医杂志2004:41(2):111-112.
21 陈晓虎,徐顺娟.冠心病(胸痹)胰岛素抵抗与中医辨证分型关系的临床研究.南京中医药大学学报2006;22(5):296-298.
22 孔丽君.冠心病患者血浆同型半胱氨酸水平与辨证分型相关性研究.实用中西医结合临床2004;4(1):7-8.
23 李超,安冬青,王娟,等.冠心病秽浊痰阻证与血浆同型半胱氨酸韵相关性研究.中西医结合心脑血管病杂志2008;6(4):384-385.
24 林凯旋,安辉,缪灿铭,等.冠心病血瘀证与同型半胱氨酸_的相关性研究.中医研究2007;20(2):32-33.
25 Goldstein JA,Chandra HR,O'Neill WW.Relation of number of complex coronary lesions to serum C-reactive protein levels and major adverse cardiovascular events at one year.Am J Cardiol 2005;96(1):56-60.
26 Futterman LG,Lemberg L.High-sensitivity C-reactive protein is the most effective prognostic measurement ofacute coronary events.Am J Crit Care 2002;11(5):482-486.
27 石刚,刘婷.冠心病及其常见中医证型与超敏C反应蛋白的关系探讨.中医药临床杂志2007;19(1):29-30.
28 商秀洋,石洁.冠心病中医辨证与血清高敏C反应蛋白的关系研究.现代中西医结合杂志2008;17(6):818-819.
29 毛以林,李旭,彭素娟,等.冠心病血瘀证与高敏C-反应蛋白相关性研究.中国中医药信息杂志2007;14(8):26-27.
30 林超,郭进建,林青,等.高敏C反应蛋白与不稳定型心绞痛中医证型相关性研究.中国中医急症2007;16(10):1221-1223.
31 易自刚,王强,张双旗.急性冠脉综合征中医证型与IL-18、Hs-CRP的相关性研究.江苏中医药2007;39(12):22-23.
32 华军益,刘艳,王坤根,等.冠心病痰瘀辨证与血清炎症因子关系的临床研究.医学研究杂志2008;37(3):112-114.
33 毛以林,袁肇凯,黄献平.冠心病血瘀证与血管紧张素转换酶基因多态性的相关性研究.中国中西医结合杂志2004;24(9):776-780.
34 黄献平,袁肇凯,谭光波,等.冠心病血瘀证患者血管紧张素转换酶基因多态性的检测分析.中医杂志2007;48(1):65-68.
35 黄献平,袁肇凯,毛以林,等.冠心病血瘀证凝血因子Ⅶ基因多态性的检测分析.中西医结合心脑血管病杂志2006;4(2):97-99.
36 李杰,袁肇凯,黄献平,等.湖南汉族人群ACE I/D基因多态性与冠心病血瘀证的遗传流行病学研究.中西医结合心脑血管病杂志2007;5(9):787-789.
37 蔡征宇.冠心病(心绞痛)辨证分型与ACE I/D基因多态性的相关性研究.河南中医2008;28(6):26-28.
38 杨保林,王 阶,姜燕.冠心病血瘀证相关基因b13的筛查和临床验证.中国中医基础医学杂志2007;13(1):69-71.
39 杨保林,王阶,姜燕.应用差异显示筛查冠心病血瘀证相关基因及分析.北京中医药大学学报2006;29(2):132-134,140.
40 薛 梅,陈可冀,殷惠军.汉族人血小板GP Ib HPA-2基因多态性与冠心病血瘀证的相关性研究.中国分子心脏病学杂志2008;8(4):196-202.
41 中国中西医结合学会心血管专业委员会.冠心病中医辨证标准.中国中西医结合杂志1991;11(5):257-258.
42 吴红金,马增春,高月,等.蛋白质组学技术对冠心病血瘀证相关蛋白的研究.中西医结合心脑血管病杂志2005;3(3):189-191.
[1]中国中西医结合学会心血管专业委员会.冠心病中医辨证标准.中西医结合杂志,1991,11(5):257-258.
[2]赵水平.中国成人血脂异常防治指南要点及解读.实用医院临床杂志,2008,5(3):3-6
[3]Conti CR.Updated pathophysiologic concepts in unstable coronary artery disease.Am Heart J 2001;141(2 Suppl):S12-4.
[4]Virmani R,Burke AP,Farb A,et al.Pathology of the vulnerable plaque[J].J Am Coll Cardiol,2006,47(8 Suppl):C13-18.
[5]Goldstein JA,Chandra HR,O'Neill WW.Relation of number of complex coronary lesions to serum C-reactive protein levels and major adverse cardiovascular events at one year[J].Am J Cardiol,2005,96(1):56-60.
[6]杨徐杭,汶医宁,魏敏慧,等.冠心病中医辨证与血清C反应蛋白的相关性研究[J].中医药学刊,2004,22(9):1649-1650.
[7]林超,郭进建,林青,等.高敏C反应蛋白与不稳定型心绞痛中医证型相关性研究[J].中国中医急症,2007,16(10):1221-1223.
[8]易自刚,王强,张双旗.急性冠脉综合征中医证型与IL-18、Hs-CRP的相关性研究[J].江苏中医药,2007,39(12):22-23.
[9]商秀洋,石洁.冠心病中医辨证与血清高敏C反应蛋白的关系研究[J].现代中西医结合杂志,2008,17(6):818-819.
[10]Duffy D,Rader DJ.Emerging therapies targeting high-densitylipoprotein metabolism and reverse cholesterol transport[J].Circulation,2006,113(8):1140-1150.
[11]冯宗忱.脂蛋白与动脉粥样硬化[M].北京:人民卫生出版社,2002:109-136
[12]龚亚驰,陈松,吴传中,等.196例冠状动脉造影患者的血脂分析.齐齐哈尔医学院学报,2008,29(23):2855-2856
[13]李峰,李秀云,王长海.冠心病冠状动脉病变与中医证型关系分析[J].陕西中医,1996,17(9):393.
[14]周明学,徐浩,陈可冀,等.黄连提取物对ApoE基因敲除小鼠主动脉易损斑块Perilipin和PPAR-γ基因表达的影响[J].中国中西医结合杂志,2008,28(6):532-536.
[15]周明学,徐浩,陈可冀,等.活血解毒中药有效部位对ApoE基因敲除小鼠血脂和动脉粥样硬化斑块炎症反应的影响[J].中国中西医结合杂志,2008,28(2):126-130.
[16]徐浩.活血解毒中药抗炎及稳定易损斑块的探索与思考[J].中国中西医结合杂志,2008,28(5):393-394.
[17]徐浩,史大卓,殷惠军,等.“瘀毒致变”与急性心血管事件:假说的提出与临床意义[J].中国中西医结合杂志,2008,28(10):934-938.