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Of dyslipidemia TCM Syndromes and their objective

Author: WangZhenHua
Tutor: LeiYan;LiuJianGang
School: China Academy of Traditional Chinese Medicine
Course: Traditional Chinese Medicine
Keywords: Dyslipidemia TCM Syndrome Factor Analysis Canonical Analysis Atherosclerosis C-Reactive Protein (CRP) Homocysteine (Hcy) Carotid Ultrasonic
CLC: R259
Type: PhD thesis
Year: 2007
Downloads: 446
Quote: 1
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Abstract

Dyslipidemia is closely related to atherosclerosis (AS), and it can causecardiovascular and cerebrovascular diseases. The actively preventing of dyslipidemiawill reduce even avoid the occurrences of AS, thereby reducing the incidence ofcoronary heart disease (CHD) and cerebrovascular disease. Traditional ChineseMedicine (TCM) is superior to western medicine in preventing and treatingdyslipidemia at some aspect. But some problems haven’t been settled yet, such as thedisordering of the category of TCM syndrome, the limiting of the laboratory items inblood lipid and so on. As these problems becoming the fundamental hindrance ofstandardization and the impersonality of TCM syndrome, they needed to be settled assoon as possible.This study consists of two parts: review of past literatures and clinicalresearch.In the first article of the two reviews, the author analyzed the literatures ofdyslipidemia about TCM in the last 10 years, including the mechanisms, the types ofTCM syndrome and the impersonality of TCM syndrome of dyslipidemia. by reviewthe past literatures, the author found that although great advances have been achieved,there are still some problems to be solved, such as the types of TCM syndromehaven’t been unified yet. In the second paper, the author reviewed the progress on therelationship between C-reaction protein (CRP), homocysteine (Hcy) and AS in therecent 10 years. The author systemically classified the mechanisms of AS whichcaused by CRP and Hcy in several aspect, such as the damage of endothelium,affecting blood vessel smooth muscle cell, participating in inflammation reaction,modifying low density lipoprotein, disturbing coagulate system, activating plateletand so on.The second part is mainly about the rules and impersonality of TCMsyndrome of dyslipidemia.1．The research of the rules of TCM syndrome of dyslipidemiaObjective:To probe the rules of TCM syndrome of dyslipidemia.Method:In the adopted 152 dyslipidemia cases, there are 87 in-patients (57．2%) and 65outpatients (42．8%), there are 67 male cases (43．1%) and 85 female cases (56．9%).The shortest course of illness is 0．4 years, and the longest is 22 years, average 4．45 years. The cases which merging hypertension are 71, merging CHD are 5,simultaneously merging hypertension and CHD are 2, merging the Meniere disease is1, having no complication cases are 73．Altogether the author selected 32 symptoms and physical sighs (including tonguemanifestation and pulse manifestation). By consulting the related literatures, andproved by the experts, the author made a dyslipidemia TCM syndrome observationtable. With the graduation quantification method, the symptoms and physical signs havebeen divided into normal, mildness, medium and severity four levels. The normalcyrecorded 0 point; the mildness recorded 1 point; the moderate recorded 2 points; andthe severity recorded 3 points. Based on the quantification, the symptoms and physicalsigns were treated as measurable variables, and then the common factors which ruledthe symptoms and physical signs were found out by the way of factor analysis. As amatter of fact, the common factors and the TCM syndrome are coherent.Results:6 common factors were selected. As two of them have been united into one, 5TCM syndromes were obtained at last. According to the TCM theory and clinicalpractice, the five TCM syndromes are kidney YIN deficiency, spleen QI deficiency,stagnation of phlegm, blood stasis, and stagnation of phlegm and blood. Among the 5TCM syndromes, the stagnation of phlegm is the most common one (42．1 %). Thenext one less than the stagnation of phlegm is the spleen QI deficiency(23．0%), andthe others in turn are the stagnation of phlegm and blood, the kidney Yin deficiencyand the blood stasis, accounts for 13．2%, 11．2%, and 10．5% separately.Conclusion:①dyslipidemia is composed of five kinds of TCM syndromes, which are kidneyYIN deficiency, spleen QI deficiency, stagnation of phlegm, blood stasis, andstagnation of phlegm and blood respectively.②An important fact which has beenoverlooked in the past is that the kidney YIN deficiency is an important type of TCMsyndromes of dyslipidemia.③Compared with traditional method, the factor analysisis more standardized and may overcome the subjectivity of traditional method. Factoranalysis method may be a promising way to make TCM syndrome standardized andneeded to be explored more deeply.2．The study of the relationship between TCM syndromes and the items oflaboratory and carotid ultrasonic detectsObjective:At the basis of the discovery of the rules of TCM syndrome of dyslipidemia, the author probed into the relationship between TCM syndrome and CRP, Hcy, bloodrheology, blood lipid and carotid ultrasonic detects.Method:Hs-CRP, Hcy, carotid ultrasonic, blood lipids and hemorheological items of the152 cases were examined, and the 6 common factors which represented the TCMsymptoms were taken as a group of variables; while hs-CRP, Hcy, carotid ultrasonic,blood lipids and hemorheological were taken as another group of variables. Thencanonical analysis method was used to find the relationship between TCM syndromesand the items of laboratory and carotid ultrasonic detects.Results:In the series of kidney YIN deficiency, the levels of C-reactive protein and themucosity of blood are higher than the other series. The level of very low densitylipoprotein (VLDL-C) in the series of spleen QI deficiency is higher. In the series ofstagnation of phlegm, the total cholesterol (TC) is significantly higher; however, thehigh density lipoprotein (HDL-C) is lower. In the series of stagnation of phlegm andblood, the Hcy is significantly higher.Conclusion:①There are close relationships between the TCM syndromes and the items oflaboratory. These discoveries have provided some new evidences for objectivity ofTCM syndromes of dyslipidemia.②Our study shows that, deficiency of kidney YINis an important mechanism of dyslipidemia. Deficiency of YIN can cause excessive ofYANG, or Fire, and this condition is resembled to the inflammation theory of AS ofwestern medicine. Deficiency of YIN, excessive of YANG and Fire may be somelatent reasons of chronic inflammation of AS. The heightened hs-CRP in the series ofkidney YIN deficiency demonstrated that there is an internal relationship betweenkidney YIN deficiency and inflammation.3．The relationship between laboratories detects and carotid ultrasonicdetectsObjective:To discover the relationship between the items of physical and biochemicaldetects and the ultrasonic detects of carotid.Method:Using multiple regression analysis method, took hs-CRP, Hcy, blood rheologyand blood lipids as independent variables, and took carotid ultrasonic as dependent variable.Results:Hcy, VLDL-C and TC have been selected into the regression equation. Their Pvalues are 0．03, 0．01 and 0．047 respectively, all less than 0．05．They all have showedsignificant statistical meaning. So the author concluded that Hcy, VLDL-C and TC allcorrelated with atherosclerosis of carotid. Atherosclerosis of carotid will more likelytake place if one of them is heightened.Conclusion:①Hcy, VLDL-C and TC all related with atherosclerosis of carotid. It verifiedformer findings.②Our findings support the viewpoint that the Carotid Ultrasonicinspection is a convenient and practical method to evaluate the levels of AS.

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