CAJ | 학술논문

目的：通过对代谢综合征(MS)常见中医证型的分析和血清脂肪因子水平的检测，研究 MS患者中医证候规律及其与血清脂肪因子的相关性。方法对235例代谢综合征患者进行中医辨证分型，分为痰瘀互结组、痰浊阻遏组、气阴两虚组和阴虚热盛组，检测其血清脂肪因子，并对中医证候进行频数分析。结果痰瘀互结组和痰浊阻遏组血清瘦素(LEP)、肿瘤坏死因子α(TNF α)、白细胞介素6(IL 6)、血清抵抗素(Resistin)、纤溶酶原激活物抑制物1(PAI 1)水平较高，与气阴两虚组比较差异有统计学意义(P<0.05)；痰瘀互结组和痰浊阻遏组血清脂联素(APN)水平较低，与气阴两虚组比较差异有统计学意义(P<0.05)；气阴两虚组视黄醇结合蛋白4(RBP4)较高，与其他3组比较差异有统计学意义(P<0.05)。代谢综合征中医症状、舌脉及病机出现的频次和频率具有一定规律，其病机出现的频次和频率由高到低依次为痰浊阻遏>痰瘀互结>气阴两虚>阴虚热盛。结论痰浊和血瘀可能是脂肪因子分泌及代谢异常并导致代谢综合征的关键病理环节。
목적：통과대대사종합정(MS)상견중의증형적분석화혈청지방인자수평적검측，연구 MS환자중의증후규률급기여혈청지방인자적상관성。방법대235례대사종합정환자진행중의변증분형，분위담어호결조、담탁조알조、기음량허조화음허열성조，검측기혈청지방인자，병대중의증후진행빈수분석。결과담어호결조화담탁조알조혈청수소(LEP)、종류배사인자α(TNF α)、백세포개소6(IL 6)、혈청저항소(Resistin)、섬용매원격활물억제물1(PAI 1)수평교고，여기음량허조비교차이유통계학의의(P<0.05)；담어호결조화담탁조알조혈청지련소(APN)수평교저，여기음량허조비교차이유통계학의의(P<0.05)；기음량허조시황순결합단백4(RBP4)교고，여기타3조비교차이유통계학의의(P<0.05)。대사종합정중의증상、설맥급병궤출현적빈차화빈솔구유일정규률，기병궤출현적빈차화빈솔유고도저의차위담탁조알>담어호결>기음량허>음허열성。결론담탁화혈어가능시지방인자분비급대사이상병도치대사종합정적관건병리배절。
Objective To investigate the relationship between traditional Chinese medicine(TCM)syndromes and serum adipokines in metabolic syndrome(MS).Methods Two hundreds and thirty five patients with MS were classified into four groups:Intermingled phlegm and blood stasis group,phlegm repressor groups,deficiency of both qi and yin group and yin deficiency and heat hyperactivity group.Serum adipokines were detected of MS,and then their TCM syndromes were counted by the frequency analysis.Results The relationship between serum fat factor and TCM syndromes showed that there was a higher level of the serum leptin(LEP),tumor nec-rosis factor α(TNF α),interleukin 6(IL 6),serum resistin and plasminogen activator inhibitor 1 (PAI 1)in both intermingled phlegm and blood stasis group and phlegm repressor group than that of deficiency of both qi and yin group,indicating a significantly statistical difference(P<0.05).The serum adiponectin(APN)level of intermingled phlegm and blood stasis group and phlegm re-pressor group were lower than that of deficiency of both qi and yin group,showing a significantly statistical differences(P<0.05). Compared with the other three groups,the retinol binding protein 4(RBP4)level was higher,there was a significantly statistical difference(P<0.05).TCM syndrome patterns of MS showed that the frequency of TCM symptoms tongue and pulse and pathogene-sis in MS patients had a certain regularity. The pathogenesis frequency was as fol ows phlegm repressor syndrome,intermingled phlegm and blood stasis syndrome,deficiency syndrome of both qi and yin,yin deficiency and heat hyperactivity syndrome in de-scending order.Conclusion Phlegm and blood stasis may be a key pathological aspects of adipokine secretion and metabolism and leading to MS.