Study On The Syndrome Characteristics Of Hyperlipidemia

Objective:To study the characteristics of syndrome types of hyperlipidemia from "The revised draft Guidelines for clinical diagnosis and treatment of hyperlipidemia in TCM ", analyze the relationship between macroscopic symptoms and objective routine indexes of hyperlipidemia in the different syndrome,so we can provide reference for clinical application of the guidelines.Methods:1. According to "The revised draft Guidelines for clinical diagnosis and treatment of hyperlipidemia in TCM ",the topics was related to five syndromes of TCM,including liver and kidney deficiency,spleen and kidney deficiency,intrinsic phlegm-turbidity,qi-blood stagnation, stagnation of phlegm and blood-stasis.The revised draft was eventually settled in 2015, through the convening of the meeting and clinical verification for more than 1 years,by specialists from the national 15 large hospitals in all departments.2. This study selected out all the outpatients and inpatients of the endocrinology department in the Affiliated Hospital to Fujian University of traditional Chinese Medicine (TCM) who was in accord with the diagnostic criteria of hyperlipidemia and had compete data from March 2014 to December 2015,the total number reached to 256.Among them,124 cases of male,female 132 cases,the maximum age was 75 years old,minimum 18 years,mean age was 57.20±11.66 years.3. Western diagnostic criteria and inclusion criteria were based on the " Guidelines for prevention and treatment of Dyslipidemia in adults in China(2007)".The traditional Chinese Medicine syndrom criteria was based on the "The revised draft Guidelines for clinical diagnosis and treatment of hyperlipidemia in TCM".4. The basic information of patients and blood lipid levels,blood rheology,hypersensitive C-reactive protein and other laboratory indexes were collected by observation table.By using SPSS 18.0 software and statistical methods,the lipid differences,laboratory indexes between each type of syndrome were compared in order to strengthen the understanding of the characteristics of each syndrome type of hyperlipidemia.Results:1.256 cases were collected,syndrome type distribution to stagnation of phlegm and blood-stasis was the most(accounting for 29.30%),followed by liver and kidney deficiency (23.05%),intrinsic phlegm-turbidity (17.97%),spleen and kidney deficiency (account 16.79%), qi-blood stagnation (12.89%).2. Among the 256 patients,about the age distribution,the largest proportion was oldest group(48.05%),followed by 45 to 59 year-old middle-aged group,44-year-old youth group and below, respectively,37.11%,14.84%.3. All ages on the distribution of TCM syndrome type was had obvious differences, among patients with syndrome of qi-blood stagnation who was equal to or less than 44 years old accounted for more proportion,who were greater than or equal to 60 years had the minimum proportion;while in the other four syndromes,patients who were greater than or equal to 60 years old had the most amount,followed by 45 to 59 years.4. There was no difference (P>0.05) between the BMI index levels in each syndrome, . but in terms of the mean,the syndrome and the overall level of BMI were in the overweight range.5. There was no difference in the composition of hyperlipidemia associated with disease (P>0.05),but the number of patients with diabetes was the most,the second was hypertension.6. Lipid levels:hyperlipidemia syndrome types in the TC level was obvious different (P <0.05),among them,intrinsic phlegm-turbidity was different from qi-blood stagnation type. on the level of HDL-C,qi-blood stagnation,liver and kidney deficiency type,spleen and kidney deficiency,phlegm turbidity implication are different,each type on the TG and LDL-C levels had no significant difference (P>0.05)7. The distribution of syndrome type of hypercholesterolemia,hypertriglyceridemia and combined hyperlipidaemia had the largest proportion about stagnation of phlegm and blood-stasis type.8. The high-sensitivity C-reactive protein of hyperlipidemia syndrome types had significant difference,stagnation of phlegm and blood-stasis and spleen and kidney deficiency were different,stagnation of phlegm and blood-stasis’s mean was greater than spleen and kidney deficiency.9. Hemorheology index had no signficant difference in the syndrome differentiation type (P>0.05),but whole blood viscosity at low shear rate, ESR and K value of ESR equation’s mean were higher than the normal range; Although the mean level of whole blood viscosity at high shear rate,erythrocyte rigidity index and erythrocyte deformation index were in the normal range,but qi-blood stagnation type was significantly higher than the other type,and the highest mean value of erythrocyte aggregation index,plasma viscosity and HCT was stagnation of phlegm and blood-stasis type.Conclusion:1. In this study,the most possible syndrome among patients with hyperlipidemia was stagnation of phlegm and blood-stasis or liver and kidney deficiency type.2. The patients with hyperlipidemia were mainly middle-aged and elderly,but tended to be younger.3. There was a certain link between hyperlipidemia and high body mass index,obesity.4. The TC and HDL-C level of qi-blood stagnation was significantly higher than intrinsic phlegm-turbidity type.5. The Hs-CRP level of stagnation of phlegm and blood-stasis was significantly higher than spleen and kidney deficiency.6. The blood viscosity of every hyperlipidemia syndrome was increased,with qi-blood stagnation and intrinsic phlegm-turbidity type were more obvious.7. Hyperlipidemia and the occurrence of "phlegm" and "blood stasis" and " qi stagnation " were closely related.