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李怡璇, 叶超, 季昭宇, 马迪, 谢琼, 李品慧, 尹思宇, 韩志华, 权瑛, 陈婧.血脂异常痰浊阻遏证和脾肾阳虚证患者血清14,15-EET/DHET、GSH-Px浓度特点研究[J].湖南中医药大学学报,2026,46(8):1597-1603[点击复制] |
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| 血脂异常痰浊阻遏证和脾肾阳虚证患者血清14,15-EET/DHET、GSH-Px浓度特点研究 |
| 李怡璇,叶超,季昭宇,马迪,谢琼,李品慧,尹思宇,韩志华,权瑛,陈婧 |
| (北京中医药大学第三附属医院, 北京 100029;北京中医药大学东直门医院, 北京 100700;广东省中医院海南医院, 海南 海口 571437) |
| 摘要: |
| 目的 研究血脂异常痰浊阻遏证和脾肾阳虚证患者血清14，15-环氧化二十碳三烯酸/二羟基二十碳三烯酸（14，15-EET/DHET）和谷胱甘肽过氧化物酶（GSH-Px）的浓度特点及其与证候程度间的相关性。方法 本研究采用横断面调查设计，选取2021年5月至2025年2月在北京中医药大学东直门医院住院的患者共135例，其中血脂异常痰浊阻遏证51例、血脂异常脾肾阳虚证47例、正常受试者37例。采用ELISA检测患者血清14，15-EET/DHET和GSH-Px浓度，以中医证候量表评分量化血脂异常痰浊阻遏证和脾肾阳虚证的严重程度，比较3组上述指标的浓度特点，并分析其与证候评分的相关性。结果 （1）血脂异常痰浊阻遏证和血脂异常脾肾阳虚证患者在一般情况（性别、年龄、呼吸、心率、血压）及血脂指标比较上未见明显统计学差异（P>0.05）；（2）血脂异常痰浊阻遏证患者的血清14，15-EET/DHET浓度低于血脂异常脾肾阳虚证患者（P<0.05），血脂异常脾肾阳虚证患者的血清GSH-Px浓度水平低于血脂异常痰浊阻遏证患者（P<0.05）；（3）血脂异常痰浊阻遏证患者血清14，15-EET/DHET浓度与中医证候评分呈弱负相关（r=-0.287，P<0.05）；血脂异常脾肾阳虚证患者该指标与中医证候评分呈中等负相关（r=-0.340，P<0.05）。（4）两组血清GSH-Px浓度与中医证候评分均未见统计学相关性（P>0.05）。结论 血脂异常痰浊阻遏证和血脂异常脾肾阳虚证患者血清14，15-EET/DHET与GSH-Px浓度存在差异，与中医理论中该病-证的病因病机分析相一致。其中血清14，15-EET/DHET浓度可在一定程度上反映血脂异常痰浊阻遏证和脾肾阳虚证患者的严重程度，其机制可能与花生四烯酸细胞色素P450代谢通路失衡所致氧化应激增强有关，为血脂异常不同证候特点的基础研究提供了依据。 |
| 关键词: 血脂异常|痰浊阻遏证|脾肾阳虚证|14，15-环氧化二十碳三烯酸/二羟基二十碳三烯酸|谷胱甘肽过氧化物酶 |
| DOI：10.3969/j.issn.1674-070X.2026.08.008 |
| 投稿时间：2026-04-07 |
| 基金项目:北京市自然科学基金面上项目（7242233）；北京中医药大学中央高校基本科研业务费（揭榜挂帅）项目（2023-JYB-JBQN-044）；中央高水平中医医院临床科研业务费项目（DZMG-ZLZX-25021）；北京高层次创新创业人才支持计划（春蕾）项目（京卫人才〔2025〕2号）；北京中医药新时代125工程培训项目（京中医药科字〔2025〕2号）；北京中医药大学第三附属医院精诚人才项目（精诚青苗）。 |
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| Characteristics of serum 14,15-EET/DHET and GSH-Px concentrations in patients with dyslipidemia of phlegm-turbidity obstruction pattern or spleen and kidney yang deficiency pattern |
| LI Yixuan, YE Chao, JI Zhaoyu, MA Di, XIE Qiong, LI Pinhui, YIN Siyu, HAN Zhihua, QUAN Ying, CHEN Jing |
| (Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China;Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China;Hainan Hospital, Guangdong Provincial Hospital of Chinese Medicine, Haikou, Hainan 571437, China) |
| Abstract: |
| Objective To investigate the characteristics of serum 14,15-epoxyeicosatrienoic acid/14,15-dihydroxyeicosatrienoic acid (14,15-EET/DHET) and glutathione peroxidase (GSH-Px) concentrations in patients with dyslipidemia of phlegm-turbidity obstruction pattern and spleen and kidney yang deficiency pattern, and their correlations with pattern severity. Methods This cross-sectional study enrolled a total of 135 participants from the inpatient department of Dongzhimen Hospital, Beijing University of Chinese Medicine, from May 2021 to February 2025, including 51 patients with dyslipidemia of phlegm-turbidity obstruction pattern, 47 patients with dyslipidemia of spleen and kidney yang deficiency pattern, and 37 healthy controls. ELISA was used to determine serum 14,15-EET/DHET and GSH-Px concentrations, and a TCM pattern scale was used to quantify the severity of phlegm-turbidity obstruction pattern and spleen and kidney yang deficiency pattern in patients with dyslipidemia; the concentrations of the above indicators were compared among the three groups, and their correlations with Chinese medicine pattern scores were analyzed. Results (1) No statistically significant differences were observed between patients with dyslipidemia of phlegm-turbidity obstruction pattern and those with dyslipidemia of spleen and kidney yang deficiency pattern in baseline characteristics (sex, age, respiratory rate, heart rate, and blood pressure) or lipid parameters (P>0.05); (2) Serum 14,15-EET/DHET concentrations in patients with dyslipidemia of phlegm-turbidity obstruction pattern were lower than those in patients with dyslipidemia of spleen and kidney yang deficiency pattern (P<0.05), while serum GSH-Px concentrations in patients with dyslipidemia of spleen and kidney yang deficiency pattern were lower than those in patients with dyslipidemia of phlegm-turbidity obstruction pattern (P<0.05); (3) Serum 14,15-EET/DHET concentrations were weakly negatively correlated with Chinese medicine pattern scores in patients with dyslipidemia of phlegm-turbidity obstruction pattern (r=-0.287, P<0.05); This indicator was moderately negatively correlated with Chinese medicine pattern scores in patients with dyslipidemia of spleen and kidney yang deficiency pattern (r=-0.340, P<0.05); (4) No statistically significant correlations were observed between serum GSH-Px concentrations and Chinese medicine pattern scores in either group (P>0.05). Conclusion Serum 14,15-EET/DHET and GSH-Px concentrations differ between patients with dyslipidemia of phlegm-turbidity obstruction pattern and those with dyslipidemia of spleen and kidney yang deficiency pattern, which is consistent with the etiology and pathogenesis of this disease-pattern combination in Chinese medicine theory. Serum 14,15-EET/DHET concentrations may, to a certain extent, reflect pattern severity in patients with dyslipidemia of phlegm-turbidity obstruction pattern and spleen and kidney yang deficiency pattern; the specific mechanism may be associated with enhanced oxidative stress caused by an imbalance in the arachidonic acid cytochrome P450 metabolic pathway, thus contributing to basic research on the characteristics of different patterns of dyslipidemia. |
| Key words: dyslipidemia|phlegm-turbidity obstruction pattern|spleen and kidney yang deficiency pattern|14,15-epoxyeicosatrienoic acid/14,15-dihydroxyeicosatrienoic acid|glutathione peroxidase |
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