数字中医药（英文）2026，Vol.9Issue(1)：91-102,12.DOI:10.1016/j.dcmed.2026.02.008
经皮冠状动脉介入术后动脉粥样硬化性心血管疾病患者中医证候分布及其与血脂和心血管预后的相关性:一项前瞻性队列研究
Association of traditional Chinese medicine syndromes with blood lipid profiles and cardiovascular prognosis in post-percutaneous coronary intervention atheroscle-rotic cardiovascular disease patients:a prospective cohort study
摘要
Abstract
Objective Patients with atherosclerotic cardiovascular disease(ASCVD)following percuta-neous coronary intervention(PCI)are classified as very-high-risk individuals in cardiovascu-lar disease(CVD)risk stratification.The distribution pattern of traditional Chinese medicine(TCM)syndromes in this patient population,as well as its association with blood lipid pro-files and clinical prognosis,remains unclear.The present prospective cohort study aims to in-vestigate these correlations,thereby providing insights to enrich the research fields. Methods We enrolled consecutive patients with ASCVD who underwent PCI at the Integrat-ed Cardiology Unit of China-Japan Friendship Hospital between September 1,2020 and De-cember 31,2022.Demographics and clinical characteristics,signs and symptoms defining each TCM syndrome,and fasting venous blood samples were collected at baseline and follow up or upon major adverse cardiovascular events(MACEs).We analyzed the correlation be-tween TCM syndromes,blood lipid profiles,and MACEs,and developed a new joint prognos-tic model incorporating both TCM syndromes and blood lipids using logistic regression.The analyses were based on detailed baseline and one-year follow-up data. Results A per-protocol analysis was performed on 586 patients with complete data ultimate-ly.During the one-year follow-up,174 patients(29.69%)experienced a MACE.We performed statistical analyses on comorbidities,medication,and biochemical indicators across groups defined by TCM syndrome differentiation.When comparing different TCM syndromes,no significant differences were found in age,body mass index(BMI),history of revascularization,comorbidities,family history of CVD,smoking or drinking,or statin intensity(P>0.05).Pa-tients with intertwined phlegm and blood stasis syndrome exhibited significantly higher lev-els of total cholesterol(TC,5.27±1.18 mmol/L,P<0.001),triglyceride(TG,1.96±1.33 mmol/L,P=0.008),low-density lipoprotein cholesterol(LDL-C,3.35±0.79 mmol/L,P<0.001),and high-density lipoprotein cholesterol(HDL-C,1.24±0.81 mmol/L,P<0.001)compared with those with other TCM syndromes combined.A multivariable logistic regression model was constructed to predict MACEs.The model included TCM syndrome type[with intertwined phlegm and blood stasis as a predictor,adjusted odds ratio(OR)=1.413,95%confidence interval(CI):0.517 – 3.864,P=0.501],age(adjusted OR=0.97,95%CI:0.955 – 1.001,P=0.057),male gender(adjusted OR=0.698,95%CI:0.416 – 1.170,P=0.173),TC(adjusted OR=1.004,95%CI:0.513 – 1.965,P=0.990),and LDL-C(adjusted OR=5.825,95%CI:2.214 –15.326,P<0.001).This model demonstrated good discriminatory ability for MACEs in post-PCI ASCVD patients[the area under the receiver operating characteristic(ROC)curve(AUC)=0.865,95%CI:0.816 – 0.914]. Conclusion The intertwined phlegm and blood stasis TCM syndrome is associated with a distinct atherogenic lipid profile characterized by elevated levels of TC and LDL-C.The prog-nostic model that incorporates this TCM syndrome type along with conventional lipid param-eters(TC and LDL-C)shows good discriminatory ability for predicting MACEs in ASCVD pa-tients after PCI,underscoring the potential clinical utility of integrating TCM syndrome differ-entiation into CVD risk assessment.关键词
动脉粥样硬化性心血管疾病/经皮冠状动脉介入术后/中医证候/血脂/队列研究Key words
Atherosclerotic cardiovascular disease/Post-percutaneous coronary interven-tion/Traditional Chinese medicine syn-dromes/Blood lipids/Cohort study引用本文复制引用
徐煌钰,李乾,熊昊哲,洪伟栋,周心怡,鹿小燕,刘小丽,樊新荣..经皮冠状动脉介入术后动脉粥样硬化性心血管疾病患者中医证候分布及其与血脂和心血管预后的相关性:一项前瞻性队列研究[J].数字中医药（英文）,2026,9(1):91-102,12.基金项目
Capital Health Development Scientific Research Project(2020-2-4064),and National Key Research and Develop-ment Program of China(2018YFC2002502). （2020-2-4064）
