系统性红斑狼疮合并血脂异常的中医证候规律研究*

作者：白怡婧1，沈炎彬1，王新昌2，范永升2，包 洁3

单位：1.浙江中医药大学第二临床医学院，浙江 杭州 310053； 2.浙江中医药大学附属第二医院，浙江 杭州 310005； 3.浙江中医药大学基础医学院，浙江 杭州 310053

引用：引用：白怡婧，沈炎彬，王新昌，范永升，包洁.系统性红斑狼疮合并血脂异常的中医证候规律研究[J].中医药导报,2025,31(8):178-183,219.

DOI：10.13862/j.cn43-1446/r.2025.08.028

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摘要：

目的：分析系统性红斑狼疮（SLE）合并血脂异常患者的中医证候规律，为其中医诊治提供依据。方法：回顾性收集214例SLE合并血脂异常患者，结合电子病历系统和现场调查，收集患者的一般信息及四诊资料，建立数据库后统计分析其临床特点，以聚类分析结合专家意见归纳中医证候，并对证候规律进行初步探索。结果：SLE合并血脂异常患者以育龄期女性为主；常见证候为阳虚湿困证、阴虚内热证、气血亏虚证、风湿痹阻证及肝郁血瘀证，其中阳虚湿困证患者占比最高（37.85%，81/214）；阳虚湿困证患者的甘油三酯、总胆固醇、低密度脂蛋白水平均高于其他证型患者（P＜0.05），而高密度脂蛋白水平、补体C3、白细胞、血小板计数则低于其他证型患者；SLEDAI评分风湿痹阻证最高，气血亏虚证最低（P＜0.05）。结论：SLE合并血脂异常以育龄期女性高发，在辨证上以阳虚湿困证为主，湿、热、虚、瘀为其关键病机。不同中医证型患者在血脂、补体C3、白细胞计数、血小板计数、SLEDAI评分方面存在差异，临床诊疗时可作参考。对于SLE患者，尤其是出现补体C3、白细胞、血小板降低，辨证为阳虚湿困证时，应警惕存在合并血脂异常的可能，有利于早期、正确地临床辨治。

关键词：系统性红斑狼疮；血脂异常；聚类分析；中医证候

Abstract：

Objective: To analyze the traditional Chinese medicine (TCM) syndrome patterns in patients with systemic lupus erythematosus (SLE) complicated with dyslipidemia, and provide a basis for TCM diagnosis and treatment of this condition. Methods: A retrospective collection of 214 patients with SLE complicated with dyslipidemia was conducted. Combined with electronic medical record systems and on-site investigations, general information and four diagnostic data of patients were collected. After establishing a database, statistical analysis of their clinical characteristics was performed. TCM syndromes were summarized using cluster analysis combined with expert opinions, and a preliminary exploration of syndrome patterns was carried out. Results: Patients with SLE complicated with dyslipidemia were mainly women of childbearing age. Common syndromes included Yang deficiency with dampness retention syndrome, Yin deficiency with internal heat syndrome, Qi and blood deficiency syndrome, wind-dampness obstruction syndrome, and liver depression with blood stasis syndrome. Among them, patients with Yang deficiency with dampness retention syndrome accounted for the highest proportion (37.85%, 81/214). Patients with Yang deficiency with dampness retention syndrome had higher levels of triglycerides, total cholesterol, and low-density lipoprotein than those with other syndromes (P<0.05), while their levels of high-density lipoprotein, complement C3, white blood cells, and platelet counts were lower than those with other syndromes. The SLEDAI score was the highest in wind-dampness obstruction syndrome and the lowest in Qi and blood deficiency syndrome (P<0.05). Conclusion: SLE complicated with dyslipidemia has a high incidence in women of childbearing age, and Yang deficiency with dampness retention syndrome is the main syndrome in syndrome differentiation. Dampness, heat, deficiency, and stasis are its key pathogenesis. Patients with different TCM syndromes show differences in blood lipids, complement C3, white blood cell count, platelet count, and SLEDAI score, which can be used as references in clinical diagnosis and treatment. For SLE patients, especially those with decreased complement C3, white blood cells, and platelets, and diagnosed with Yang deficiency with dampness retention syndrome, the possibility of complicated dyslipidemia should be vigilant, which is conducive to early and accurate clinical syndrome differentiation and treatment.

Key words：systemic lupus erythematosus; dyslipidemia; cluster analysis; traditional Chinese medicine syndrome

发布时间：2026-01-06

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