民航飞行员脂代谢异常对中医体质的影响重点

·306· 国际中医中药杂志2016年4月第38卷第4期 Int J Trad Chin Med, April 2016, Vol. 38, No.4 ·论著· 民航飞行员脂代谢异常对中医体质的影响

赵润栓 白雪琴 平昭 许峻峰 刘欢 时敬宇 赵明 【摘要】 目的 研究民航飞行员脂代谢异常与中医体质的相关性，探讨职业环境对血脂、体质的影响。方法 评测656名飞行员的血脂状况，对脂代谢异常的496人进行中医体质类型评估。按年龄分为青年组、中年组；按血脂异常类型分为单纯TC代谢异常，单纯TG代谢异常，TC、TG双代谢异常。比较不同年龄段、不同血脂异常类型9种中医体质人员分布的差异。结果 656名飞行员中，脂代谢异常为75.61%。脂代谢异常人群前3位偏颇体质分别是痰湿质(35.89%)、湿热质(33.06%)、阳虚质(20.97%)。不考虑年龄因素时，TC代谢异常与TG代谢异常的9种中医体质人员分布无明显差异(P值均＞0.05)，但TC代谢异常的阳虚质、湿热质人员分布高于TC、TG双代谢异常者(χ2值分别为6.793、5.077，P＜0.05)。

考虑年龄因素后，青年组TC代谢异常时，湿热质人员分布高于TC、TG双代谢异常者(χ2＝7.637，P＜

0.01)；TG代谢异常时，气虚质和阳虚质人员分布高于TC、TG双代谢异常者(χ2值分别为6.139、7.525，

P＜0.05)。中年组TC代谢异常时，阳虚质与气郁质人员分布高于TG代谢异常者(χ2值分别为9.750、3.922，

P＜0.05)，阳虚质人员分布高于TC、TG双代谢异常者(χ2＝5.208，P＜0.05)；TC、TG双代谢异常的阳

虚质人员分布高于TG代谢异常者(χ2＝4.489，P＜0.05)。结论 年龄与脂代谢状况可影响民航飞行员的

中医体质分布。湿热质是青年飞行员脂代谢异常者的常见体质；阳虚质、气郁质是中年飞行员脂代谢异常者常见体质。单纯TC代谢异常对中医体质的影响可能较TC、TG双代谢异常者更大。 【关键词】 民航飞行员；脂类代谢紊乱；中医体质；患病率

Study on the effect of abnormal lipid metabolism of civil aviation pilots on traditional Chinese medicine constitution Zhao Runshuan, Bai Xueqin, Ping Zhao, Xu Junfeng, Liu Huan,

Shi Jingyu, Zhao Ming. Health Management Center, Beijing Xiaotangshan Rehabilitation Hospital(The

Beijing Center for the Promotion of Health Management), Beijing 102211, China Corresponding author: Bai Xueqin, Email: 652360306@qq.com. 【Abstract】 Objective Research on the correlation of dyslipidemia of civil aviation pilots and the TCM constitution aimed to explore that how professional environmental affects the lipid metabolism and the constitution. Methods Measure the lipid statusand TCM constitution of 656 pilots, and 496 of them with dyslipidemia were studied. The sample were stratified according to the age and the types of dyslipidemia, including young and middle-aged groups, only abnormal total cholesterol metabolism (TC), only abnormal triglyceride metabolism (TG), and both abnormal cholesterol and triglycerides metabolism groups and then the differences in prevalence of traditional Chinese medicine in different groups were analyzed and discussed. Results The prevalence of abnormal lipid metabolism was 75.61% in 656 pilots. The top three TCM constitutions among the pilot with dyslipidemia were phlegm dampness constitution (35.89%), dampness heat constitution (33.06%) and deficiency of Yang(20.97%). If age was not considered, the prevalence of TCM constitutions were not significantly different between the groups of only abnormal TC and TG (P>0.05), while the prevalence of Yang deficiency and dampness heat constitutions of only either TC or TG abnormal group were significantly higher than those of the group of both abnormal TC, TG (χ2 values were 6.793, 5.077,

P<0.05). Take age as considered, TC metabolic abnormalities in youth group, the prevalence of damp heat

DOI: 10.3760/cma.j.issn.1673-4246.2016.04.006 基金项目：北京市科学技术委员会重点实验室基金资助项目(2014LCLB02) 作者单位：102211北京小汤山康复医院健康管理中心(北京市健康管理促进中心) 通信作者：白雪琴，Email: 652360306@qq.com 国际中医中药杂志2016年4月第38卷第4期 Int J Trad Chin Med, April 2016, Vol. 38, No.4 ·307· constitution of the only TC abnormal group was higher than both TC, TG abnormal group (χ2=7.637, P<0.01);

and the prevalence of Qi deficiency and Yang deficiency constitution of the only TG abnormal group were higher than both TC, TG abnormal group (χ2 values were 6.139, 7.525, P<0.05). In the middle-aged group, the

prevalences of Yang deficiency and Qi stagnation constitution of only TC abnormal group were higher than only TG abnormal group (χ2 values were 9.750, 3.922, P<0.05), and the prevalence of Yang deficiency of only TC

abnormal group was higher than both TC, TG abnormal group (χ2=5.208, P<0.05). The prevalence of Yang

deficiency of both TC, TG abnormal group was higher than only TG abnormal group (χ2= 4.489, P<0.05). Conclusions The result showed high prevalence of dyslipidemia in the population of civil aviation pilots. Age and lipid metabolism status could affect the types of TCM constitution. Damp-heat constitution was the common type of TCM constitution in the population of the young pilot, and Yang deficiency and Qi stagnation constitution were the common types in the population of middle-aged people whose lipid metabolism were disorder. The group of only abnormal TC influence on TCM constitution more than both abnormal TC and TG. 【Key words】 Airline pilot; Lipid metabolism disorders; TCM constitution; Prevalence

中医体质辨识是在“治未病”思想指导下，被广泛认可与采用的认识人体健康状况的方法。近年来已有学者对特殊职业人群开展了中医体质评估，以探讨职业环境对体质的影响。民航飞行员作为一种特殊职业人群，研究该群体的体质状况及影响因素，对中国航空卫生事业具有一定意义。目前，有关民航飞行员脂代谢异常与中医体质相关性分析的文献报道较少，本文探讨了中国民航飞行员不同年龄、不同脂代谢异常类型与中医体质的关系。 1 资料与方法 1.1 研究对象：调查2012年3月－2014年12月在北京小汤山疗养院进行健康疗养的国内某航空公司的民航飞行员656人。 1.2 研究方法：对656名飞行员进行中医体质评估并测定血脂水平。按年龄段分析不同脂代谢异常类型飞行员9种中医体质的分布，探讨年龄与脂代谢异常对飞行员体质的影响。 1.3 中医体质评定标准：采用《中医体质分类与判定》[1]标准分为9种类型，平和质属健康体质，气虚质、阴虚质、阳虚质、痰湿质、湿热质、气郁质、瘀血质、特禀质属偏颇体质。同一个体可能同时存在几种体质类型。 1.4 年龄分层标准：采用WHO年龄划分标准[2]，≤44岁为青年人，45～59岁为中年人。 1.5 脂代谢异常判定标准：根据文献[3]标准制定。TC＞5.2 mmol/L；TG＞1.7 mmol/L；LDL-C＞3.37 mmol/L；HDL-C＜0.9 mmol/L。满足其中任何1项指标即可诊断为血脂异常。本研究将脂代谢异常分为3种类型，①单纯TC代谢异常：指TC、LDL-C、HDL-C中至少有1项异常，同时TG在正常范围；②单纯TG代谢异常：指TG＞1.7 mmol/L，同时TC、LDL-C、HDL-C均在正常范围；③ TG、TC双代谢异常：指TC、LDL-C、HDL-C中至少有1项异常，同时TG＞1.7 mmol/L。 1.6 质量控制：由中级职称以上专业中医师指导飞行员填写中医体质评估问卷，并根据舌苔、脉象评估中医体质类型。受评者前一天要求清淡饮食，禁饮酒，晚10时以后禁食禁水。第二天清晨采空腹血，使用全自动生化分析仪检测血脂水平。标本的采集、送检，数据的录入、导出、统计分析均由受过培训的专职人员完成。 1.7 统计学方法：采用SPSS 13.0软件进行数据分析。计数资料以人数及百分率表示，采用χ2检