绝经后血脂异常的中医药认识及防治思路
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摘要
绝经后血脂异常发生率明显增加,早期干预血脂异常,可以减少或延缓绝经后心血管疾病。目前有部分临床及实验研究显示了中医药防治该病的疗效,但研究数量和质量均有待提高。在下一步研究中,应着重3个方面,首先开展绝经后血脂异常的证候流行病学及基于代谢组学证候本质的研究;其次基于中医药对于更年期症状的有效性和症状与绝经后心血管疾病发生的相关性,发挥中医"治未病"优势,评价中医药治疗绝经相关症状从而改善血脂代谢的疗效;最终要完善顶层设计,开展大样本高质量的长期随访研究以提供中医药防治绝经后血脂异常的有力证据。
引文
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[8]郁琦,尚梦远.绝经相关激素补充治疗现状[J].实用妇产科杂志,2013,29(2):81-83.
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[12]MARJORIBANKS J,FARQUHAR C M,ROBERTS H,et al.Cochrane corner:long-term hormone therapy for perimenopausal and postmenopausal women[J].Heart,2018,104(2):93-95.
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[16]KARGOZAR R,AZIZI H,SALARI R.A review of effective herbal medicines in controlling menopausal symptoms[J].Electronic Physician,2017,9(11):5826-5833.
[17]杨瑞合.“肾虚”与高脂血症发病关系的探讨[J].中国中西医结合杂志,1989,9(5):313-314.
[18]王清霞.芪仙调脂汤联合生活方式干预对妇女绝经后脂代谢异常的临床观察[D].南京:南京中医药大学,2017.
[19]钱宏图,陈霞.益坤口服液治疗肝肾阴虚型围绝经期综合征合并脂质代谢紊乱的临床观察[J].湖北中医杂志,2009,31(12):52-53.
[20]邓伟民,黄海,曾东,等.补肾壮骨冲剂对更年期综合征患者性激素及血脂的影响[J].中医杂志,2011,52(3):208-210.
[21]李书娟,任艳玲,孙月娇.左归丸与右归丸及其拆方对去卵巢大鼠脂质代谢的影响[J].时珍国医国药,2016(9):2107-2109.
[22]费震宇,王文健,关明,等.补肾方对去势高脂血症兔血脂及ox-LDLmRNA表达的作用[J].复旦学报(医学版),2003,30(2):99-102.
[23]GAST G C,POP V J,SAMSIOE G N,et al.Vasomotor menopausal symptoms are associated with increased risk of coronary heart disease[J].Menopause-the Journal of the North American Menopause Society,2011,18(2):146-151.
[24]FRASURE-SMITH N,LESPARANCE F.Depression and cardiac risk:present status and future directions[J].Heart,2010,96:173-176.
[2]赵立军,魏朝晖,孙亚.绝经后女性血脂异常状况的分析[J].中国中医药现代远程教育,2010,8(15):189.
[3]YUSFUS S,HAWKEN S,OUNPUU S,et al.Effect of potentially modifiable risk factors associated with myocardial infarction in 52countries(the INTERHEART study):case-control study[J].Lancet,2004,364(9438):937-952.
[4]中国医师协会心血管内科医师分会女医师工作委员会.中国女性心血管疾病预防专家共识[J].中华内科杂志,2017,56(6):472-476.
[5]XU J,MURPHY S L,KOCHANEK K D,et al.Deaths:final data for 2013[J].Natl Vital Stat Rep,2016,64(2):1-119.
[6]RAMEZANI T F,BAHRI M,GHOLAMI R,et al.Secular trend of menopausal age and related factors among Tehrani women born from1930to 1960;Tehran Lipid and Glucose Study[J].Archives of Iranian Medicine,2014,17(6):406-410.
[7]KANNEL W B.Metabolic risk factors for coronary heart disease in women:perspective from the Framingham study[J].Am Heart J,1987,114(2):413-419.
[8]郁琦,尚梦远.绝经相关激素补充治疗现状[J].实用妇产科杂志,2013,29(2):81-83.
[9]LOBO R A.Menopause and aging[M]//Barbiera RL.Yen and Jaffe′s reproductive endocrinology,physiology,pathophysiology and clinical management.7th ed.Philadelphia:Elsevier Saunders,2013:308-339.
[10]VILLIERS T J D,GASS M L S,HAINES C J,et al.Global consensus statement on menopausal hormone therapy[J].Climacteric the Journal of the International Menopause Society,2013,16(2):203.
[11]BABER R J,PANAY N,FENTON A,et al.2016 IMS recommendations on women′s midlife health and menopause hormone therapy[J].Climacteric,2016,19(2):109-150.
[12]MARJORIBANKS J,FARQUHAR C M,ROBERTS H,et al.Cochrane corner:long-term hormone therapy for perimenopausal and postmenopausal women[J].Heart,2018,104(2):93-95.
[13]SMITH S C J R,BENJAMIN E J,BONOW R O,et al.AHA/AC-CF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease:2011 update:aguideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World[J].Journal of the American College of Cardiology,2011,58(23):2432-2446.
[14]ROSSOUW J E,ANDERSON G L,PRENTICE R L,et al.Risks and benefits of estrogen plus progestin in healthy postmenopausal women:principal results from the women′s health initiative randomized controlled trial[J].JAMA,2002,288(3):321-333.
[15]COLLABORATORS B V M W S.Breast cancer and hormone-replacement therapy:the million women study[J].Lancet,2003,997(1):341-350.
[16]KARGOZAR R,AZIZI H,SALARI R.A review of effective herbal medicines in controlling menopausal symptoms[J].Electronic Physician,2017,9(11):5826-5833.
[17]杨瑞合.“肾虚”与高脂血症发病关系的探讨[J].中国中西医结合杂志,1989,9(5):313-314.
[18]王清霞.芪仙调脂汤联合生活方式干预对妇女绝经后脂代谢异常的临床观察[D].南京:南京中医药大学,2017.
[19]钱宏图,陈霞.益坤口服液治疗肝肾阴虚型围绝经期综合征合并脂质代谢紊乱的临床观察[J].湖北中医杂志,2009,31(12):52-53.
[20]邓伟民,黄海,曾东,等.补肾壮骨冲剂对更年期综合征患者性激素及血脂的影响[J].中医杂志,2011,52(3):208-210.
[21]李书娟,任艳玲,孙月娇.左归丸与右归丸及其拆方对去卵巢大鼠脂质代谢的影响[J].时珍国医国药,2016(9):2107-2109.
[22]费震宇,王文健,关明,等.补肾方对去势高脂血症兔血脂及ox-LDLmRNA表达的作用[J].复旦学报(医学版),2003,30(2):99-102.
[23]GAST G C,POP V J,SAMSIOE G N,et al.Vasomotor menopausal symptoms are associated with increased risk of coronary heart disease[J].Menopause-the Journal of the North American Menopause Society,2011,18(2):146-151.
[24]FRASURE-SMITH N,LESPARANCE F.Depression and cardiac risk:present status and future directions[J].Heart,2010,96:173-176.