Analysis of Clinical and Phenomics Characteristics of Patients with Phlegm-Stasis Binding Syndrome and Its Accompanied Patterns in Stable Angina Pectoris of Coronary Heart Disease

LI Chongchai; LI Han; LI Zheng; LI Zeng; ZHOU Yushi; AO Yuhan; XU Shuang; WANG Xue; SUN Yaoyao; WU Dongning; SHANG Hongcai; ZHANG Mingxue

doi:10.13288/j.11-2166/r.2026.14.009

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Analysis of Clinical and Phenomics Characteristics of Patients with Phlegm-Stasis Binding Syndrome and Its Accompanied Patterns in Stable Angina Pectoris of Coronary Heart Disease

更新时间：2026-07-17

- Analysis of Clinical and Phenomics Characteristics of Patients with Phlegm-Stasis Binding Syndrome and Its Accompanied Patterns in Stable Angina Pectoris of Coronary Heart Disease
- Journal of Traditional Chinese Medicine Vol. 67, Issue 14, Pages: 1514-1522(2026)
- 作者机构：
  
  1.辽宁中医药大学，辽宁省沈阳市皇姑区崇山东路79号，110032
  2.沈阳市卫生健康服务中心
  3.辽宁中医药大学附属医院
  4.中国中医科学院临床评价中心
  5.北京中医药大学东方医院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2026.14.009
  CLC：
- Received：28 June 2025，
  
  Revised：2026-05-13，
  
  Accepted：17 November 2025，
  
  Online First：15 July 2026，
  
  Published：17 July 2026
- 稿件说明：
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李崇钗,李涵,李峥等.冠心病稳定型心绞痛痰瘀互结证及其兼证患者临床与表型组学特征分析[J].中医杂志,2026,67(14):1514-1522.

LI Chongchai,LI Han,LI Zheng,et al.Analysis of Clinical and Phenomics Characteristics of Patients with Phlegm-Stasis Binding Syndrome and Its Accompanied Patterns in Stable Angina Pectoris of Coronary Heart Disease[J].Journal of Traditional Chinese Medicine,2026,67(14):1514-1522.
李崇钗,李涵,李峥等.冠心病稳定型心绞痛痰瘀互结证及其兼证患者临床与表型组学特征分析[J].中医杂志,2026,67(14):1514-1522. DOI： 10.13288/j.11-2166/r.2026.14.009.

LI Chongchai,LI Han,LI Zheng,et al.Analysis of Clinical and Phenomics Characteristics of Patients with Phlegm-Stasis Binding Syndrome and Its Accompanied Patterns in Stable Angina Pectoris of Coronary Heart Disease[J].Journal of Traditional Chinese Medicine,2026,67(14):1514-1522. DOI： 10.13288/j.11-2166/r.2026.14.009.

摘要

目的

探讨冠心病稳定型心绞痛痰瘀互结证及其兼证患者的临床特征与表型组学特征。

方法

采用多中心横断面研究设计，纳入300例冠心病稳定型心绞痛患者，按照中医证型分为痰瘀互结证120例及痰瘀互结兼气虚证125例、兼气滞证38例、兼毒蕴证17例。收集各中医证型患者一般资料、中医症状、血脂、凝血功能、免疫分子及血清代谢组学数据；采用代谢通路富集分析等方法比较各组表型特征差异，以变量对样本分类的贡献度（VIP）≥1、差异倍数（FC）≥2的代谢物为代表性代谢物。

结果

各中医证型患者均以60~75岁年龄段为多，男性占比较高。中医症状方面，痰瘀互结证患者弦涩或弦滑脉、胸痛、胸闷最为多见；痰瘀互结兼气虚证患者乏力、弱脉、胸痛最为多见；痰瘀互结兼气滞证患者弦涩或弦滑脉

，胸痛，症状随情绪或嗳气、矢气而增减最为多见；痰瘀互结兼毒蕴证患者口苦、胸闷、心烦易怒或烦躁不安或狂躁谵妄、大便干结或下利臭秽最为多见。各中医证型患者比较，凝血及血液流变学指标差异有统计学意义（

＜0.05），血脂与免疫分子指标比较差异无统计学意义（

＞0.05）。代谢组学分析提示，甘油磷脂代谢途径和缬氨酸、亮氨酸、异亮氨酸代谢紊乱是痰瘀互结证及其兼证的特征，痰瘀互结证与其兼气虚证的代表性代谢差异物为7

8-二氢生物蝶呤（FC=3.58）和奥昔嘌醇（FC=124.50）；痰瘀互结证与其兼气滞证的代表性代谢差异物为胞苷5'-二磷胆碱（FC=2.62）和D-甘露糖胺（FC=2.99）；痰瘀互结证与其兼毒蕴证的代表性代谢差异物为鹅丝氨酸（FC=7.83）和坎利酮（FC=8.94）。

结论

冠心病稳定型心绞痛痰瘀互结证及其兼证患者的临床特征及表型组学特征存在一定差异，其表型组学特征主要为脂代谢紊乱、氨基酸代谢异常及多重免疫分子激活等生物学改变，可为冠心病稳定型心绞痛中医临床精准辨治提供参考。

Abstract

Objective

To explore the clinical and phenomics characteristics of patients with phlegm-stasis binding syndrome and its accompanied patterns in stable angina pectoris （SAP） of coronary heart disease （CHD）.

Methods

A multicenter cross-sectional study design was adopted. A total of 300 patients with SAP of CHD were enrolled and classified into 120 cases of phlegm-stasis binding syndrome， 125 cases of

deficiency-accompanied syndrome， 38 cases of

stagnation-accompanied syndrome， and 17 cases of toxin accumulation-accompanied syndrome according to traditional Chinese medicine （TCM） patterns. Data of patients with different TCM patterns were collected， including general condition， TCM symptoms， blood lipids， coagulation function， immune indicators， and serum metabolomics. Metabolic pathway enrichment analysis was used to compare differences in phenomics characteristics among groups. Metabolites with variable importance in projection （VIP） ≥1 and fold change （FC） ≥2 were considered as representative differential metabolites.

Results

Patients in each TCM pattern type were most commonly in the 60-75 years age group， with a relatively high proportion of males. Regarding TCM symptoms， patients with phlegm-stasis binding syndrome most commonly presented with wiry-choppy or wiry-slippery pulse， chest pain， and chest tightnes

s； in patients with

deficiency-accompanied syndrome， fatigue， chest pain， and weak pulse were most common； in patients with

stagnation-accompanied sydnrome， wiry-choppy or wiry-slippery pulse， chest pain， and symptoms that increase or decrease with emotional changes， belching， or flatulence were most common； in patients with toxin accumulation-accompanied syndrome， bitter taste in the mouth， chest tightness， irritability， restlessness or manic delirium， and dry and hard stools or foul-smelling diarrhea were most common. Comparisons among the different TCM patterns showed statistically significant differences in coagulation parameters （

＜0.05）， whereas no statistically significant difference was found in blood lipid levels and immune indicators （

＞0.05）.Metabolomics analysis suggested that disorders of glycerophosphate metabolism and valine， leucine， and isoleucine metabolism are characteristic features of phlegm-stasis binding syndrome and its accompanied patterns. The representative differential metabolites between phlegm-stasis binding syndrome and

deficiency-accompanied syndrome were 7

8-dihydrobiopterin （FC = 3.58） and oxypurinol （FC = 124.50）. Those between phlegm-stasis binding syndrome and

stagnation-accompanied syndrome were cytidine 5′-diphosphocholine （FC = 2.62） and D-mannosamine （FC = 2.99）. Those between phlegm-stasis binding syndrome and toxin accumulation-accompanied syndrome were anserine （FC = 7.83） and canrenone （FC = 8.94）.

Conclusion

There are certain differences in the clinical characteristics and phenomics characteristics among patients with SAP due to CHD exhibiting phlegm-stasis binding syndrome and its accompanied patterns. The phenomics characteristics mainly involve biological alterations such as lipid metabolism disorders， amino acid metabolism abnormalities， and multiple immune indicators activation， which may provide a reference for precise differentiation and treatment of SAP of CHD in TCM clinical practice.

关键词

Keywords

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