冠心病合并高血压患者中医证型与冠脉病变相关性的研究

发布时间：2018-02-25 16:31

本文关键词： 冠心病高血压中医证型　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:总结冠心病高血压患者与冠心病患者中医证型分布特点及冠心病高血压患者中医证型与冠脉病变的相关性。方法:纳入行冠脉造影检查的冠心病患者92例,冠心病高血压患者103例为研究对象。采集两组患者的一般资料、既往史、中医证候表现及冠状动脉造影结果,填写临床观察表,所有数据录入Excell表格建立数据库。将所有纳入病例根据中医证候表现确定其相应中医证型,并观察所有患者冠脉病变情况。采用SPSS17.0软件进行统计分析,计数资料采用χ2检验,计量资料两组间比较采用t检验,多组间比较采用单因素方差分析,冠心病高血压组与中医证型的相关性采用logistic回归分析。结果:1、一般资料:两组患者性别、年龄、体质指数、烟酒史、糖尿病病程、冠心病病程比较,均无统计学差异(P0.05)。2、血脂、血糖、血压:两组患者TC、TG、HDL-C、LDL-C、血糖比较,均无统计学意义(P0.05)。冠心病高血压组患者收缩压、舒张压均高于冠心病组患者,有统计学意义(P0.05)。3、冠脉病变特点:冠心病高血压组以冠脉多支病变居多,冠心病组以冠脉单支病变居多,两组比较有统计学意义(P0.05)。冠心病高血压组冠脉狭窄程度以4级居多,冠心病组冠脉狭窄程度以2级、3级居多,两组比较有统计学意义(P0.05)。冠心病高血压组Gensini评分明显高于冠心病组Gensini评分,有统计学意义(P0.05)。4、冠脉病变情况与血压分级的关系:冠心病高血压3级组Gensini评分明显高于冠心病高血压1级组、2级组Gensini评分,有统计学意义(P0.05)。5、中医证型分布特点:冠心病高血压组以气滞心胸证、心血瘀阻证、痰阻心脉证为主,其中气滞心胸证、心血瘀阻证与冠心病高血压的关系最为密切。冠心病组主要以心气亏虚证和心血瘀阻证为主。两组中医证型分布比较,有统计学意义(P0.05)。6、冠脉病变特点与中医证型组合的关系:与冠心病高血压组相比,单一证型、兼夹证型的Gensini评分均高于冠心病组,有统计学意义(P0.05)。7、冠心病高血压组冠脉病变情况与中医证型关系:单支组、双支组、多支组病变的冠脉均以气滞心胸证、心血瘀阻证和痰阻心脉证所占比例居多,其中气滞心胸证所占比例最大。但三组中医证型在病变冠脉支数上的分布无统计学意义(P0.05)。冠脉狭窄2级组、3级组、4级组均以气滞心胸证占有比例最大。但三组中医证型在病变冠脉狭窄程度上的分布无统计学意义(P0.05)。结论:1、冠心病高血压组的冠脉病变以多支病变、4级程度狭窄为主,并且冠心病高血压组Gensini评分明显高于冠心病组。冠脉病变程度与血压分级成正相关。2、冠心病高血压组与气滞心胸证、心血瘀阻证关系最为密切。冠心病组主要以心气亏虚证、心血瘀阻证为主。3、冠心病高血压组单一证型、兼夹证型的冠脉病变程度均重于冠心病组。兼夹证型表现的冠心病高血压组冠脉病变程度较重。
[Abstract]:Objective: to summarize the distribution characteristics of TCM syndromes in patients with coronary artery disease (CHD) and patients with coronary heart disease (CHD) and the correlation between TCM syndromes and coronary lesions in patients with CHD. Methods: 92 cases of coronary artery disease (CHD) were examined by coronary angiography. 103 patients with coronary heart disease and hypertension were studied. The general data, past history, TCM syndromes and coronary angiography results were collected, and the clinical observation forms were filled out. All the data were input into the Excell form to establish the database. According to the syndromes of TCM, all the cases were selected to determine their corresponding TCM syndromes, and the coronary lesions of all patients were observed. The statistical analysis was carried out by SPSS17.0 software, and the count data were analyzed by 蠂 2 test. The correlation between CHD and TCM syndromes was analyzed by logistic regression analysis. Results: 1. General data: sex, age, body mass index of the two groups. There was no significant difference in the history of tobacco and alcohol, the course of diabetes, and the course of coronary heart disease (P 0.05). Diastolic blood pressure (DBP) was significantly higher than that in coronary heart disease (CHD) group (P 0.05). The characteristics of coronary artery disease were as follows: coronary artery disease was more common in hypertension group and single coronary artery disease in coronary heart disease group. There was significant difference between the two groups (P 0.05). The degree of coronary artery stenosis in CHD hypertension group was mostly grade 4, and that in coronary heart disease group was grade 2 and grade 3, and the degree of coronary artery stenosis in coronary heart disease group was higher than that in coronary artery disease group. There was significant difference between the two groups (P 0.05). The Gensini score of CHD hypertension group was significantly higher than that of CHD group Gensini score. The relationship between coronary artery disease and blood pressure grade: the Gensini score of coronary artery disease grade 3 group was significantly higher than that of coronary heart disease grade 1 hypertension grade 2 group, Gensini score was significantly higher than that of coronary artery disease grade 1 group and grade 2 group. The distribution characteristics of TCM syndromes were as follows: Qi stagnation heart and chest syndrome, heart blood stasis syndrome, phlegm blocking heart vein syndrome, and qi stagnation heart and chest syndrome. The relationship between heart blood stasis syndrome and coronary heart disease hypertension is most close. In coronary heart disease group, heart qi deficiency syndrome and heart blood stasis syndrome are the main factors. The relationship between the characteristics of coronary artery disease and the combination of TCM syndromes: compared with the coronary hypertension group, the Gensini scores of the single syndrome type and the clipping type were higher than that of the coronary heart disease group. The relationship between coronary artery disease and TCM syndromes in coronary heart disease and hypertension group was as follows: single vessel group, double vessel group and multi-vessel group all had Qi stagnation heart chest syndrome, heart blood stasis syndrome and phlegm blocking heart vein syndrome. The proportion of qi stagnation cardiothoracic syndrome was the largest, but the distribution of TCM syndrome type in the number of coronary artery branches in the three groups was not statistically significant (P 0.05). The proportion of Qi stagnation cardiothoracic syndrome was the largest in grade 2, grade 3, grade 3 and grade 4 of coronary stenosis group, but in the three groups, the proportion of Qi stagnation cardiothoracic syndrome was the largest. There was no significant difference in the distribution of the degree of coronary stenosis between the two groups (P 0.05). Conclusion the coronary artery disease in the group of coronary heart disease and hypertension is mainly composed of multi-vessel stenosis and grade 4 stenosis. The Gensini score of coronary artery disease hypertension group was significantly higher than that of coronary heart disease group. The degree of coronary artery disease was positively correlated with blood pressure grade. The relationship between coronary heart disease hypertension group and qi stagnation heart blood stasis syndrome was the most close. The degree of coronary artery disease in CHD hypertension group was more serious than that in coronary heart disease group, and the coronary artery lesion degree in CHD hypertension group was more serious than that in coronary heart disease group.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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