冠心病心绞痛中医证侯特点回顾性分析研究及活血化瘀药物治疗冠心病心绞痛（瘀血阻络证）的临床观察

发布时间：2018-01-19 15:39

本文关键词： 冠心病心绞痛胸痹辨证分型中医药治疗　出处：《长春中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过对冠心病心绞痛患者的分析研究,探讨冠心病心绞痛中医证侯分布与性别、年龄、病程、家族史、吸烟、饮酒的关系,以及与其合并病高血压病、糖尿病、血脂异常的联系,明确冠心病心绞痛的中医辨证分型的流行病学特点,为中医药治疗冠心病心绞痛奠定基础;并探索活血化瘀中成药治疗冠心病心绞痛临床疗效及安全性研究。方法:参照冠心病的诊断标准,中医证侯分布研究部分选取了病例资料齐全的430例患者,对其中医证侯分为八个证侯:心血瘀阻、气虚血瘀、气滞血瘀、痰浊阻络、阴寒凝滞、气阴两虚、心肾阴虚、阳气虚衰。并对患者的性别、年龄、病程、家族史、吸烟、饮酒,是否高血压病、糖尿病、血脂异常等基本信息,对患者的信息建立数据库,将数据运用SPSS20.0统计软件进行处理,计数资料用X2检验,统计学处理以P=0.05为检验标准,P0.05时认为统计学有显著性差异,P0.05时认为统计学无显著性差异,分析其与中医证侯的关系;药物疗效临床观察部分选取40例患者分为对照组与治疗组,观察两组患者在服药后的运动试验(ETT)持续时间变化。结果:对430例冠心病心绞痛患者分析情况如下:1.总体分布中医证侯分布情况:心血瘀阻证气阴两虚证气虚血瘀证痰浊阻络证心肾阴虚证气滞血瘀证阳气虚衰证阴寒凝滞证。各证型的百分比依次为67.2%,38.8%,29.1%,26.5%,15.8%。2.性别因素在冠心病中医证候中的分布情况:男性辨为心血瘀阻、气阴两虚、痰浊阻络的比例大于女性;女性辨为气虚血瘀、心肾阴虚、气滞血瘀的比例大于男性;3.年龄及病程时间因素在冠心病中医证候中的分布情况:年轻者、病程短者以标实为主,多为心血瘀阻证、痰浊阻络证;年老者、病程长者以本虚为主,多为气阴两虚证、气虚血瘀证、心肾阴虚证;4.家族史与否在冠心病中医证候中的分布情况:有家族史与没有家族史患者比较,心血瘀阻证、气虚血瘀证较多;5.吸烟与否在冠心病中医证候中的分布情况:吸烟与不吸烟患者比较,痰浊阻络证较多且有统计学意义;6.饮酒与否在冠心病中医证候中的分布情况:饮酒与不饮酒患者比较,心血瘀阻证、痰浊阻络证较多;7.合并症与否在冠心病中医证候中的分布情况:冠心病心绞痛合并高血压病者与非合并高血压病者的心血瘀阻证、痰浊阻络证、心肾阴虚证有统计学差异,冠心病心绞痛合并糖尿病者与非合并糖尿病者的心肾阴虚证有统计学差异,冠心病心绞痛合并高脂血症者与非合并高脂血者的心血瘀阻证、痰浊阻络证有统计学差异。药物临床试验研究结果表明,活血化瘀中成药延黄消心痛胶囊在运动试验(ETT)持续时间变化有统计学意义,证明药物安全有效。结论:1.冠心病心绞痛中医证型分布最多为心血瘀阻证,气阴两虚证、气虚血瘀证、痰浊阻络证、心肾阴虚证依次递减。2.各证侯的分布与性别、年龄、病程、家族史、吸烟、饮酒、合并高血压病、合并糖尿病、合并血脂异常在统计学上均有显著性差异。3.延黄消心痛胶囊是治疗冠心病稳定型心绞痛的有效中药制剂。
[Abstract]:Objective: To study in patients with coronary heart disease and angina pectoris of coronary heart disease and angina pectoris, TCM Syndrome Distribution and sex, age, course of disease, family history, smoking, drinking, and disease complicated with hypertension, diabetes, dyslipidemia, epidemiological features of clear TCM crown heart disease angina type and lay the foundation for the Chinese medicine treatment of angina pectoris of coronary heart disease; and to explore the Huoxuehuayu drugs in treating coronary heart disease angina pectoris clinical efficacy and safety study. Methods: the diagnosis standard of coronary heart disease, TCM syndrome distribution of Hou selected 430 cases of patients with complete data, including medicine syndrome divided into eight syndromes: blood blood stasis, Qi deficiency and blood stasis, qi stagnation and blood stasis, phlegm stasis, stagnation of Yin cold, heart qi and yin deficiency, yin deficiency, Yang deficiency. And the patient's sex, age, course of disease, family history, smoking, alcohol consumption, blood pressure Disease, diabetes mellitus, dyslipidemia and other basic information, the establishment of a database of patient information, the data using SPSS20.0 statistical software for processing, count data using X2 test statistics based on P=0.05 testing standards, P0.05 believes that there are statistically significant differences, P0.05 believes that there was no significant difference, and analyze its relationship with TCM Hou; drug clinical observation on the effect of selected 40 patients were divided into control group and treatment group, observe two groups of patients in the exercise test after medication (ETT) duration changes. Results: 430 cases of patients with coronary heart disease angina analysis are as follows: 1. the overall distribution of TCM Syndrome Distribution: blood stasis syndrome Qi and yin deficiency of qi deficiency and blood stasis phlegm Blocking Collaterals qi stagnation and blood stasis syndrome of kidney yin deficiency and heart Yang Qi decline syndrome of stagnation of Yin cold. The percentage of each type were 67.2%, 38.8%, 29.1%, 26.5%, 15.8%.2. sex factors in the crown The distribution of TCM Syndromes of heart disease in men: identification for blood stasis, deficiency of Qi and Yin, phlegm stasis was higher than women; women diagnosed as Qi deficiency and blood stasis, heart Yin deficiency, qi stagnation and blood stasis was higher than the male; 3. the distribution of age and duration of the time factor in the TCM Syndromes of coronary heart disease: the young, the course short the real standard mainly for blood stasis, phlegm blocking collaterals; age, duration of the elderly to the deficiency, for more than two Qi and yin deficiency syndrome, Qi deficiency and blood stasis, heart and kidney yin deficiency; 4. family history or in TCM Syndromes of coronary heart disease, family history and distribution no family history of patients, blood stasis syndrome, Qi deficiency and blood stasis more; 5. smoking in TCM Syndromes of coronary heart disease: a comparison of the distribution of smoking and non-smoking patients, phlegm Blocking Collaterals and more significant; 6. alcohol or not in syndromes of coronary heart disease in distribution Compared with patients not drinking alcohol, blood stasis, phlegm stasis syndrome more; 7. comorbidities and coronary heart disease in TCM Syndrome Distribution: angina pectoris of coronary heart disease with blood stasis syndrome of hypertension and non hypertension patients, phlegm blocking collaterals, heart and kidney yin deficiency had significant difference, angina pectoris of coronary heart disease with diabetes and non diabetes mellitus heart kidney yin deficiency had significant difference, blood stasis syndrome of coronary heart disease and hyperlipidemia with high fat and non blood, there is significant difference between the phlegm blocking collaterals. Drug clinical trial results show that Huoxuehuayu drugs Yan Huang. Capsule in exercise test (ETT) duration change was statistically significant, that the drug is safe and effective. Conclusion: 1. angina pectoris of coronary heart disease syndromes up to blood stasis syndrome, Qi Yin deficiency two, Qi deficiency and blood stasis, phlegm The collaterals, heart and kidney yin deficiency syndrome by decreasing.2. and the distribution of gender, age, course of disease, family history, smoking, drinking, hypertension, diabetes, and dyslipidemia were statistically significant differences for the.3. extension of yellow Xiaoxintong Capsule is an effective traditional Chinese medicine preparation for treating coronary heart disease angina pectoris.

【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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