冠心病稳定型心绞痛中医证型与ABI及BaPWV的相关性研究

发布时间：2018-03-21 03:44

  本文选题：冠心病稳定型心绞痛　切入点：中医证型　出处：《云南中医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过检测冠心病稳定型心绞痛患者的动脉弹性指标:踝臂指数(ABI)和肱踝脉搏波传导速度(BaPWV),结合祖国医学的理论,分析ABI及BaPWV与冠心病稳定性心绞痛部分中医证型的相关性,进而为中西结合防治冠心病提供新的思路,同时,分析ABI及BaPWV的影响因素,为早期发现和干预外周动脉疾病,预防心血管事件的发生提供新的方向。方法:选取符合标准的120例冠心病稳定性心绞痛患者,年龄为45~75岁,其中男性患者64例,女性患者56例,男女比例约1.14:1。在签署知情同意书之后,按照统一制定的调查表,以问卷调查的形式,收集每位患者的四诊资料及一般情况。四诊资料包括:症状、脉象、舌象,归纳中医证型。一般情况包括:性别、年龄、吸烟史、心血管病家族史、既往史、身高和体重(计算出体重指数BMI)、收缩压和舒张压(计算出脉压差)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、空腹血糖(GLU)。采用日本科林公司的全自动动脉硬化检测仪BP-203RPEⅡ(VP-1000)采集ABI、BaPWV数值。结果:(1)本研究共纳入四个证型的冠心病稳定型心绞痛患者,四个证型所占比例依次为痰阻心脉证,占31.67%;气阴两虚证,占25.83%;心血瘀阻证,占22.5%;阳气虚衰证,占20%。其中,痰阻心脉证所占比例最高;所纳四个证型组痰阻心脉证、气阴两虚证、心血瘀阻证、阳气虚衰证组间男女比例依次为1:1.38,1.21:1,1.45:1,1.67:1。(2)各证型组间一般情况的比较:冠心病稳定型心绞痛痰阻心脉证患者的BMI值明显高于心血瘀阻证、气阴两虚证、阳气虚衰证的患者,收缩压、舒张压、脉压差、TC、TG、LDL-C、HDL-C四组间比较均无统计学差异;(3)冠心病稳定型心绞痛痰阻心脉证患者的ABI值低于气阴两虚证、心血瘀阻证、阳气虚衰证的患者,差异有统计学意义(P0.05);冠心病稳定型心绞痛痰阻心脉证患者的baPWV值高于其他三组,差异具有统计学意义(P0.05);(4)ABI的主要影响因素是性别与TG,TG与ABI呈负相关;(5)baPWV的主要影响因素是年龄和收缩压,且两者都与baPWV呈正相关。结论:冠心病稳定型心绞痛痰阻心脉证患者ABI值低于心血瘀阻证、气阴两虚证、阳气虚衰证的患者,而baPWV值则高于其他三组证型的患者;冠心病稳定型心绞痛痰阻心脉证患者BMI高于其他三组证型的患者;ABI的主要影响因素是性别和TG,TG与ABI呈负相关;baPWV的主要影响因素是年龄和收缩压,且两者都与baPWV呈正相关;其中TG和收缩压是可控因素,而性别、年龄是不可控因素。
[Abstract]:Objective: to study the arterial elasticity index (ABI) and brachial pulse wave velocity (BWV) in patients with stable angina pectoris of coronary heart disease (CHD), combined with the theory of traditional Chinese medicine. To analyze the correlation between ABI and BaPWV and some TCM syndromes of stable angina pectoris of coronary heart disease, and to provide a new idea for the prevention and treatment of coronary heart disease by combining Chinese and western medicine. At the same time, to analyze the influencing factors of ABI and BaPWV, so as to find and intervene in peripheral artery disease early. Methods: 120 patients with stable angina pectoris of coronary heart disease, aged 4575 years, including 64 male and 56 female, were selected to prevent cardiovascular events. The ratio of men to women is about 1.14: 1.After signing the informed consent form, according to the unified questionnaire, the data of four diagnoses and general information of each patient are collected in the form of questionnaire. The information of four diagnoses includes: symptoms, pulse, tongue, etc. Generalize TCM syndromes. General conditions include: sex, age, smoking history, family history of cardiovascular disease, past history, Height and weight (calculated body mass index BMIA, systolic blood pressure and diastolic pressure, calculated pulse pressure difference, total cholesterol TCU, triglyceride TGG, low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), high density lipoprotein (HDL-C), fasting blood glucose (GLU)). BP-203RPE 鈪，

本文编号：1642115