急性冠脉综合征患者血运重建后中医证型变化研究

发布时间：2018-05-28 17:23

本文选题：胸痹 + 急性冠脉综合征　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:应用预先制备的临床研究表,进行临床病例资料收集,分析归纳急性冠脉综合征的证候分布特点,探讨急性冠脉综合征(ACS)患者血运重建前后中医证型变化特点,为中西结合治疗急性冠脉综合征提供参考依据。方法:纳入符合诊断与研究标准的96例急性冠脉综合征住院患者,于血运重建前、后分别根据中医四诊信息辨证分型,建立数据库,进行统计学处理,分析急性冠脉综合征患者的证候特点,并分析其血运重建前后的中医证型的主要变化特点。结果:1.ACS患者血运重建治疗以65～74岁年龄组最多,占研究病历的34.3%。2.各年龄组患者血运重建前均以气滞证最常见,其次为气虚证及血瘀证。各年龄组兼证均以血瘀证最常见,其次为痰浊证。3.男性患者主证以气滞证最常见,其次为痰浊证、气虚证;女性患者主证也以气滞证最常见,其次为血瘀证、气虚证。4.有吸烟嗜好者主证以气滞证最多见,其次为痰浊证;有饮酒嗜好者主证以气滞证最多见,其次为气虚证及寒凝证。5.各年龄组患者血运重建后均以气虚证最常见,其中75岁年龄组患者术后主证气虚证增多最显著,增幅高达82.4%,其次为55～64年龄组,增幅为62.5%。6.各年龄组患者血运重建后兼证均有变化,兼血瘀证显著减少,而阳虚证、阴虚证明显增加。7.气虚证在植入三个及以上支架的患者中比例最高,占83.3%。结论:血运重建前后,各年龄组ACS患者中医辨证主证及兼证均发生变化,血运重建术前以气滞证最多见,血运重建术后以气虚证对多见,提示血运重建术影响患者的中医症候变化,中医治疗应在术后再次辨证诊断的基础上实施。
[Abstract]:Objective: to use the pre prepared clinical study table, collect the clinical case data, analyze and summarize the characteristics of the syndrome distribution of acute coronary syndrome (ACS), and discuss the characteristics of TCM syndrome type changes before and after the reconstruction of acute coronary syndrome (ACS), and provide the reference basis for the combination of Chinese and Western combined with the treatment of acute coronary artery syndrome. In 96 patients with acute coronary syndrome, before the reconstruction of blood transport, a database was established according to the syndrome differentiation and classification of four diagnosis information of Chinese medicine. Statistical processing was carried out to analyze the syndrome characteristics of patients with acute coronary syndromes, and the main characteristics of TCM syndrome types before and after the reconstruction of blood transport were analyzed. Results: blood of 1.ACS patients. The most common 34.3%.2. age groups were qi stagnation and Qi deficiency syndrome and blood stasis syndrome. All age groups were the most common syndrome of blood stasis, followed by.3. male patients with phlegm syndrome, the most common syndrome was qi stagnation, followed by phlegm syndrome and Qi deficiency syndrome; The main syndrome of patients with qi stagnation is the most common, followed by blood stasis syndrome, Qi deficiency syndrome.4. has the main evidence of qi stagnation, the second is phlegm syndrome, and the main syndrome of drinking hobby is Qi stagnation, followed by qi deficiency syndrome and cold coagulating syndrome in.5. age group, the most common syndrome is Qi deficiency syndrome after 75 years old age group. The increase of qi deficiency syndrome in the post main syndrome was the most significant, up to 82.4%, followed by the 55~64 age group, the increase of the rate of 62.5%.6. in all age groups was changed, and the syndrome of blood stasis significantly decreased, but the deficiency of Yang deficiency syndrome, yin deficiency proved to increase.7. Qi deficiency with the highest proportion of the patients implanted with three or more stents, accounting for 83.3%. conclusion: blood transport weight Before and after construction, the syndrome differentiation and syndrome of ACS patients in all age groups were changed. The qi stagnation syndrome was most common before the reconstruction of blood transport, and the Qi deficiency syndrome was more common after the reconstruction of blood transport. It suggested that the reconstructive operation of blood affect the change of TCM syndrome. The treatment of Chinese medicine should be carried out on the basis of diagnosis and diagnosis again after the operation.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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