冠状动脉造影下血管病变程度与脉证关系的研究

发布时间：2018-05-30 16:49

本文选题：中医证候 + 脉象　；参考：《长春中医药大学》2016年硕士论文

【摘要】：目的:通过冠状动脉造影下血管病变程度与证候及脉象的关系研究,提高脉诊对冠心病的确诊率,藉此丰富并指导冠心病中医诊疗学。方法:选取100例因胸闷或胸闷痛为主症于我院做冠状动脉造影检查的住院患者为研究对象。于冠状动脉造影检查前完成病史、中医症状、脉象等要素的采集,进行记录,并做出中医辨证分型。脉象及中医证型的确立在行医至少5年、副主任及以上医师指导下完成。采用标准技术进行冠状动脉造影检查,记录冠脉病变结果。使用SPSS 13.0统计学软件进行数据分析,统计中医证候及脉象与冠脉造影下血管病变程度的关系。结果:各证候组间不同病变支数存在显著差异(P0.05),气阴两虚挟痰瘀证病变血管支数多,多为多支血管病变;气滞挟痰湿证组冠脉病变累及血管支数少,多为正常或单支病变。各证候组间冠脉血管不同狭窄程度存在统计学差异(P0.05),气阴两虚挟痰瘀证组冠脉狭窄程度重,多为重度狭窄,气滞挟痰湿证组冠脉狭窄程度轻,多见于轻中度病变。各证候组间冠脉血管病变积分不同分段存在显著差异(P0.05),气阴两虚挟痰瘀证组病变积分高,气滞血瘀证组冠脉病变积分较低。各脉象组间不同血管病变支数存在统计学差异(P0.05),诊脉属弦细滑组病变累及血管支数多,多为多支血管病变。各脉象组间冠脉不同狭窄程度存在统计学差异(P0.05),弦细滑脉组冠脉狭窄程度重,涩脉组多为轻度狭窄。各脉象组间冠脉血管变病积分不同分段存在显著差异(P0.05),弦细滑脉组病变积分高。结论:冠脉病变程度与中医证候及脉象具有相关性,气阴两虚挟痰瘀证组及切脉属弦细滑者提示冠脉病变程度较重,气滞挟痰湿证组提示冠脉病变程度较轻,多见于早期病变,可以对冠心病的诊断及预后提供一定参考价值。
[Abstract]:Objective: to improve the diagnostic rate of coronary artery disease (CHD) through the study of the relationship between the degree of coronary artery disease and syndromes and pulse patterns under coronary angiography, so as to enrich and guide the diagnosis and treatment of coronary artery disease (CHD). Methods: 100 inpatients with chest tightness or chest tightness were selected for coronary angiography. The history, symptoms and pulse of coronary artery were collected and recorded before coronary angiography. Pulse and TCM syndromes are established for at least 5 years under the guidance of Deputy Director and above. Coronary angiography was performed with standard technique to record the results of coronary artery disease. SPSS 13.0 statistical software was used to analyze the relationship between TCM syndromes and pulse patterns and the degree of coronary artery lesion. Results: there were significant differences in the number of different pathological branches among different syndrome groups (P0.05A). The number of vessel branches in the syndrome of Qi and Yin deficiency with phlegm and stasis was more than that in the group of qi stagnation with phlegm dampness, and the number of coronary artery lesions with phlegm dampness was less in the group of qi stagnation with phlegm dampness, which was normal or single vessel disease. There were significant differences in different degree of coronary artery stenosis among different syndrome groups (P 0.05). The degree of coronary artery stenosis was severe in the group of Qi and Yin deficiency with phlegm and blood stasis, and the degree of coronary artery stenosis was mild in the group of Qi stagnation with dampness of phlegm, which was often seen in mild and moderate pathological changes. There were significant differences in the scores of coronary artery lesion between different syndromes groups (P 0.05). The pathological score of Qi and Yin deficiency combined with phlegm and stasis syndrome group was higher than that of Qi stagnation and Blood stasis syndrome group. The coronary artery lesion score of Qi stagnation and Blood stasis Syndrome group was lower than that of Qi stagnation and Blood stasis group. There were significant differences in the number of branches of different vascular lesions among different pulse groups (P0.05A). The number of branches involved in the diagnosis of vascular diseases was more than that of the control group, and most of them were multi-vessel diseases. There were significant differences in different degree of coronary stenosis among different pulse groups (P 0.05). The degree of coronary artery stenosis was severe in the chord fine smooth vein group and mild stenosis in the astringent vein group. There were significant differences among different segments of coronary artery angiopathy score among different pulse groups (P 0.05), and the lesion score of chord fine smooth vein group was higher. Conclusion: the degree of coronary artery lesion is correlated with syndrome and pulse of TCM. The patients with Qi and Yin deficiency combined with phlegm stasis syndrome and those with fine and slippery veins suggest that the severity of coronary artery lesion is serious, and the degree of coronary artery disease is lighter in Qi stagnation with phlegm dampness syndrome, and it is more common in early stage. It can provide some reference value for the diagnosis and prognosis of coronary heart disease.
【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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