急性下壁心肌梗死并发房室传导阻滞中医证型及临床特点分析

发布时间：2018-05-30 16:59

  本文选题：急性心肌梗死 + 急性下壁心肌梗死　； 参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:探讨及分析急性下壁心肌梗死(Acute Inferior Myocardial Infarction,AIMI)并发房室传导阻滞(Atrioventricular Block,AVB)的特点、中医证型分布情况,为急性下壁心肌梗死并发房室传导阻滞中医临床辨证论治提供科学依据。方法:2011年1月至2017年3月有438例下壁AMI就诊于辽宁中医药大学附属医院心内二科,其中未并发AVB患者359例,按照中医证型分为痰瘀互结组、气滞血瘀组、气阴两虚组、心肾阳虚组四组。并发AVB患者79例,按照中医证型分为痰瘀互结组、气滞血瘀组、气阴两虚组、心肾阳虚组四组;按AVB类型分为Ⅰ度AVB,Ⅱ度AVB,Ⅲ度AVB三组,对病例资料进行回顾性分析。结果:1.359例下壁AMI未并发AVB患者中医证型以实证居多,79例并发AVB患者以虚症居多,P=0.0000.05有统计学意义。2.下壁AMI患者中医证型为实证或虚症的,并发AVB的发生时间上无差别,P=0.130.05无统计学意义。3.79例下壁AMI患者24h内并发AVB 26例,多为Ⅲ度AVB;24h后并发AVB 53例,多为Ⅱ度AVB,P=0.0000.05有统计学意义。4.79例下壁AMI并发AVB患者死亡2例,出院77例,死亡率2.53%,中医证型实症与虚症的死亡率无差别,采用Fisher精确检验,P=1.0000.05无统计学意义。结论:1.急性下壁心肌梗死患者中医辨证分型属虚症者易并发房室传导阻滞。2.急性下壁心肌梗死患者24小时内易并发Ⅲ度房室传导阻滞;24小时后易并发Ⅱ度房室传导阻滞。3.急性下壁心肌梗死并发房室传导阻滞患者,中医证型实症与虚症的死亡率无差别。4.急性下壁心肌梗死未并发房室传导阻滞患者中医证型痰瘀互结证、气滞血瘀证、气阴两虚证、心肾阳虚证所占比例依次减少;急性下壁心肌梗死并发房室传导阻滞患者中医证型心肾阳虚证、气阴两虚证、痰瘀互结证、气滞血瘀证所占比例依次减少,有利于临床采用中西医结合预防和治疗急性下壁心肌梗死并发房室传导阻滞。尽早采用中西医结合预防和治疗急性下壁心肌梗死并发房室传导阻滞,提高其治疗效果。
[Abstract]:Objective: to investigate and analyze the characteristics and the distribution of TCM syndromes of acute Inferior Myocardial Infarctionm (AIMI) complicated with atrioventricular block (AVB) in acute inferior wall myocardial infarction (AMI), and to provide a scientific basis for clinical diagnosis and treatment of AV block in acute inferior wall myocardial infarction (AMI) complicated with atrioventricular block (AVB). Methods: from January 2011 to March 2017, 438 cases of lower wall AMI were admitted to the Department of Cardiac, affiliated Hospital of Liaoning University of traditional Chinese Medicine, of which 359 cases were not complicated with AVB. According to TCM syndrome type, they were divided into phlegm and blood stasis group, Qi stagnation and blood stasis group, qi and yin deficiency group. Four groups of heart and kidney yang deficiency group. 79 patients with AVB were divided into four groups according to TCM syndromes: phlegm and blood stasis group, qi stagnation and blood stasis group, qi and yin deficiency group, heart and kidney yang deficiency group, and according to the type of AVB, they were divided into three groups: 鈪，

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