冠心病中医证型分布特征与冠状动脉病变程度相关性的研究

发布时间：2018-06-09 23:12

本文选题：冠心病 + 胸痹　；参考：《湖北中医药大学》2016年硕士论文

【摘要】：目的:通过对冠心病患者的中医病性证素血瘀、痰浊、气虚、气滞、阴虚、阳虚、血虚,中医证型气虚血瘀、心血瘀阻、痰阻心脉、心肾阴虚、气滞血瘀、气阴两虚、心肾阳虚进行统计分析,研究其分布规律,及其与冠脉病变程度的相关性,为冠心病的中医辩证分型及临床评估病情提供参考。方法:收集湖北省中医院2015年8月至2016年3月间于心内科住院的60例患者的临床资料,对其进行中医辩证分型,并行冠状动脉造影,得到的数据应用SPSS17.0软件系统进行统计学分析。结果:1、在60例冠心病患者中单一病性证素出现频率依次是血瘀气虚气滞、痰浊阳虚阴虚血虚,血瘀的出现频率最高。2、在病位证素中分布最广泛的是心,其余的病位证素分布频率为脾肾肝肺。3、冠心病患者不同中医证型中单一证素分布情况:气虚血瘀证患者以气虚、血瘀为主,部分患者出现了阳虚和痰浊的一些临床症候。心肾阳虚证以气虚和阳虚表现为主。痰阻心脉证患者的冠脉病变最重,兼证也最多,除了痰浊症以外,过半数的患者还出现了血瘀、气虚、气滞的临床表现。4、证素组合中心血瘀阻证的患者主要表现为二证相兼和三证相兼,气虚血瘀证的患者为三种证素和四种证素的复合,痰阻心脉组的临床症候最为复杂,以四种证素和五种证素的复合为主。5、冠心病患者中各中医证型出现的频率为气虚血瘀心血瘀阻痰阻心脉心肾阴虚气滞血瘀气阴两虚心肾阳虚。6、冠脉造影为轻度狭窄和单支病变的患者中以血瘀证为多见,冠脉造影为重度狭窄和多支病变的患者中以痰浊证最为多见。7、冠脉造影为轻度狭窄和单支病变的患者中以心血瘀阻证为多见,其次是气虚血瘀证。冠脉造影为重度狭窄和三支病变的患者中以痰阻心脉证为多见。结论:心、肝、脾、肺、肾任何一脏腑功能的失调都可能导致胸痹的发生,其中胸痹的发生与心脏生理功能的失调关系最为密切。冠心病患者病性证素以血瘀最为多见,中医证型以气虚血瘀最为多见。血瘀在冠心病整个发生发展的过程中始终是一个重要的病理因素。冠状动脉粥样硬化发生的初始阶段,血瘀、气滞、气虚发挥着重要的作用。但在导致冠状动脉粥样硬化由轻度狭窄向重度狭窄、单支病变向多支病变的发展过程中痰浊发挥的作用逐渐凸显。冠心病的中医证型以气虚血瘀为最常见的证型且多有兼夹证。本研究中发现随着冠状动脉管腔狭窄程度的加重,其中医证型出现了由心血瘀阻→气虚血瘀→痰阻心脉的变化,同时随着冠状动脉病变支数的增多,其中医证型出现了由心血瘀阻→气虚血瘀→痰阻心脉的变化。
[Abstract]:Objective: to study the factors of TCM disease syndrome in patients with coronary heart disease, such as blood stasis, phlegm, qi deficiency, qi stagnation, yin deficiency, yang deficiency, blood deficiency, TCM syndrome type qi deficiency and blood stasis, heart blood stasis, phlegm blocking heart vein, heart kidney yin deficiency, qi stagnation and blood stasis, qi and yin deficiency. The statistical analysis of deficiency of heart and kidney yang was carried out to study its distribution law and its correlation with the degree of coronary artery disease, which provided a reference for TCM dialectical classification and clinical evaluation of coronary heart disease. Methods: the clinical data of 60 patients who were hospitalized in the Department of Cardiology from August 2015 to March 2016 in Hubei traditional Chinese Medicine Hospital were collected. The obtained data were analyzed statistically by SPSS 17.0 software system. Results in 60 patients with coronary heart disease, the frequency of single syndrome factor was blood stasis qi stagnation, phlegm turbid yang deficiency yin deficiency blood deficiency, blood stasis frequency was the highest. The most widely distributed factor in disease location syndrome was heart. The distribution frequency of other syndromes was spleen, kidney, liver and lung. 3. The distribution of single syndromes in different TCM syndromes of patients with coronary heart disease: Qi deficiency and blood stasis syndrome were mainly qi deficiency, blood stasis, and some patients had some clinical symptoms of yang deficiency and phlegm turbidity. The deficiency of heart and kidney yang is mainly characterized by deficiency of qi and yang. In addition to phlegm turbidity, more than half of the patients also had blood stasis and deficiency of qi. The clinical manifestations of Qi stagnation. 4. In the combination of syndrome factors, the patients with heart blood stasis syndrome are mainly manifested as two syndromes and three syndromes, the patients with qi deficiency and blood stasis syndrome are the combination of three syndromes and four syndromes, and the clinical symptoms of phlegm blocking heart pulse group are the most complex. With the combination of four syndromes and five syndromes, the frequency of TCM syndromes in patients with coronary heart disease is qi deficiency, blood stasis, heart blood stasis, phlegm blocking heart, heart and kidney yin deficiency, qi stagnation, blood stasis, yin deficiency, deficiency of heart and kidney yang deficiency. In patients with narrow and single vessel disease, blood stasis syndrome was more common. Phlegm turbid syndrome was the most common in patients with severe stenosis and multi-vessel disease, coronary angiography was mild stenosis and single vessel disease, heart blood stasis syndrome was the most common, followed by Qi deficiency and blood stasis syndrome. The syndrome of phlegm blocking heart pulse was more common in patients with severe stenosis and three vessel disease. Conclusion: any disorder of heart, liver, spleen, lung and kidney may lead to chest obstruction. Blood stasis is the most common syndrome in patients with coronary heart disease, and qi deficiency and blood stasis is the most common syndrome type in traditional Chinese medicine. Blood stasis is always an important pathological factor in the development of coronary heart disease. In the initial stage of coronary atherosclerosis, blood stasis, qi stagnation and qi deficiency play an important role. However, phlegm turbid plays an important role in the development of coronary atherosclerosis from mild stenosis to severe stenosis and from single vessel disease to multiple vessel disease. Qi deficiency and blood stasis are the most common syndromes of coronary heart disease. In this study, it was found that with the severity of coronary artery stenosis, the TCM syndromes changed from heart blood stasis to qi deficiency, blood stasis and phlegm blocking the heart vein, and at the same time, with the increase of the number of coronary artery disease branches. Its TCM syndrome type appeared the change of heart blood stasis blocking Qi deficiency and blood stasis phlegm blocking heart vein.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【相似文献】