冠心病痰瘀互结证病机转化为阻络、化火、生毒证候宏观及微观诊断指标的权重研究

发布时间：2018-07-12 16:28

本文选题：主成分分析法 + 冠心病　；参考：《中国中西医结合杂志》2017年05期

【摘要】：目的研究冠心病痰瘀互结证病机转化相关证候诊断指标的权重,为冠心病痰瘀互结证转化相关证候的诊断标准研究提供依据。方法邀请全国各地具有丰富临床经验的中医心脑血管病专家,采用现场问卷调查的方法,对冠心病痰瘀互结病机转化3个证候(阻络、化火、生毒)诊断指标的重要程度进行问卷调查,采用主成分分析法利用综合评价函数确定其权重。结果 (1)阻络证候诊断指标权重顺序:心悸、脉涩、胸痛反复发作,日久不愈、斑块不稳定、炎性活动增强、肢体麻木、烦躁、胸闷、脉弦、斑块形成;(2)化火证候诊断指标权重顺序:斑块形成、斑块不稳定、炎性活动增强、心痛如灼、烦躁、脉数、口苦、苔黄、舌红、咽干、溲赤、便秘;(3)生毒证候诊断指标权重顺序:咽痛甚、口疮、重度口苦、病情凶险、舌下络脉紫红或绛紫、老舌、剥苔(不含类剥苔)、中重度心绞痛、脉涩、斑块形成、斑块不稳定、舌青或青紫、炎性活动增强、脉结代。结论冠心病痰瘀互结转化证候的宏观诊断指标:阻络证候以心悸、脉涩、胸痛反复发作、日久不愈、肢体麻木、烦躁为重要参考指标;化火证候以心痛如灼、烦躁、脉数、口苦、苔黄、舌红;为重要参考指标,生毒证候以咽痛甚、口疮、重度口苦、病情凶险、舌下络脉紫红或绛紫、老舌为重要参考指标。斑块和炎症活动在转化证候中占较大权重,在临床辨证中有重要参考价值。
[Abstract]:Objective to study the weight of diagnosis index of pathogenesis transformation of phlegm and blood stasis syndromes in coronary heart disease (CHD), and to provide basis for the study of diagnostic criteria of syndrome transformation of phlegm and blood stasis syndromes in coronary heart disease (CHD). Methods the experts of cardiovascular and cerebrovascular diseases with rich clinical experience from all over the country were invited to transform the pathogenesis of phlegm and blood stasis of coronary heart disease into three syndromes (blocking collaterals and removing fire) by using the method of on-the-spot questionnaire. The importance of the diagnostic index was investigated by questionnaire, and the weight was determined by the comprehensive evaluation function by principal component analysis (PCA). Results (1) weight order of diagnosis index of blocking collateral syndrome: palpitation, pulse acerbity, chest pain repeated attack, long unhealed, unstable plaque, increased inflammatory activity, limb numbness, irritability, chest tightness, pulse string, (2) weight order of diagnosis index of fire syndrome: plaque formation, plaque instability, inflammatory activity, heart pain such as burning, irritability, pulse number, bitter mouth, yellow moss, tongue red, dry pharynx, Deutzia, etc. Constipation; (3) weight order of diagnostic indexes of toxic syndromes: sore throat, mouth sore, severe oral pain, dangerous condition, purple or purple sublingual collaterals, old tongue, exfoliating fur (excluding exfoliation), moderate and severe angina pectoris, acerbity of veins, plaque formation, plaque instability, The tongue is green or blue, inflammatory activity is increased, pulse knot generation. Conclusion the macroscopical diagnostic indexes of syndrome transformation of phlegm and blood stasis in coronary heart disease are palpitation, pulse acerbity, chest pain repeated attack, long days without healing, limb numbness and irritability, and fire syndrome with heart pain such as cauterization, irritability, pulse number, etc. Bitter mouth, yellow fur, red tongue; as an important reference index, toxic syndromes are very sore throat, mouth sore, severe bitter mouth, dangerous condition, purple or crimson of the sublingual collaterals, and the old tongue is an important reference index. Plaque and inflammation play an important role in transforming syndromes and have important reference value in clinical syndrome differentiation.
【作者单位】：河南中医药大学第一附属医院;中国中医科学院中医基础理论研究所;
【基金】：国家重点基础研究发展计划(No.2014CB542903) 中国中医科学院中医基础理论研究所第九批自主选题研究生资助项目(No.YZ-1545)
【分类号】：R259

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