不稳定型心绞痛中医常见证型与其相关危险因素的关系研究

发布时间：2018-10-21 13:45

【摘要】：目的:通过对本次收集的病例进行辨证分型,得出不稳定型心绞痛中医证型分布规律,常见证型,分析中医常见证型与性别、年龄、诱发因素、发病季节、高血压、糖尿病、高脂血症的关系。目的使中医对不稳定型心绞痛更加全面的了解,更加科学化、客观化的指导其在临床中的应用。方法:收集我院2015年9月至2015年12月心内科病房不稳定型心绞痛患者150例,中医分型标准采用“新世纪(第二版)中医内科学胸痹之分型标准”,西医诊断标准采用“第八版西医内科学诊断标准”。性别不限,分别记录其姓名、性别、年龄、发病季节、诱发因素及其临床症状,根据临床症状、舌、脉等辨证确定证型,入院后空腹检查血脂、血糖等生化检查。利用统计学软件SPSS17.0进行统计分析,计数资料采用卡方检验或Fisher检验,计量资料采用方差分析,得出结果,进行分析。结果:1)通过对150例不稳定型心绞痛患者进行辨证分型,得出心血瘀阻47例,痰浊闭阻41例,气阴两虚35例,气滞心胸12例,心肾阴虚9例,心肾阳虚4例,寒凝心脉2例,总结出不稳定型心绞痛中医证型分布从大到小依次为:心血瘀阻痰浊闭阻气阴两虚气滞心胸心肾阴虚心肾阳虚寒凝心脉;2)不稳定型心绞痛中医常见证型为心血瘀阻、痰浊闭阻、气阴两虚,并且三者在所有证型中所占比例为82%;3)分析心血瘀阻、痰浊闭阻、气阴两虚与性别之间的关系,结果表明此三型与性别之间无关(P0.05),但此三型中男性占69例,女性占54例,男性发病人数较女性人数多,原因可能与男性过度饮酒、吸烟等不良习惯有关;4)分析心血瘀阻、痰浊闭阻、气阴两虚与年龄的关系,结果表明此三型与年龄之间具有明显差异性(P0.01),此三型中41-50岁占18例,51-60岁占32例,61-70岁占34例,71-80岁占39例,可以认为随着年龄的增加,不稳定型心绞痛的发病率逐渐上升;5)分析心血瘀阻、痰浊闭阻、气阴两虚与诱发因素之间的关系,得出此三型与诱发因素之间具有差异性(P0.05),心血瘀阻证型中劳累和情绪激动共占63.8%,认为心血瘀阻多因劳累及情绪激动所诱发,痰浊闭阻中饱食占41.5%,认为痰浊闭阻证型多因饱食所诱发;6)分析心血瘀阻、痰浊闭阻、气阴两虚与发病季节的关系,得出此三型与发病季节无关(P0.05);7)分析心血瘀阻、痰浊闭阻、气阴两虚与高脂血症的关系,得出此三型与高脂血症之间具有差异性(P0.05);8)分析心血瘀阻、痰浊闭阻、气阴两虚与高血压、糖尿病、吸烟之间的关系,得出此三型与高血压、糖尿病、吸烟无关(P0.05)。结论:1)不稳定型心绞痛中医常见证型为心血瘀阻、痰浊闭阻、气阴两虚;2)不稳定型心绞痛中医常见证型与年龄、高脂血症、诱发因素具有差异性;3)不稳定型心绞痛中医常见证型与性别、发病季节、高血压、糖尿病、吸烟无关。
[Abstract]:Objective: to obtain the distribution rule of TCM syndrome type and common syndrome type of unstable angina pectoris, analyze the common syndromes and sex of TCM, age, inducing factors, onset season, hypertension, diabetes mellitus, and analyze the distribution of TCM syndromes, common syndromes and gender, age, inducing factors, onset season, hypertension, diabetes mellitus. The relationship between hyperlipidemia and hyperlipidemia. Objective to make Chinese medicine more comprehensive understanding of unstable angina pectoris, more scientific, objective guidance in clinical application. Methods: 150 patients with unstable angina pectoris were collected from September 2015 to December 2015 in our hospital. Western medicine diagnostic standard adopted the eighth edition of western medicine diagnostic criteria. Gender is not limited, their names, sex, age, onset season, inducing factors and their clinical symptoms, according to clinical symptoms, tongue, pulse and other syndrome differentiation, fasting examination of blood lipid, blood sugar and other biochemical examination. Statistical software SPSS17.0 is used for statistical analysis, chi-square test or Fisher test is used for counting data, and variance analysis is used for measurement data. The results are obtained and analyzed. Results: 1) according to the classification of 150 patients with unstable angina pectoris, there were 47 cases of heart blood stasis, 41 cases of phlegm turbid obstruction, 35 cases of deficiency of qi and yin, 12 cases of qi stagnation, 9 cases of heart and kidney yin deficiency, 4 cases of heart and kidney yang deficiency, 2 cases of cold coagulation heart vein. It is concluded that the distribution of TCM syndromes of unstable angina pectoris from big to small is as follows: heart blood stasis, phlegm stagnation, stagnation of qi and yin, stagnation of heart, kidney, yang deficiency, and cold clotting the heart pulse; 2) the common TCM syndromes of unstable angina pectoris are heart blood stasis, phlegm turbid blocking, The relationship between blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and sex was analyzed. The results showed that there was no correlation between the three types (P0.05), but 69 cases of these three types were male. 54 cases were female, the number of male patients was more than that of female, the reason may be related to male excessive drinking, smoking and other bad habits; 4) analysis of the relationship between heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and age. The results showed that there was a significant difference between the three types and age (P0.01). Among the three types, 18 cases were 41-50 years old, 32 cases were 51-60 years old, 34 cases were 61-70 years old, and 39 cases were 71-80 years old. The incidence of unstable angina pectoris increased gradually. 5) the relationship between heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and inducing factors were analyzed. The results showed that there was a difference between these three types and induced factors (P0.05). In the type of heart blood stasis syndrome, fatigue and emotional agitation accounted for 63.8%. It was considered that heart blood stasis was induced by overwork and emotional agitation. Satiety accounts for 41.5% of the total phlegm turbid obstruction. It is believed that the syndrome type of phlegm turbid blocking obstruction is mostly induced by satiety. 6) the relationship between heart blood stasis, phlegm and turbid obstruction, qi and yin deficiency and the onset season is analyzed. The results show that these three types are not related to the onset season (P0.05); 7) the analysis of heart blood stasis, phlegm turbid blocking obstruction, The relationship between the deficiency of qi and yin and hyperlipidemia, the difference between these three types and hyperlipidemia (P0.05); (8) the analysis of the relationship between blood stasis, phlegm stagnation, deficiency of qi and yin and hypertension, diabetes mellitus, smoking, and the relationship between these three types and hypertension, There was no correlation between smoking and diabetes (P0.05). Conclusion: 1) the common TCM syndromes of unstable angina pectoris are heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin, 2) common syndrome type and age of unstable angina pectoris, hyperlipidemia, hyperlipidemia. The common syndrome types of unstable angina pectoris were not related to sex, onset season, hypertension, diabetes, smoking.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

【参考文献】