非瓣膜性房颤患者中医证型分布特点与Hcy的相关性研究
发布时间：2019-03-14 20:00
【摘要】：研究目的:研究非瓣膜性房颤患者的中医证型分布特点与同型半胱氨酸(Hcy)的相关性。研究方法:本次研究根据制定的"非瓣膜病性房颤患者中医证型量表"收集北京中医药大学东方医院心内科2016年3月1日至2017年3月31日的住院非瓣膜性房颤病人,收集信息包括患者的基本信息、中医四诊资料以及辅助检查,按照纳入以及排除标准,共入选了118例非瓣膜性房颤患者。对照组遵循年龄分层原则,按照入院先后顺序连续选取2016年8月1日～2016年9月30日北京中医药大学东方医院心内科病房70例非房颤患者作为对照组研究对象。应用SPSS21.0统计学软件对数据进行分析,计数资料以例数(n)、百分数(%)表示,采用X2检验,计量资料以"X±S"表示,采用t检验或Z检验,以P0.05为差异有统计学意义。研究结果:1.非瓣膜性房颤危险因素:高血压、脑血管病在房颤组与对照组间比较具有统计学意义(P0.05),未发现糖尿病、冠心病与房颤的相关性;2.非瓣膜性房颤患者中医证型分布特点:对118例非瓣膜性房颤患者中医证型分布特点研究发现,中医证型以气虚血瘀证最多(59例,50%)气阴两虚证(24例,20.3%)痰瘀互阻证(14例,11.9%)阴虚火旺证(7例,5.9%)心血不足证(5例,4.2%)水饮凌心证(4例,3.4%)痰火扰心证(3例,2.5%)心阳不振证(2例,1.7%)。其中气虚血瘀证与临床研究认为是房颤患者常见中医证型相符合。3.非瓣膜性房颤患者与左心房内径(LAD)的关系:房颤组和对照组患者间的LAD比较具有统计学意义(P0.05),说明在房颤患者中LAD普遍增大。4.非瓣膜性房颤患者与同型半胱氨酸(Hcy)的关系:118例非瓣膜性房颤患者血浆Hcy水平普遍升高,房颤组和对照组患者间的血浆Hcy水平比较具有统计学意义(P0.05),提示Hcy与非瓣膜性房颤的发病有一定的相关性。5.对85例Hcy升高(15 μmol/L)的房颤患者和与之相对应的LAD进行相关性检验,提示Hcy增高与LAD之间没有呈明显的正相关性(P0.05)。对41例病程超过一年的房颤患者Hcy升高与LAD再次进行相关性检验,提示二者之间也没有呈明显的正相关性(P0.05)。研究结论:1.气虚血瘀证型是非瓣膜性房颤患者的最常见中医证型。2.非瓣膜性房颤患者中LAD普遍增大。3.非瓣膜性房颤患者血浆Hcy水平普遍升高,提示Hcy与非瓣膜性房颤发病有一定的相关性。
[Abstract]:Objective: to study the relationship between the distribution of TCM syndromes and homocysteine (Hcy) in patients with non-valvular atrial fibrillation. Methods: in this study, patients with non-valvular atrial fibrillation were collected from the Department of Cardiology of Oriental Hospital of Beijing University of traditional Chinese Medicine from March 1, 2016 to March 31, 2017, according to the scale of TCM Syndrome Type of non-valvular Atrial Fibrillation patients. According to the inclusion and exclusion criteria, 118 patients with non-valvular atrial fibrillation were enrolled in the data collection, including the basic information of the patients, the data of the four diagnostic methods of TCM and the auxiliary examination. 70 patients with non-atrial fibrillation were selected from August 1, 2016 to September 30, 2016 in Department of Cardiology, Oriental Hospital, Beijing University of traditional Chinese Medicine, in accordance with the principle of age stratification in the control group. SPSS21.0 statistical software was used to analyze the data. The counting data was expressed as (n), percentage (%), X2 test was used, the measurement data was expressed as "X + S", t-test or Z-test was used, and the data were measured by X-test and Z-test. The difference was statistically significant (P0.05). Research findings: 1. Non-valvular atrial fibrillation risk factors: hypertension, cerebral vascular disease in AF group and control group were statistically significant (P0.05), no diabetes mellitus, coronary heart disease and atrial fibrillation; 2. Distribution characteristics of TCM syndrome types in patients with non-valvular atrial fibrillation: according to 118 cases of non-valvular atrial fibrillation, it was found that the most of them were qi deficiency and blood stasis syndrome (59 cases, 50%), Qi-yin deficiency syndrome (24 cases), qi deficiency and blood stasis syndrome (50%) and Qi-yin deficiency syndrome (24 cases, P < 0.01). 20.3%) phlegm-stasis syndrome (14 cases, 11.9%) Yin deficiency and fire exuberance syndrome (7 cases, 5.9%) deficiency of heart and blood (5 cases, 4.2%) water drink Lingxin syndrome (4 cases, 3.4%) phlegm-fire disturbing heart syndrome (3 cases), 2. 5% (2 / 2, 1.7%) were diagnosed as heart-yang failure (2 cases, 1.7%). Among them, Qi deficiency and blood stasis syndrome is considered to be the common TCM syndrome type in patients with atrial fibrillation by clinical study. 3. The relationship between left atrial diameter (LAD) and non-valvular atrial fibrillation: there was significant difference in LAD between AF group and control group (P0.05), indicating that LAD generally increased in AF patients. 4. The relationship between homocysteine (Hcy) and non-valvular atrial fibrillation: the plasma Hcy level in patients with non-valvular atrial fibrillation was significantly higher than that in control group (P0.05), and the plasma Hcy level was significantly higher in patients with non-valvular atrial fibrillation than that in control group (P0.05). It is suggested that there is a certain correlation between Hcy and non-valvular atrial fibrillation. 5. 85 patients with atrial fibrillation with elevated Hcy (15 渭 mol/L) and the corresponding LAD were tested. The results showed that there was no significant positive correlation between the increase of Hcy and LAD (P0.05). There was no significant positive correlation between the increase of Hcy and LAD in 41 patients with AF more than one year old (P0.05). Research conclusions: 1. The most common TCM syndrome type in patients with non-valvular atrial fibrillation due to qi deficiency and blood stasis syndrome. 2. General increase of LAD in patients with non-valvular atrial fibrillation. 3. The level of plasma Hcy in patients with non-valvular atrial fibrillation was generally elevated, suggesting that Hcy was related to the pathogenesis of non-valvular atrial fibrillation.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259
本文编号：2440323
[Abstract]:Objective: to study the relationship between the distribution of TCM syndromes and homocysteine (Hcy) in patients with non-valvular atrial fibrillation. Methods: in this study, patients with non-valvular atrial fibrillation were collected from the Department of Cardiology of Oriental Hospital of Beijing University of traditional Chinese Medicine from March 1, 2016 to March 31, 2017, according to the scale of TCM Syndrome Type of non-valvular Atrial Fibrillation patients. According to the inclusion and exclusion criteria, 118 patients with non-valvular atrial fibrillation were enrolled in the data collection, including the basic information of the patients, the data of the four diagnostic methods of TCM and the auxiliary examination. 70 patients with non-atrial fibrillation were selected from August 1, 2016 to September 30, 2016 in Department of Cardiology, Oriental Hospital, Beijing University of traditional Chinese Medicine, in accordance with the principle of age stratification in the control group. SPSS21.0 statistical software was used to analyze the data. The counting data was expressed as (n), percentage (%), X2 test was used, the measurement data was expressed as "X + S", t-test or Z-test was used, and the data were measured by X-test and Z-test. The difference was statistically significant (P0.05). Research findings: 1. Non-valvular atrial fibrillation risk factors: hypertension, cerebral vascular disease in AF group and control group were statistically significant (P0.05), no diabetes mellitus, coronary heart disease and atrial fibrillation; 2. Distribution characteristics of TCM syndrome types in patients with non-valvular atrial fibrillation: according to 118 cases of non-valvular atrial fibrillation, it was found that the most of them were qi deficiency and blood stasis syndrome (59 cases, 50%), Qi-yin deficiency syndrome (24 cases), qi deficiency and blood stasis syndrome (50%) and Qi-yin deficiency syndrome (24 cases, P < 0.01). 20.3%) phlegm-stasis syndrome (14 cases, 11.9%) Yin deficiency and fire exuberance syndrome (7 cases, 5.9%) deficiency of heart and blood (5 cases, 4.2%) water drink Lingxin syndrome (4 cases, 3.4%) phlegm-fire disturbing heart syndrome (3 cases), 2. 5% (2 / 2, 1.7%) were diagnosed as heart-yang failure (2 cases, 1.7%). Among them, Qi deficiency and blood stasis syndrome is considered to be the common TCM syndrome type in patients with atrial fibrillation by clinical study. 3. The relationship between left atrial diameter (LAD) and non-valvular atrial fibrillation: there was significant difference in LAD between AF group and control group (P0.05), indicating that LAD generally increased in AF patients. 4. The relationship between homocysteine (Hcy) and non-valvular atrial fibrillation: the plasma Hcy level in patients with non-valvular atrial fibrillation was significantly higher than that in control group (P0.05), and the plasma Hcy level was significantly higher in patients with non-valvular atrial fibrillation than that in control group (P0.05). It is suggested that there is a certain correlation between Hcy and non-valvular atrial fibrillation. 5. 85 patients with atrial fibrillation with elevated Hcy (15 渭 mol/L) and the corresponding LAD were tested. The results showed that there was no significant positive correlation between the increase of Hcy and LAD (P0.05). There was no significant positive correlation between the increase of Hcy and LAD in 41 patients with AF more than one year old (P0.05). Research conclusions: 1. The most common TCM syndrome type in patients with non-valvular atrial fibrillation due to qi deficiency and blood stasis syndrome. 2. General increase of LAD in patients with non-valvular atrial fibrillation. 3. The level of plasma Hcy in patients with non-valvular atrial fibrillation was generally elevated, suggesting that Hcy was related to the pathogenesis of non-valvular atrial fibrillation.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259
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