106例急性冠状动脉综合征患者证候分布特点研究

Study on Characteristics of Distribution of TCM Syndrome Types in 106 Cases of Acute Coronary Syndrome

目的:探讨急性冠状动脉综合征患者的中医证候分布特点。方法:选择106例急性冠状动脉综合征患者,按照胸痹的中医辨证标准进行证型归纳。结果:急性冠状动脉综合征患者的证型分布依次为:阳虚寒凝血瘀证>气虚痰瘀证>气滞血瘀证=阴虚痰瘀证>阳虚痰瘀证=痰瘀交阻证>单纯血瘀证>单纯痰浊证=单纯阴虚证>单纯阳虚证>单纯气滞证>单纯气虚证;进一步归纳:阳虚及其各兼证组(单纯阳虚证+阳虚痰瘀证+阳虚寒凝血瘀证)>气虚及其兼证组(单纯气虚证+气虚痰瘀证)>阴虚及其兼证组(单纯阴虚证+阴虚痰瘀证)>气滞血瘀组>痰瘀交阻组>单纯血瘀组>单纯痰浊组>单纯气滞组。阳虚兼证组内出现率超过50%的症状依次为:心前区疼痛、胸闷、心悸、气短、畏寒、肢冷、乏力、腰膝酸软、夜尿频多,常见舌象有:舌质紫暗、淡紫、暗红、淡红,舌体胖大、齿痕、嫩,苔多白腻、白滑,脉象常见沉弦、沉弱、沉涩。结论:急性冠状动脉综合征患者的病机复杂,虚实相兼;阳虚寒凝血瘀是本病的主要病机。

Objective:To study on characteristics of TCM syndrome type distribution in the patient of acute coronary syndrome.Methods: 106 cases of acute coronary syndrome were selected and summed up according to TCM syndrome differentiation criteria of obstruction of Qi in the chest.Results:TCM syndrome type distribution in the patient of acute coronary syndrome is in the following order:Yang-deficiency,cold accumulation and blood stasis syndrome>Qi-deficiency and phlegm stagnation syndrome> Qi stagnation and blood stasis syndrome=Yin-deficiency and phlegm stagnation syndrome>Yang-deficiency and stagnation of phlegm=phlegm stasis with stagnation>simple blood stasis>simple phlegm turbid syndrome=simple Yin-deficiency syndrome simple Yang-deficiency syndrome>simple Qi-stagnation syndrome>simple Qi-deficiency syndrome.The symptoms with incidence of over 50% in the Yang-deficiency and accompanied syndromes group were in the following order:precordial pain, oppressed feeling in chest,palpitation,short breath,aversion to cold,cold limbs,weakness,lassitude in loin and knee,polyuria at night.Conclusion:Acute coronary syndrome has complicated pathogenesis,deficiency with excess,and Yang-deficiency,cold accumulation and blood stasis are the main pathogenesis of the disease.