冠心病中医证候临床实验指标的计量诊断研究

The Quantu Diagnosis Study on the Clinical Experimental Index of the Traditional Chinese Medicine(TCM)Syndromes of Coronary Heart Disease(CHD)

目的研究冠心病临床常见的7类证候临床实验检测指标计量诊断。方法应用心功能、血脂、血液流变学、脉图、面部血流容积图、舌微循环等方法对冠心病心血瘀阻证56例、痰阻心脉证41例、寒凝心脉证34例、气滞心脉证33例、心气亏虚证35例、心阴亏虚证38例、心阳亏虚证32例及健康人63例开展临床实验检测,运用逐步判别分析法对所有检测资料进行统计检验和判别分析,筛选判别指标,并建立各证型的Fisher判别函数;应用回代性检验和前瞻性检验以评价所建判别各证型Fisher函数的判别效果。结果从6类实验检测的32项指标中筛选出动脉顺应性、三酰甘油、全血黏度高切变率、快速充盈系数、外周阻力系数、血管硬度系数、舌蕈状乳头横径和舌微血流速度等8项,建立了冠心病7类证候的Fisher判别函数。本组判别函数的回代符合率为93.07%,前瞻性检验总符合率为87.5%。结论所建立的Fisher判别函数能较准确地作出冠心病7类证候的诊断和鉴别诊断,所入选的指标对深入研究冠心病证候形成的机理有启发意义。

Objective To study the quantu diagnosis of the clinical experimental detective index of the seven kinds of familiar syndromes of CHD. Methods A research include： 56 patients of Heart Blood-Stasis Syndrome; 41 patients of Obstruction of Heart Collaterals due to Phlegm-accumulation Syndrome; 34 patients of Obstruction of Heart Collateral due to Cold-stagnancy Syndrome; 33 patients of Obstruction of Heart Collateral due to Qi-stagnancy Syndrome; 35 patients of Deficiency of Heart-Qi Syndrome; 38 patients of Deficiency of Heart-Yin syndrome; 32 patients of deficiency of Heart-Yang Syndrome and 63 healthy people. We make the clinical experimental detects on these CHD patients by the cardiac function,blood lipid,hemotheology,pulse graph,facial blood flow volume graph, tongue microcirculation, etc. We make the statistical checks and judgement analysis to the all detected information by Stepwise method, select the judge markers, and set up the Fisher judgement function for the Sndrome types, then we assess the judge effection of the Fisher function for the Syndromes by the backward cheek method and the forward check method. Results Select 8 kinds of markers from 32 kinds in 6 types experimental detects： artery compliance, triacylglycerol （TG） ,blood hypertonic change rate,rapid filling coefficient,perlpheral resistance coefficient,vessel sclerotic coefficient,the diameter of tongue fungiform papilla, and the velocity of the blood flow of tongue microcircu lation. Set up the Fisher judgement function for the Syndromes of CHD. as a result, the backward check coincidence is 93.07%, and the forward check coincidence is 87.5%. Conclusion we can make relatively correct diagnosis and differential diagnosis by the Fisher judgement function for the seven types Syndromes of CHD, and the selected markers are valuable for the study on the mechanism of Syndromes of CHD.