冠状动脉造影与冠心病中医辨证研究探讨

Exploration of TCM Syndrome Differentiation of Coronary Heart Disease and Coronary Arteriography

冠状动脉造影检查是当前诊断冠心病公认的金标准。为探讨冠状动脉造影在冠心病中医辨证研究中的应用情况及价值,推进冠心病的中西医结合病证研究,通过对2000年以来冠状动脉造影在冠心病中医辨证研究中应用情况的回顾,对冠状动脉病变情况与中医证型之间的关系进行了探讨。研究表明,冠状动脉病变程度及病变支数与中医证型之间有一定的关系,随着冠心病程度的加重(冠状动脉狭窄较重或病变支数较多),中医辨证更加复杂化。既往的检测指标和冠心病中医辨证分型与临床实际存在差距。冠状动脉造影对探讨冠心病的辨病与辨证结合的规律有重要价值,应按照循证医学的方法,借鉴现代最新的医学检测技术进行综合观察研究,病证结合,宏观辨证与微观辨证相结合,在全国组织开展冠心病的大样本、多中心、中西医结合辨证研究。

Coronary arteriography （CAG） examination is the widely accepted gold standard for diagnosis of coronary heart disease （CHD） nowadays. In order to explore the situation and value of CAG applied in TCM syndrome differentiation of CHD, and to facilitate the research on disease-syndrome diagnosis of CHD in integrated traditional Chinese and Western medicine （ICWM）, the relationship between coronary arterial pathological changes and the TCM syndrome types was probed through reviewing literatures concerning the application of CAG in studying syndrome differentiation of CHD since 2000. The results showed that syndrome types are cor- related to the severity and number affected of coronary artery branches. Along with the aggravation of CHD, TCM syndrome typing become even more complicated. There is a gap between the previous detectable index for CHD as well as the TCM syndrome typing and clinical practice. CAG is of vital importance in exploring rules of integrated syndrome differentiation and disease diagnosis of CHD. Therefore, to launch a nationwide multi-centrie study on large sample of syndrome differentiation with ICWM is necessary, which should be based on the evidence-based medicine and by dint of the modern medical detecting technique to conduct the study comprehensively in combining differentiation of syndrome and disease, and in both macroscopic and microscopic views.