319例冠心病患者证候分布规律分析

Analysis on TCM Syndrome Distribution Laws in 319 Patients with Coronary Heart Disease

目的通过流行病学调查了解胸痹心痛患者的证候分布规律。方法对2004年1—12月间在我院住院的319例经冠脉造影确诊为冠心病的胸痹心痛患者进行病例调查,分析了证候分布规律,对证型、证候要素、常见症状、舌脉象与冠脉造影结果间的关系、中医证型与血脂之间关系进行了分析。结果胸痹心痛患者证候中气虚占比例最大,占87.1%,其次为血瘀和痰浊,分别为79.9%和78.7%。分析显示冠脉不同病变支数间舌象、脉象,均以舌淡暗、苔白腻、脉弦滑为主。不同的证候组间血脂水平差异无显著性。结论以气虚为核心,以痰浊和血瘀为重要病理产物的病机为冠心病的病机所在。

Objective To study TCM syndrome distribution laws in patients with coronary heart diseases （CHD） by epidemiological investigation. Methods A clinical survey was carried out in 319 inpatients with CHD, whose diagnosis was confirmed by coronary arteriography, in the authors＇ hospital from January 2004 to December 2004. The TCM syndrome distribution laws were analyzed, and the relationship of coronary arteriographic picture with TCM syndrome elements, common symptoms, pulse and tongue figures, as well as the correlation between syndrome typing and blood-lipid levels were analyzed, too. Results Qi deficiency was the most popular syndrome in patients with CHD （87.1%）, blood stasis syndrome and phlegm retention syndrome took the second place, accounting for 79.9 % and 78.7% respectively. No significant difference was shown in comparison of tongue and pulse figures with the affected branches of coronary artery, the dark-pale tongue with white greasy fur and taut-slippery pulse being the dominance in patients. The blood-lipid levels in patients with various TCM syndrome types were similar, showing insignificant difference. Conclusion The TCM pathogenesis of CHD takes qi deficiency as the core, blood stasis and phlegm retention as the important pathologic products.