冠心病心绞痛证候要素与应证组合研究

Study on Syndrome Elements and Their Combination Laws in Patients with Angina Pectoris

目的探讨冠心病心绞痛证候要素的提取和应证组合规律,对证候规范化进行深化研究。方法对297例经冠脉造影确诊的冠心病心绞痛患者进行临床流行病学调查,研究其各个证候要素及组合形式,运用现代医学统计学方法进行数据处理。结果(1)冠心病心绞痛的证候要素中,血瘀占86.5%,气虚占78.8%,是主要证候要素,其他由多到少依次为热蕴、痰浊、气滞、阳虚、阴虚、寒凝。(2)证候要素共有74种组合形式,虚实两种证候要素的组合占90.2%,实性证候要素间的组合占9.8%。(3)证候要素的组合可归结为气虚血瘀兼其他要素、气虚痰浊兼其他要素、阳虚血瘀兼其他要素、气滞血瘀兼其他要素4种主要形式,其涵盖了90.2%的病例。结论气虚、血瘀是冠心病心绞痛的基本病机;气虚血瘀兼其他证候要素是证候的主要组合形式;证候要素组合呈现一定规律性。

Objective To explore the syndrome elements of angina pectoris of coronary heart disease and their combination laws so as to deepen further the syndrome standardization study. Methods The clinical epidemiologic survey was carried out on 297 patients with angina pectoris of coronary heart disease diagnosed by coronary arteriography and the data was processed with medical statistics. Results （1） Of syndrome elements of angina pectoris, blood stasis occupied 86.5% and qi deficiency 78.8%, being the main ones. Others lining up from more to less were heat stagnancy, phlegm turbidity, qi stagnation, yang deficiency, yin deficiency, and cold congealing. （2）There were a total of 74 combination patterns of syndrome elements, among which the combination of deficiency element with excess accounted for 90.2%, while the combination of excess elements was 9.8%. （3）The main patterns of combination could be summed up as： qi deficiency and blood stasis plus others, qi deficiency and phlegm turbidity plus others, yang deficiency and blood stasis plus others, and qi stagnation and blood stasis plus others. These four patterns covered 90.2% of all cases. Conclusion Qi deficiency and blood stasis are the basic mechanism of angina pectoris. Qi deficiency and blood stasis plus other syndrome elements is the main combination pattern. The combination of syndrome elements owns certain regularity.