主动脉夹层中医证候特点分析

Analysis on Pattern Characteristic of Aoric Dissection

目的探讨主动脉夹层(AD)的中医证候特点及辨证分型规律。方法收集51例AD患者的临床资料,应用SPSS11.5软件统计证候分布特点,总结辨证分型规律,初步探讨证候分型与疾病的关系。结果AD主要分痰瘀互结证、气虚痰瘀证、阳虚痰瘀证三型,气虚痰瘀组、阳虚痰瘀组患者油腻饮食者比例高于痰瘀互结组;阳虚痰瘀组患者DeBakeyⅢ型占100%,高于痰瘀互结组、气虚痰瘀组;痰瘀互结组、气虚痰瘀组、阳虚痰瘀组患者发生并发症的比例逐渐升高,其中阳虚痰瘀组患者发生并发症比例达88.33%;阳虚痰瘀组CRP明显高于痰瘀互结组,阳虚痰瘀组BNP高于气虚痰瘀组和痰瘀互结组。结论AD属中医痛证范畴,痰瘀互阻是病变的核心;如出现阳气不足,提示病情重,预后差。

Objective： To study the character of a syndrome of TCM and regularity of differential diagnosis of patients with AD. Methods： We collected 51 case of clinical infromation of patients with AD to analyzed distribution feature of its syndrome with spssl 1.5 software, summarize the regularity of differenting and classing and first discuss the relation between syndrome classing and disease. Results： AD mainly was classed into 3 types, the type of syn- drome of coagulation of phlegm and blood stasis, that of deficiency of qi with coagulation of phlegm and that of deficiency of yang with coagulation of phlegm. The proportion of people with greasy food in the latter two groups was higher than that in the first group. DeBakey m in the last group occupys 100% , which were higher than other groups. Complication appearance rate in three groups of patients were gradually elevated, especially that in the third group rising to 88.33%. CRP in the third group was markedly higher than that in the first group. BNP in the third group was higher than that in other groups. Conclusion： AD is belonged to syndrome of pain of Chinese medicine, and coagulation of phlegm and blood stasis is core of disease development. It indicates violent attack and poor prognosis when patients appear insufficiency of yang - qi.