冠心病中医辨证分型与临床指标相关性研究

Correlation of CHD Clinical Index with Traditional Chinese Medicine's Differentiation of Symptoms and Signs for Classification of Syndrome

目的:探讨冠心病(CHD)常见中医证型与冠状动脉造影(CAG)及血脂水平等相关临床指标之间的关系。方法:对96例冠脉造影确诊为CHD的患者进行同步中医辨证分型,并检测其血脂水平,再将以上结果作对照。结果:CHD患者中医证型中痰阻心脉证比例最大,占37.50%,其次为气虚血瘀证,占21.88%,阳气虚衰证最少,仅占2.08%,其余证型分布较均匀,气阴两虚证、气滞血瘀证以及心血瘀阻证分别占16.67%、11.46%和10.42%。气虚血瘀证、痰阻心脉证和心血瘀阻证多为三支病变,气阴两虚证多为双支病变,气滞血瘀证则多发单支病变。气虚血瘀证和阳气虚衰证平均狭窄程度最重,分别为81.1%和85.0%,气滞血瘀证病变程度最轻,为67.1%,且与气虚血瘀证有显著差别。各个证型的甘油三酯(TG)均显著高于正常对照组,其余血脂、脂蛋白水平基本正常。结论:随冠脉病变部位及程度不同,CHD的证型分布各有特点,CAG结果及血脂水平与中医证型有一定的相关性。

Objective： to study the correlation between different type of syndrome in traditional Chinese medicine of CHD and clinical index such as coronary arteriongraphy and blood fat. Method ： find ninty - six CHD patients, carry out coronary arteriongraphy, differentiate type of syndrome, detect blood fat and analyze these results. Result ： type of stagnation of phlegm occupy 37.50 percent, deficiency of vital energy and blood stasis occupy 21.88 percent, deficiency of both vital energy and yin occupy 16.67 percent, qistagnancy and blood stasis occupy 11.46 percent, cariac blood stasis occupy 10.42 percent,deficient and weak YANG QI occupy 2.08 percent. Most of deficiency of vital energy and blood stasis, stagnation of phlegm and cariac blood stasis are three rami pathological changes in aeteria coronaria. Most of deficiency of both vital energy and yin are two rami pathological changes. Most of qi - stagnancy and blood stasis are one ramus pathological changes. The mean extent of angusty in deficient and weak YANG QI is 85.0 percent, deficiency of vital energy and blood stasis is 81.1 percent, qi - stagnancy and blood stasis is 67.1 percent and this has conspicuous difference with the type of deficiency of vital energy and blood stasis. Triglyceride of all types have conspicuous difference with normal control and most of the rest blood fat index is normal. Conclusion ： with the difference of diseased region and extent of aeteria coronaria, the distribution of different type of syndrome has its＇characteristic. There is some dependability between different type of syndrome and clinical index.