冠心病心绞痛患者证候要素与生存质量的相关性

Correlation between TCM Syndrome Elements and Quality of Life of the Patients with Angina Pectoris

目的探讨冠心病心绞痛患者中医证候要素与其生存质量的关系。方法采用临床流行病学方法,多中心收集233例经冠脉造影证实的冠心病心绞痛患者,以西雅图心绞痛量表(SAQ)评价其生存质量,运用Spearman等级相关分析对SAQ中躯体活动受限程度、心绞痛稳定状态、发作情况、治疗满意度及疾病认识程度5个不同维度得分及总分与证候要素的相关性进行分析。结果气滞、血瘀、痰浊、热蕴、阳虚、阴虚6个因素分别与SAQ中1个或多个维度及总分呈现相关关系,其中痰浊对生存质量的影响呈负相关(P<0.05);气滞、热蕴、阴虚对生存质量的影响呈正相关,主要影响患者的心绞痛稳定状态及5项积分之和(P<0.05或P<0.01);热蕴对心绞痛发作情况具有保护作用(P<0.05);痰浊对治疗满意度具有负向影响(P<0.05),阳虚为正向影响(P<0.05)。结论冠心病心绞痛患者中医证候要素与生存质量存在一定相关性,其结论在一定程度上佐证了中医理论内涵的合理性。

Objective To explore the correlation between syndrome elements of traditional Chinese medicine （TCM） and quality ot life （QOL） of the patients with angina peetoris. Methods With the clinical epidemiology method, 233 patients with angina peetoris confirmed by coronary angiograpby were collected, and their QOL were assessed by the Seattle Angina Questionnaire （SAQ）. The correlation of the scores of five different dimensions, including somatic movement limitation, angina stability and attacks, treatment satisfaction, and disease recognition, and the total scores of SAQ and the TCM syndrome elements was analyzed by Spearman rank correlation analysis. Results The six factors, namely, qi stagnation, blood stasis, phlegm turbidity, stagnated heat, yang and yin deficiency, had the correlation with one or more of the dimensions and total score of QOL, in which the phlegm turbidity had a negative impact （P〈0. 05）, while the qi stagnation, stagnated heat, and yin deficiency had a positive impact on angina stability and total scores （P〈0. 05 or P〈0.01 ）, stagnated heat had a protective effect for angina frequency （P〈0.05）, phlegm turbidity had a negative impact on the treatment satisfaction （P〈0.05）, but yang deficiency had a positive effect （P〈0.05）. Conclusion There was a correlation between the TCM syndrome elements and QOL of the patients with angina peetoris. To some extent, the conclusion evidenced the reasonable connotation of TCM theory.