40例冠心病合并2型糖尿病患者冠状动脉病变及中医证型分析

Analysis on Characteristics of Traditional Chinese Medicine Syndromes and Pathological Changes of Coronary Artery in Patients with Coronary Heart Disease Complicated with Type 2 Diabetes: A Report of 40 Cases

目的观察冠心病合并2型糖尿病(diabetes mellitus type 2-coronary heart disease,DM-CHD)患者冠状动脉病变及中医证型的特征。方法经冠状动脉造影诊断的冠心病患者80例,根据有无合并糖尿病分为2组,其中DM-CHD组40例,非合并糖尿病的冠心病(non diabetes mellitus type 2-coronary heart dis-ease,NDM-CHD)组40例,观察两组患者冠状动脉病变情况(累及支数、狭窄程度及形态病变)及中医证型(虚证、实证及虚实夹杂证)的分布特征。结果DM-CHD组冠状动脉病变多见于3支病变或重度弥漫狭窄或严重钙化,与NDM-CHD患者的1支病变、轻重度狭窄和局限性狭窄比较,差异具有显著性(P<0.01)。两组多见气虚、血瘀、痰浊、阴虚4证,DM-CHD组痰浊、阴虚、阳虚证发生率显著高于NDM-CHD组(P<0.05),同时DM-CHD组多见复合证及虚实夹杂证,与NDM-CHD比较,差异具有显著性(P<0.05)。结论DM-CHD患者冠脉病变程度较NDM-CHD患者严重,DM-CHD患者中医证型复杂,在气虚、血瘀基础上,多有阴虚、痰浊。

Objective To observe the characteristics of traditional Chinese medicine （TCM） syndromes and pathological changes of coronary artery in patients with diabetes mellitus complicated with coronary heart disease （DM-CHD）. Methods A total of 80 patients with coronary heart disease （CHD） diagnosed by coronary artery angiography, were divided into two groups complicated with or without type 2 diabetes, 40 patients with diabetes mellitus into DM CHD group and another 40 patients with non diabetes mellitus （NDM） into NDM-CHD group. Pathological changes of coronary artery （including involved branches, the severity of coronary stenosis and morphological lesions）, and distribution characteristics of TCM syn- dromes （including asthenia syndrome, sthenia syndrome, and asthenia complicated with sthenia syndrome） were observed and compared/ Results Pathological changes of coronary artery in DM-CHD group showed multiple lesions in three branches of coronary artery, or widespread stenosis or severe calcification; the in- cidence rates of one branch lesion, mild stenosis, severe stenosis, and local stenosis were significantly low- er than those in NDM-CHD group .The main four syndromes in both groups were qi deficiency, blood stasis, turbid-phlegm and yin deficiency in turn; the incidence rates of turbid-phlegm, yin deficiency and yang deficiency in DM-CHD group were higher than those in NDM-CHD group; and complex syndrome and asthenia complicated with sthenia syndrome were frequently found in DM-CHD group, incidence rates being significantly higher than those in NDM-CHD group. Conclusion The coronary lesions in patients with DM-CHD are severer than those in NDM-CHD patients; TCM syndromes are complex in DM-CHD patients, fre- quently showing yin deficiency and turbid-phlegm on the basis of qi deficiency and blood stasis.