女性冠心病患者中医证型及冠状动脉造影特点的研究

Study on the Characteristics of Traditional Chinese Medicine Syndrome and Coronary Angiography in Female with Coronary Heart Disease

目的:通过对比女性与男性冠心病患者的差异,探讨女性冠心病患者中医证型及冠状动脉病变的特点。方法:将冠脉造影确诊的146例女性冠心病患者与同期造影确诊的男性冠心病患者的临床资料、中医证型及冠脉病变特点相互对比分析。结果:与男性相比,女性冠心病患者的年龄较大,合并高血压、糖尿病及高脂血症的比例高,血浆纤维蛋白原(Fg)水平明显高于男性患者(P<0.05或P<0.01);冠脉病变程度严重,病变累及左前降支及三支的比例较男性高(P<0.01);中医证型方面,伴有气虚、阴虚及气滞等证表现者其比例明显高于男性患者(P<0.05或P<0.01),而具有血瘀、痰浊、寒凝等证的比例则与男性相似(P>0.05)。结论:与男性相比,女性冠心病患者年龄偏大,合并冠心病危险因素者比例高,冠脉病变程度严重,应重视绝经期后女性冠心病危险因素的预防与控制;中医治疗应在活血祛瘀、化痰通络治标的同时,顾护正气,加强益气养阴,同时注意调畅情志,提高治疗效果。

Objective： To explore the characteristics of traditional Chinese medicine （TCM） syndromes and the coronary angiography in female with coronary heart disease （CHD） compared with male patients. Methods： The characteristics of the clinical data, TCM syndromes and the coronary angiography in 146 cases of female patients with CHD were compared with the male patients in the same period. Results： Compared with male patients the female with CHD were elder; the incidence of hypertension, diabetes mellitus and dyslipidemia and the level of plasma fibrinogen （Fg） were significantly higher than male patients （ P 〈 0.05 or P 〈0.01 ）. Compared with male patients, coronary disease was more severe and more frequent involvement of left anterior descending artery and triple vessels lesion in female patients. The incidence of TCM syndromes of qi deficiency, yin deficiency and qi stagnation in female patients was significantly higher than those in male patients （ P 〈 0.05 or P 〈 0.01 ）, while the incidence of TCM syndromes of blood stasis, phlegm turbidity and cold obstruction was similar to male patients. Conclusion： Compared with male patients, the female patients are older; the incidence of risk factors of CHD is higher; and the coronary disease is more severe. As a result, we should pay attention to preventing and controlling the risk factors of CHD in post-menopausal women. The therapy of TCM should strengthen replenishing qi and nourishing yin on basis of activating blood to eliminate stagnation and resolving phlegm to dredge collaterals, and meanwhile regulate emotion to improve the effects of treatment.