活动平板试验阴性的冠心病患者中医证候特点分析

Analysis of Traditional Chinese Medicine Syndromes of Coronary Heart Disease Patients with Negative Results of Treadmill Exercise Test

目的:分析活动平板试验阴性的冠心病患者中医证候特点,为冠心病的早期辨证治疗及二级预防提供依据。方法:将36例活动平板试验阴性,但经冠状动脉造影确诊的冠心病患者进行辨证分型,辨证方法采用虚实辨证,虚证分为气虚、阴虚、阳虚,实证分为气滞、血瘀、痰浊、寒凝;并对证型分布、证型相兼、血瘀证积分及冠状动脉造影情况分别进行初步分析。结果:在证型分布中以气滞证、阴虚证为主,而所有病例均存在有不同程度的血瘀征象;与冠状动脉造影对照,这类患者主要为单支病变,狭窄程度较轻。结论:活动平板试验阴性的冠心病患者中医证候特点以气滞证、阴虚证为主,血瘀贯穿于冠心病的整个发生、发展过程;这类患者的冠脉病变通常较轻,早期干预治疗有助于延缓冠心病的发展速度。

Objective：To analyze characteristics of traditional Chinese medicine syndromes of coronary heart disease（CHD） patients with negative results of treadmill exercise test,and guide early dialectical therapy and secondary prevention of CHD.Methods：Using differential diagnosis with asthenia and sthenia,to divide 36 cases of CHD,whose Treadmill exercise tests were negative and Coronary angiography were positive,into asthenia syndrome and sthenia syndrome.The former included Qi-deficiency syndrome,Yin-deficiency syndrome and Yang-deficiency syndrome;the latter included Qi-stagnation syndrome,Blood-stasis syndrome,Phlegm-dampness syndrome and Congealing-cold syndrome.Then to analyze preliminarily according to syndrome-distribution,syndrome-concurrent,grade of blood-stasis syndrome and findings in Coronary angiography.Results：Qi-stagnation syndrome and Yin-deficiency syndrome are major in the syndrome distribution.Blood-stasis syndrome with various degrees can be found in all cases whose reports of Coronary angiography are mainly single-vessel stenosis,and mainly lesser degree of stenosis.Conclusion：The characteristics of syndromes of TCM are that Qi-stagnation syndrome and Yin-deficiency syndrome are major in the patients of CHD whose Treadmill exercise tests are negative.Blood stasis syndrome exists in the occurrence and development process of CHD.Coronary artery disease is usually to a lesser degree in these patients.Treating with TCM in the early phase contributes to slow down the developmental speed of CHD.