急性冠脉综合征患者中医辨证分型与冠脉造影结果的关系研究

Relationship between syndrome differentiation of traditional Chinese medicine of acute coronary syndrome and coronary angiography

目的探讨急性冠脉综合征(ACS)患者中医辨证分型和冠脉造影结果之间的关系,为中医药干预ACS提供中医证型研究依据。方法对202例ACS患者进行中医辨证分型和冠状动脉造影检查,分析不同证型ACS患者造影结果的特点。结果各证型组冠状动脉多支病变者的比例从高到低依次为:痰阻心脉证组>心肾阴虚证组>气阴虚证组>心血瘀阻证组>阳气虚衰证组(P<0.05);各证型组冠状动脉闭塞病变者的比例从多到少依次为:阳气虚衰证组>痰阻心脉证组>心血瘀阻证组>气阴虚证组>心肾阴虚证组(P>0.05);各证型组冠状动脉病变综合严重程度(冠脉病变Leaman积分)从高到低依次为:痰阻心脉证组>阳气虚衰证组>心肾阴虚证组>气阴虚证组>心血瘀阻证组(P<0.01);各证型组冠状动脉侧支积分由高到低:气阴虚证组>痰阻心脉证组>心肾阴虚证组>心血瘀阻证组>阳气虚衰证组(P<0.05)。结论痰阻心脉证组冠状动脉病变范围最广,阳气虚衰证组冠状动脉闭塞病变最多,2组侧支循环均不丰富,ACS中痰阻心脉证组和阳气虚衰证组病变重、预后差。

Objective To explore the relationship between syndrome differentiation of traditional Chinese medicine of acute coronary syndrome（ACS） and coronary angiography. Methods 202 patients with ACS were detec- ted by traditional Chinese medicine syndrome differentiation and coronary angiography analysis, angiographic findings characteristic of different syndromes in patients with ACS were analyzed. Results The descending order of proportion of muhivessel coronary lesions in different syndrome group ： stagnation of phlegm in the vessel of heart pattern group 〉 deficiency of heart and kidney - YIN type group 〉 Qi and Yin deficiency type group 〉 cardiac blood stasis syndrome group 〉 deficient and weak Yang Qi type group. The descending order of proportion of coronary occlusion lesions in different syndrome group ： deficient and weak Yang Qi type group 〉 stagnation of phlegm in the vessel of heart pattern group 〉 cardiac blood stasis syndrome group 〉 Qi and Yin deficiency type group 〉 deficiency of heart and kidney -YIN type group. The descending order of comprehensive severity of coronary artery lesions in different syndrome group ： stagnation of phlegm in the vessel of heart pattern group 〉 deficient and weak Yang Qi type group 〉 deficien- cy of heart and kidney - YIN type group 〉 Qi and Yin deficiency type group 〉 cardiac blood stasis syndrome group. The descending order of coronary collateral integral in different group ： Qi and Yin deficiency type group 〉 stagnation of phlegm in the vessel of heart pattern group 〉 deficiency of heart and kidney - YIN type group 〉 cardiac blood stasis syndrome group 〉 deficient and weak Yang Qi type group. Conclusion The range of coronary artery lesions in stagnation of phlegm in the vessel of heart pattern group is widest, coronary occlusion lesions in deficient and weak Yang Qi type group is the most, collateral circulation in these groups is not rich, and there is serious lesions and poor prog- nosis.