胸痹病冠状动脉粥样硬化斑块性质及其与中医体质分类关系的研究

Relationship between characteristics of coronary atherosclerotic plaque and types of TCM constitutions in thoracic obstruction patients

目的探讨胸痹病冠状动脉粥样硬化斑块的性质及其与中医体质分类的关系。方法选择89例临床确诊的具有心血管系统疾病的胸痹病患者,根据《中医体质分类和判定》中的有关标准判别中医体质类型;进行64层螺旋CT冠状动脉造影,判断冠状动脉粥样硬化斑块的性质,并分析其与中医体质类型的关系。结果①89例患者中,正常体质者(即平和质)4例次,占总例次的3.51%;病理体质者110例次,占总例次的96.49%。病理体质中,血瘀质出现频率最高(26.32%),其他依次为痰湿质、气虚质、湿热质、阳虚质、阴虚质、气郁质和特禀质。②89例(114例次)患者中51例(72例次)出现冠状动脉粥样硬化斑块,38例(42例次)未出现冠状动脉粥样硬化斑块。③所有72例次冠状动脉粥样硬化斑块中,软斑块多出现在湿热体质(18.18%),钙化斑块多出现在阳虚体质(40.00%),而复合斑块多出现在血瘀体质(60.00%);不同性质的冠状动脉粥样硬化斑块,在此三类体质中呈现出的差异比较明显(P=0.002),其中软斑块与钙化斑块的体质分布差异比较明显(P=0.003);软斑块与复合斑块在体质分布上也具有很大差异(P=0.003),而钙化斑块与复合斑块的体质分布差异不明显(P=0.874)。结论冠状动脉软斑块与非软斑块在胸痹病患者体质分布上有显著差异,软斑块最常见于湿热质、痰湿质和气虚质。

Objective To discuss the relationship between characteristics of coronary atherosclerotic plaque and types of TCM constitutions in thoracic obstruction patients. Methods Eighty-nine cases with thoracic obstruction were classified into different types of constitutions. We judged the characteristics of coronary atherosclerotic plaque by 64-slice spiral CT angiography and analyzed the relationship between characteristics of coronary atherosclerotic plaque and types of constitutions. Results （~ Four in 89 cases were normal constitution （3.51% ）, and 1 l0 cases were pathological constitution （96.49%）. Among pathological constitution, blood stasis constitution was 26.32%, with the highest frequency. Phlegm dampness, qi deficiency, damp heat, yang deficiency, yin deficiency, qi depression and unique continuation were followed by. （~） Fifty-one cases in 89 cases had coronary atherosclerotic plaque, while 38 cases without coronary atherosclerotic plaque. （~） Seventy-two cases with atherosclerosis of coronary artery, 18.18% damp heat constitution with soft plaque, most calcified coronary atherosclerotic plaque are yang deficiency constitution （40.00%）, compound plaque are blood stasis constitution （60.00% ）; significant difference was fond among this three different plaque （ P = 0. 002 ） ; significant difference was found in constitution distribution between soft plaque and calcified plaque cases （P =0. 003 ） ; significant difference was found between soft plaque and compound plaque （P =0. 003 ）. No significant difference was found between calcified plaque and compound plaque （ P =0. 874 ）. Conclusion There are significant difference in constitution distribution between soft plaque and non-soft plaque in patients with thoracic obstruction, and the soft plaque is most common found in damp heat constitution, phlegm damp constitution and qi deficiency constitution.