基于比较流行病学的冠心病中医证型及证素地域性分布特征研究

Study on Regional Distribution Characteristics of Syndrome and Syndrome Element of Coronary Heart Disease Based on Comparative Epidemiology

目的:探讨不同地域冠心病证候分布和证素的特点及差异。方法:1500例冠心病患者分别来自长沙、太原和新乡3个不同地域,在质量控制的前提下,进行证候和证素的判定,并对不同地域冠心病患者证候和证素情况进行描述和对比研究。结果:整体分布情况表明,冠心病的常见证候因素中,本虚中以气虚为主,阴虚、阳虚次之;标实中以血瘀为主,痰浊,气滞次之。地域差异较明显的证型为寒滞心脉证和气滞心脉证;证素方面,除阳虚外,其它均有较明显的地域差异性,标实的差异性大于本虚。结论:冠心病中医证候和证素分布均表现出一定的地域特征,证素尤为明显。这种差异可能与各地域地理环境气候特征及其影响下的患者人群体质和生活习惯相关。通过本研究提示文献归纳研究不能代替流行病学的比较研究。

Objective： To explore the characters and differences of syndrome and syndrome element of coronary heart disease patients in different regions. Methods： The 1500 patients were from Changsha, Taiyuan and Xinxiang. In the premise of quality control, the syndromes and syndrome elements were determined, and the syndrome and syndrome element of coronary heart disease patients were described and compared. Resuhs： In the common syndrome factors of coronary heart disease, Qi deficiency ranked first in deficiency syndrome, then the Yin deficiency and Yang deficiency; Blood stasis ranked first in empirical syndrome, then phlegm and Qi stagnation. The coagulated cold syndrome and Qi stagnation syndrome showed obvious difference in different place. All the elements showed obviously regional difference except Yang deficiency. Conclusion： There were some differences in TCM syndromes and syndrome elements among different zones, especially the elements. The difference may be related to the patients＇ physical and lifestyle practices which formed in different geographical. This study suggests that the literature research can not replace the comparative epidemiological study.