冠心病合并房颤患者中医证型与心室率和左房内径的关系

Relationships of Chinese Medicine Syndrome,Ventricular Rate and Left Atrial Diameter in Patients with Coronary Heart Disease and Atrial Fibrillation

目的:观察冠心病合并房颤患者中医证候与心室率和左房内径的关系。方法:采用回顾性临床研究方法,选取229例在本院诊断为冠心病合并房颤患者,分别记录患者的基本信息,并根据临床症状及舌脉进行中医辨证分型。结果:本研究纳入的患者以气滞血瘀证和痰浊阻滞证居多,分别为65例(28.38%)和64例(27.95%)。虚证组快速型心室率发生率为34.67%,实证组快速型心室率发生率为59.74%,2组比较,差异有统计学意义(P<0.01)。虚证组左房内径(36.63±1.84)mm,实证组左房内径(28.35±2.17)mm,2组比较,差异有统计学意义(P<0.01)。心脾两虚证与水饮凌心证、气滞血瘀证、痰浊阻滞证患者的左房内径比较,差异均有统计学意义(P<0.01);心阳不振证与肝肾亏虚证、水饮凌心证、气滞血瘀证、痰浊阻滞证患者的左房内径比较,差异均有统计学意义(P<0.05,P<0.01);肝肾亏虚证与水饮凌心证、气滞血瘀证、痰浊阻滞证患者的左房内径比较,差异均有统计学意义(P<0.01);水饮凌心证与气滞血瘀证、痰浊阻滞证患者的左房内径比较,差异均有统计学意义(P<0.01)。结论:冠心病合并房颤患者中医证候主要以气滞血瘀证及痰浊阻滞证为主,虚证患者的左房内径长于实证患者。各证型中,肝肾亏虚证患者左房内径最长,气滞血瘀证患者左房内径最短。

Objective：To observe the relationships of Chinese medicine syndrome,ventricular rate and left atrial diameter in patients with coronary heart disease and atrial fibrillation. Methods ：Selected 229 cases of patients diagnosed with coronary heart disease and atrial fibrillation in our hospital by retrospective clinical research methods. Respectively recorded the basic information of each patient, and conducted Chinese medicine syndrome differentiation according to clinical symptoms,tongue and pulse. Results ：In the study,the patients with qi stagnation and blood stasis syndrome and phlegm turbidity and stagnation syndrome were the majority,there being respectively 65 cases（28.38%） and 64 cases（27.95%）. The incidence of fast-type ventricular rate was 34.67% in deficiency syndrome group and 59.74% in excess syndrome group,the difference being significant（P〈0.01）. The left atrial diameter was（36.63±1.84） in deficiency syndrome group and（28.35±2.17） inexcess syndrome group,the difference being significant（P〈0.01）. Compared left atrial diameters of patients with deficiency of heart and spleen syndrome with those of patients with pathogenic water attacking heart syndrome,qi stagnation and blood stasis syndrome and phlegm turbidity and stagnation syndrome, differences were all significant（P〈0.01）. Compared left atrial diameters of patients with devitalization of heart yang syndrome with those of patients with deficiency of the liver and kidney syndrome,pathogenic water attacking heart syndrome,qi stagnation and blood stasis syndrome and phlegm turbidity and stagnation syndrome, differences were all significant（P〈0.05, P〈0.01）. Compared left atrial diameters of patients with deficiency of the liver and kidney syndrome with those of patients with pathogenic water attacking heart syndrome, qi stagnation and blood stasis syndrome and phlegm turbidity and stagnation syndrome,differences were all significant（P〈0.01）.Compared left atrial diameters of patients with pathogenic water attacking heart syndrome with those of patients with qi stagnation and blood stasis syndrome and phlegm turbidity and stagnation syndrome,differences were all significant（P〈0.01）.Conclusion： The major Chinese medicine symptoms of patients with coronary heart disease and atrial fibrillation are qi stagnation and blood stasis syndrome and phlegm turbidity and stagnation syndrome. Left atrial diameters of patients with deficiency syndrome are longer than those of patients with excess syndrome. Among all syndromes,left atrial diametersof patients with deficiency of the liver and kidney syndrome are the longest,while those of patients with qi stagnation and blood stasis syndrome are the shortest.