冠心病患者中医证型与冠脉血管病变程度相关性研究

Correlation Between TCM Syndrome Types and the Degree of Coronary Vascular Lesions in Patients with Coronary Artery Disease

目的:研究冠心病患者的中医证型与冠状动脉血管病变程度的相关性。方法:纳入2016年6月—2016年11月就诊于我院心内科,诊断为冠心病并行冠脉造影的患者。于入院当天采集病史,患者行冠脉造影术后将造影结果及病史资料转化成数据资料输入电脑,对数据进行分析,探索中医证型与冠脉血管病变程度的相关性。结果:(1)高血压患者血压分级与Gensini积分呈正相关,有统计学差异(P<0.05);(2)心血瘀阻证15例(18.99%)>气阴两虚证10例(12.66%)>心肾阴虚证、气滞心胸证各9例(11.39%)>痰浊闭阻证7例(8.86%)等,统计Gensini积分得出:气阴两虚证(85.50±59.33)分>气滞心胸证+心肾阴虚证(41.80±24.21)分>心血瘀阻证(40.73±21.22)分>气滞心胸证(35.08±25.71)分>心肾阴虚证(31.25±28.19)分等,积分比较有统计学差异(P<0.05);(3)冠心病患者单一证型42例(53.16%),复合证型37例(46.84%),两组Gensini积分比较有统计学差异(P<0.01);(4)统计LAD、LCX、RCA发病频次:LAD 63例(79.75%)>RCA 53例(67.09%)>LCX 33例(41.77%),LAD、LCX以复合证型多见,RCA多为单一证型;(5)按证型虚实统计,实证39例(49.37%)>虚证21例(26.58%)>虚实夹杂证19例(24.05%),组间Gensini积分比较:虚证>虚实夹杂证>实证,LAD、LCX、RCA均以实证发生例数最多。结论:冠心病患者中医证型与冠脉血管病变程度存在相关性,通过了解冠心病患者的中医证型,可以判断其病变特点、病情轻重及预后,能够指导冠心病患者的临床治疗。

Objective ：To study the correlation between TCM syndrome types and the degree of coronary vascular lesions in patients with coronary artery disease. Methods ：Patients admitted to our hospital from June to November 2016 were diagnosed with coronary artery disease and had coronary angiography. On hospital day collected medical history,inputted the angiography results and clinical data into computer after patients underwent coronary angiography,then analysed the data and explored the relationship between TCM syndrome and the degree of coronary vascular lesions. Results ：（1）The grade of hypertension and Gensini score was positively correlated with significant differences（P〈0.05）;（2）15 cases of heart blood stasis syndrome（18.99%）10 cases of Qi-Yin deficiency syndrome（12.66%）heartkidney Yin deficiency,Qi stasis syndrome 9 cases（11.39%）7 cases of phlegm accumulated syndrome（8.86%）. Gensini score obtained ：Qi-Yin deficiency syndrome was（85.50 ＋ 59.33）pointQi stasis syndrome and heart-kidney Yin deficiency was（41.80 ＋ 24.21）pointheart blood stasis syndrome was（40.73 ＋ 21.22）point Qi stasis syndrome was（35.08＋ 25.71））pointheart-kidney Yin deficiency was（31.25＋28.19）point,integral comparison were statistics difference（P〈0.05）;（3）42 cases of patients with coronary artery disease had single syndrome type（53.16%）,the compound syndromes of 37 cases（46.84%）,the Gensini scores of two groups were statistically significant difference（P〈0.01）;（4） LAD,LCX,RCA statistical incidence frequency ：LAD 63 cases（79.75%）53 cases of RCA（67.09%）LCX 33 cases（41.77%）,LAD and LCX were common in compound syndrome type,RCA was common in single syndrome type;（5）According to virtual and actual of syndrome types,39 cases of excess syndrome（49.37%）21 cases of deficiency syndrome（26.58%）19 patients with syndrome of intermingled deficiency and excess（24.05%）,comparison between Gensini scores among different groups ：deficiency syndrome syndrome of intermingled deficiency and excessexcess syndrome,LAD,LCX,RCA were high in excess syndrome. Conclusion ：There is a correlation between TCM syndrome types and the degree of coronary vascular lesions in patients with coronary artery disease,through understanding the TCM syndromes can determine its clinical characteristics,severity and prognosis,and to guide clinical treatment of patients with coronary artery disease.