冠心病合并高血压中医证型分布特点与冠脉病变相关性

Distribution Characteristics of TCM Syndromes of Coronary Heart Disease with Hypertension and Correlativity with Coronary Artery Lesions

目的：总结冠心病合并高血压患者与冠心病非高血压患者中医证型分布特点及与冠脉病变的相关性,为冠心病合并高血压患者的临床治疗提供可靠依据。方法：纳入行冠脉造影检查且符合标准的冠心病高血压患者103例,冠心病非高血压患者92例为研究对象,采集全部患者症候表现和冠脉造影结果,根据症候表现确定相应证型并评估冠脉病变情况。所有数据录入Excel表格,采用SPSS17.0进行统计分析。结果：冠心病高血压组患者冠脉病变支数以多支为主,冠脉狭窄程度以4级为主,Gensini评分亦高于冠心病非高血压组患者,有统计学意义（P〈0.05）。冠心病高血压组患者中医证型分布比例以气滞心胸证、痰阻心脉证、心血瘀阻证为主,其中气滞心胸证、心血瘀阻证与其关系密切,有统计学意义（PΧ2〈0.01,PX3〈0.01）。两组患者单一证型及兼夹证型冠脉Gensini评分比较（P〈0.05）,有统计学意义。结论：冠心病合并高血压患者冠脉病变程度更重,中医证型以实证居多且气滞心胸证和心血瘀阻证与其关系最为密切。

Objective：To summarize the distribution of TCM syndromes and the correlation with coronary artery lesions in patients with coronary heart disease complicated by hypertension and nonhypertensive patients,in order to provide reliable evidence for clinical treatment of coronary heart disease patients with hypertension.A total of 92 patients with simple coronary heart disease and 103 coronary heart disease patients with hypertension were included in this study,according to the syndromes to determine the corresponding syndromes.Coronary angiography was performed in all patients and coronary artery lesions were assessed,and all data entry Excell table,using SPSS17.0 for statistical analysis.Results：The number of coronary artery lesions in hypertensive patients was mainly multivessel,grade of coronary stenosis was grade 4,Gensini score was also higher than that of non-hypertensive patients,was statistically significant（P0.05）.The proportions of TCM syndromes in hypertensive patients were as follows：stagnation of Qi stagnation,phlegm stenosis,heart blood stasis,among which Qi stagnation and blood stasis were closely related,statistically significant（PX20.01,PX30.01）.Two groups of patients a single syndrome and merge syndromes of the Gensini score of coronary artery had significant difference（P0.05）.Conclusion：In patients with coronary heart disease complicated with hypertension,the degree of coronary artery lesions is more severe.TCM syndrome type is the most excess pattern and the relationship between Qi stagnation and blood stasis is the closest.