801例冠心病患者PCI术后中医证候及相关因素的回顾性研究

Retrospective Study on Traditional Chinese Medicine Syndromes and Related Factors of 801 Cases with Coronary Heart Disease after Percutaneous Coronary Intervention

目的分析冠心病经皮冠状动脉介入治疗(PCI)术后患者的证候分布及相关因素。方法 801例接受PCI手术的冠心病患者,以住院原始病历及造影数据资料为研究对象进行回顾性分析,总结中医证候分布规律,分析患者基本特征与中医证候的相关性。结果 801例患者中气虚血瘀证298例(37.20%),气阴两虚证163例(20.35%),心血瘀阻证126例(15.73%),痰瘀互阻证95例(11.86%)。男性与气虚血瘀证、气阴两虚证、心肾阴虚证分布相关;而年龄(≤65岁)与心血瘀阻证、气虚血瘀证、痰瘀互阻证、寒凝血瘀证、气阴两虚证分布相关;慢性肾功能不全与心血瘀阻证、气虚血瘀证、痰瘀互阻证、寒凝血瘀证、气阴两虚证相关;血脂异常与痰瘀互阻证相关;ST段抬高型心肌梗死与气阴两虚证相关,不稳定型心绞痛与气虚血瘀证、气阴两虚证相关(P<0.05)。结论气虚血瘀证是PCI术后的主要证候。男性、年龄≤65岁、不稳定型心绞痛患者术后更容易出现气虚血瘀证,血脂异常患者术后更容易出现痰瘀互阻证;ST段抬高型心肌梗死患者和不稳定型心绞痛患者更容易出现气阴两虚证。

Objective To analyze the traditional Chinese medicine（ TCM） syndromes and related factors of patients with coronary heart disease（ CHD） after percutaneous coronary intervention（ PCI）. Methods A total of 801 patients with CHD who underwent PCI were selected. Retrospective study was conducted based on their original medical records and angiography data to explore the distribution pattern of TCM syndromes and to analyze the correlation between basic characteristics of patients and TCM syndromes. Results In the 801 cases,qi deficiency and blood stasis syndrome occurred in 298 patients（ 37. 20%）,followed by qi and yin deficiency syndrome occurred in 163 patients（ 20. 35%）,stagnant blockage of heart blood syndrome occurred in 126 patients（ 15. 73%） and phlegm and blood stasis syndrome occurred in 95 patients（ 11. 86%）. The correlation analysis showed gender（ male） was correlated with heart blood stasis syndrome,qi and yin deficiency syndrome and heart and kidney yin deficiency syndrome,and age（ ≤65 years old） was associated with heart blood stasis syndrome,qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,cold congeal and blood stasis syndrome and qi and yin deficiency syndrome. Chronic kidney dysfunction was correlated with heart blood stasis syndrome,qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,cold congeal and blood stasis syndrome and qi and yin deficiency syndrome,and blood lipid disorder was related with phlegm and blood stasis syndrome. ST-segment elevation myocardial infarction was associated with qi and yin deficiency syndrome. Unstable angina was associated with qi deficiency and blood stasis syndrome,qi and yin deficiency syndrome（ P〈0. 05）. Conclusion Qi deficiency and blood stasis syndrome was the major TCM syndrome after PCI. Correlation analysis showed that male patients under 65 years old with unstable angina were more prone to qi deficiency and blood stasis syndrome; patients with blood lipid disorder were more prone to have phlegm and blood stasis syndrome,and patients with ST-segment elevation myocardial infarction or unstable angina were more prone to have qi and yin deficiency syndrome.