冠心病合并颈动脉粥样硬化斑块形成病人中医证素分布规律研究

The Research on Distribution of Chinese Medicine Syndrome Factor in Patients of Coronary Heart Disease with Carotid Atherosclerotic Plaque Formation

目的 探讨冠心病合并颈动脉粥样硬化斑块形成病人证候要素分布规律。方法 选择2013年8月—2015年8月于陕西中医药大学第二附属医院住院确诊的冠心病合并颈动脉粥样硬化斑块形成病人150例作为研究对象,采用流行病学横断面调查的方法,采集研究对象一般资料、既往病史、冠状动脉造影资料、颈动脉超声检查资料及中医四诊信息,建立三维结构化关联数据库,采用证候、证素判定标准进行判定,分析冠心病合并颈动脉粥样硬化斑块形成病人中医证素分布规律。结果 经证素归类合并后出现频率从高到低排序依次为:血瘀102例(68.00%)、肾虚98例(65.33%)、痰浊93例(62.00%)、气虚76例(50.67%)、气滞55例(36.67%)、内毒36例(24.00%)、阳虚28例(18.67%)、血虚22例(14.67%)、阴虚19例(12.67%)、水饮12例(8.00%)。颈动脉斑块部位与中医证素分布情况:斑块位于颈总动脉者多见气虚、肾虚、气滞、血瘀等证素;斑块位于颈内动脉者多见肾虚、气虚、痰浊、气滞等证素;斑块位于颈总动脉分叉处者多见血瘀、痰浊、肾虚、气虚等证素。结论 冠心病合并颈动脉粥样硬化斑块形成病人中医证素以血瘀为主,其次为肾虚、痰浊、气虚。

Objective To invetigate the distribution of traditional Chinese medicine(TCM) syndrome factor in patients of coronary heart disease(CHD) with carotid atherosclerotic plaque formation. Methods One hundred and fifty patients of the coronary heart disease with carotid atherosclerotic plaque formation were studied by epidemiological cross- sectional survey.The general information,previous medical history,the date of coronal artery angiograph,and carotid ultrasound examination and the four TCM diagnostic information were collected,to establish three-dimensional structured relational database.Judging by the TCM syndrome and syndrome elements’ criterion, the distribution of TCM syndrome factor in patients of CHD with carotid atherosclerotic plaque formation was anaugsed. Results After being classified and merged about syndrome elements ,the frequency ranked from high to low was blood stasis102 times(68.00%), kidney deficiency 98 times(65.33%),phlegm turbidity 93 times(62.00%),qi deficiency 76 times(50.67%),qi stagnation55 times(36.67%),internal poison36 times (24.00%),yang deficiency28 times(18.67%),blood deficiency22 times(14.67%),yin deficiency19 times(12.67%) and retained fluid12 times(8.00%).The carotid artery plaque area and the distribution of TCM sy ndrome factor:plaques in carotid artery, qi deficiency,kidney deficiency,and qi stagnation and blood stasis syndrome factor.Plaques in internal carotid artery were kidney deficiency, qi deficiency,phlegm turbidity,and qi stagnation syndrome factor.Plaques in carotid artery bifurcation were blood stasis were phlegm turbidity,kidney deficiency,qi deficiency syndrome factor. Conclusion TCM syndrome factors in the patients of CHD with carotid atherosclerotic plaque formation were mainly blood stasis,followed by kidney deficiency,phlegm turbidity,and qi deficiency.