冠心病心绞痛无合并疾病时四诊分布特征及证候要素的临床研究

Clinical Study on Distribution Characteristics and Syndrome Elements of Four Diagnoses of Coronary Heart Disease with Angina Pectoris without Comorbidity

目的:研究冠心病心绞痛无合并疾病四诊分布特征及证候要素,为临床辨证论治提供本底资料。方法:以冠心病心绞痛患者为研究对象,于2016年10月—2018年3月多中心观察了1158例,其中无合并疾病患者117例(10.10%),有合并疾病患者1041例(89.90%),采用描述性和多元统计分析研究无合并疾病患者的四诊分布特征及证候要素。结果:①频数分析:频率分布超过20%的症状,其频数由高到低依次为:胸闷,胸痛,舌质紫黯,舌下脉络青紫,面色晦黯,生瘀点瘀斑,身重,疲乏,脉滑,口唇青紫等34个症状;②因子分析:证候要素由高到低依次为:痰湿>痰湿血瘀>气虚>气滞阴虚、火热>气虚痰湿>气虚血瘀。结论:冠心病心绞痛无合并疾病时四诊分布特征常见10个表现为:胸闷,胸痛,舌质紫黯,舌下脉络青紫,面色晦黯,生瘀点瘀斑,身重,疲乏,脉滑,口唇青紫,证候要素归纳为痰湿,痰湿血瘀,气虚,气滞阴虚,火热,气虚痰湿,气虚血瘀,为临床辨证论治冠心病心绞痛提供参考。

Objective:To study the distribution characteristics and syndrome elements of angina pectoris without comorbidity in coronary heart disease and provide background information for clinical syndrome differentiation.Methods:A total of 1158 patients with coronary heart disease and angina pectoris,including 117 patients(10.10%)without comorbiditiy and 1041 patients(89.90%)with comorbidity,were observed from October 2016 to March 2018.Descriptive and multivariate statistical analysis were used to study the distribution characteristics and syndrome elements of patients without comorbidity.Results:①Frequency analysis:The order of frequency distribution of more than 20%of the symptoms from high to low was:chest tightness,chest pain,dark purple tongue,purple sublingual veins,dark complexion,ecchymosis,heavy body,fatigue,slippery pulse,purple lips and other 34 symptoms.②Factor analysis:The order of syndrome elements from high to low was:phlegm>phlegm and blood stasis>Qi deficiency>Qi-Yin deficiency,fire-heat>Qi deficiency and dampness>Qi deficiency and blood stasis.Conclusion:There were 10 common symptoms of coronary heart disease without comorbidity:chest tightness,chest pain,dark purple tongue,purple sublingual veins,dark complexion,ecchymosis,heavy body,fatigue,slippery pulse,purple lips.The syndrome elements were summarized as phlegm,phlegm and blood stasis,Qi deficiency,Qi-Yin deficiency,fire-heat,Qi deficiency and dampness,Qi deficiency and blood stasis,providing reference for clinical syndrome differentiation and treatment of coronary heart disease angina pectoris.