冠心病左室重构患者中医证素、危险因素与左室重构的关联规则分析

Analysis of Association Rules between Traditional Chinese Medicine Syndrome Factors,Risk Factors and Left Ventricular Remodeling in Patients with Coronary Heart Disease and Left Ventricular Remodeling

目的探讨冠心病左室重构与证素、危险因素的关系。方法运用临床流行病学调查方法,对261例疑似冠心病患者进行冠状动脉造影和心脏彩超检查,对确诊为冠心病左室重构患者的中医证素和危险因素进行横断面调查,运用频数分析和关联规则方法进行数据统计。结果 261例疑似患者最终确诊为冠心病左室重构病例为231例。231例患者中病位证素以心(226例)、肺(116例)、肾(69例)为主;病性证素以血瘀(221例)、气虚(77例)、阴虚(72例)、阳虚(58例)为主。关联规则提示冠心病左室重构与心、肺、肾、血瘀、气虚、阳虚、阴虚等证素有关,在吸烟、年龄、男性、心、血瘀条件下出现左心室重构概率为98. 49%;冠心病左室重构患者2个证素以心与阳虚、心与气虚等组合多见,3个证素以心与阳虚、肾,心与阳虚、肺等组合多见。4个证素以心与阳虚、肾、血瘀,心与阳虚、肺、血瘀等组合多见。结论冠心病左室重构患者多见本虚标实,病位多与心、肺、肾相关,气虚、阴虚、阳虚等虚证是发病之本,血瘀、痰是发病之标,危险因素是发作的重要因素。

Objective To investigate the relationship between left ventricular remodeling and syndrome elements and risk factors. Methods Using clinical epidemiological investigation methods,261 patients with suspected coronary heart disease underwent coronary angiography and echocardiography,and cross-sectional survey was conducted for traditional Chinese medicine( TCM) syndromes and risk factors in patients with left ventricular remodeling diagnosed as coronary heart disease. The frequency analysis and the association rule method were used for data statistics.Results Totally 231 cases were final diagnosed of left ventricular remodeling in 261 suspected patients. Among the 231 patients,the main pathogenic factors were heart( 226 cases),lung( 116 cases),and kidney( 69 cases);the main pathogenic factors were blood stasis( 221 cases),qi deficiency( 77 cases),yin deficiency( 72 cases),and yang deficiency( 58 cases). The association rule suggested that left ventricular remodeling was related to heart,lung,kidney,blood stasis,qi deficiency,yang deficiency,yin deficiency. The probability of left ventricular remodeling was 98. 49% under smoking,age,male,heart,and blood stasis conditions. For two syndrome elements,the combination of heart and yang deficiency,heart and qi deficiency were more common in patients with left ventricular remodeling of coronary heart disease. For three syndrome elements,the combination of heart,yang deficiency and kidney,heart,yang deficiency and lung were more common. For four syndromes,the combination of the heart,yang deficiency,kidney and blood stasis,heart,yang deficiency,lung and blood stasis were more common. Conclusion Patients with left ventricular remodeling in coronary heart disease are more likely to have root deficiency and manifestation excess,and the disease location is mostly related to heart,lung and kidney. Deficiency of qi,yin deficiency and yang deficiency were the causes of the disease. Blood stasis and phlegm are the targets of the disease,and risk factors are important factors for the onset of the disease.