冠状动脉粥样硬化性心脏病患者的中医辨证分型与左心功能指标相关性分析  

Correlation between different dialectical types of traditional Chinese medicine and indexes of left cardiac function of patients with coronary atherosclerotic heart disease

作　　者：张继红[1] 苗志林[1] 刘冬梅[1] 杨俊英[1] 夏丽[1] 孙晶[2] 王平[3] 张爽[3] 白岩[4] 

机构地区：[1]沈阳医学院沈州医院心内科,辽宁省沈阳市110001 [2]沈阳市第一制药厂研究室,辽宁省沈阳市110022 [3]辽宁中医学院附属医院介入科,辽宁省沈阳市110031 [4]沈阳经济技术开发区卫生防疫站,辽宁省沈阳市110141

出　　处：《中国临床康复》2006年第7期4-6,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析冠状动脉粥样硬化性心脏病患者的中医辨证分型与左心功能指标相关性,并与正常人对照,探讨其规律性。方法:选择2002-04/2005-04前来沈阳医学院沈洲医院就诊及住院的冠状动脉粥样硬化性心脏病患者198例,入选病例均在治疗开始前由资深中医师进行辨证诊断,设气虚(n=33)、阴虚(n=16)、阳虚(n=19)、气滞(n=71)、血瘀(n=198)、寒凝(n=37)、痰浊偏寒型(n=34)和痰浊偏热型(n=48)8个基本证型。对照组选择同期在本院进行健康体检的正常人35例,男20例,女15例。所有入选者经美国阿帕奇RX-400心脏彩超仪在治疗前1周内进行心功能测试。对比分析不同中医证型的冠状动脉粥样硬化性心脏病患者和正常人静息的左心功能数据。结果:198例冠状动脉粥样硬化性心脏病患者和35例对照组全部进入结果分析,无脱失。①与总体样本比较,痰浊偏热、阳虚和寒凝型冠状动脉粥样硬化性心脏病患者的平均年龄明显偏大,痰浊偏寒和阴虚型冠状动脉粥样硬化性心脏病患者的平均年龄明显偏小,从平均病程来看,气虚、阳虚和寒凝型患者明显偏长,而痰浊偏寒和痰浊偏热型患者明显偏短(P均<0.05～0.01)。②冠状动脉粥样硬化性心脏病总体样本和不同中医证型患者的舒张晚期峰值流速和舒张早期峰值流速/舒张晚期峰值流速比等多数舒张功能指标均明显高于对照组,而舒张早期峰值流速明显低于后者;阳虚型和寒凝型冠状动脉粥样硬化性心脏病患者舒张晚期峰值流速、舒张早期峰值流速/舒张晚期峰值流速比、左心房射血时间和左心室等容舒张时间等多数舒张功能指标均明显低于总体样本,而舒张早期峰值流速、左心房射血前期时间等指标明显高于总体样本(P<0.05～0.01)。③冠状动脉粥样硬化性心脏病总体样本和不同中医证型患者的每搏量、心排出量和心脏指数大多数左心室心排量指标�AIM： To investigate the correlation between different dialectical types of traditional Chinese medicine and indexes of lest cardiac function of patients with coronary atherosclerotic heart disease （CAHD） in comparison with the normals in order to probe into their regularity. METHODS： Totally 198 CAHD patients were selected from Shenzhou Hospital of Shenyang Medical College between Aprial 2002 and Aprial 2005. All subjects received dialectical typing of TCM after treatment and divided into 8 types： qi-defieiency （n=33）, yin-deficiency （n=16）, yangdeficiency （n=19）, sluggishness of qi （n=71）, blood stasis （n=198）, coldness （n=37）, turbid phlegm due to mild cold （n=34） and turbid phlegm due to mild heat （n=48）. Another 35 people with healthy examination were selected as control group with 20 males and 15 females. Cardiac function of all subjects was tested With Apache RX-400 color Doppler ultrasonic cardiogram before treatment for 1 week. Data of left cardiac function were compared hetween CAHD patients and normal persons. RESULTS： Totally 105 CAHD patients and 35 normal subjects entered the final analysis withont any loss. ① As compared with total samples, mean age of CAHD patients were older in turbid phlegm due to mild heat, yang-deficiency and coldness than those in turbid phlegm due to mild cold and yin-deficiency. Mean courses of CAHD patients were longer in qideficiency, yang-deficiency and coldness than those in turbid phlegm due to mild cold and turbid phlegm due to mild heat （P 〈 0.05-0.01）. ② Total samples of CAHD patients and diastolic functional marker, such as later diastolic peak flow rate and the ratio between early diastolic peak flow rate and later diastolic peak flow rate, were higher than those of subjects in control group, but early diastolic peak flow rate was higher than that of the latter one. Most diastolic functional indexes, such as later diastolic peak flow rate, ratio between early diastolic peak flow rate and later diastolic peak flo

关 键 词：辨证分型 冠状动脉硬化/分类 心绞痛/分类 心脏/解剖学和组织学 心室/超声检查 心室功能 左 

分 类 号：R543.3[医药卫生—心血管疾病]