1124例急性心肌梗死住院患者中医证候特征与病死率相关性研究  

Study of the Characteristics of TCM Syndrome on Patients with Acute Myocardial Infarction and Its Relationship with Mortality of Chinese Medicine Hospitals in Beijing Area

作　　者：刘红旭[1] 王玲[1] 尚菊菊[1] 

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《中华中医药学刊》2010年第4期771-774,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：首都医学发展科研基金北京医学卫生科技联合攻关项目(2003-I-4)

摘　　要：目的:调查北京地区中医医院急性心肌梗死(AMI)住院患者中医证候特征及其与病死率的关系。方法:采用临床调查表的方式对2002年1月1日-2005年12月31日北京地区14家中医医院AMI住院患者进行调查,ACCESS建立数据库,SPSS统计软件进行中医证型规律及其与病死率关系等分析。结果:1124例AMI患者中男女患病比例为1.75∶1,患者平均年龄(66.7±12.3)岁。证素分布虚证以气虚所占比例最多(58.1%),实证以血瘀所占比例最多(85.1%)。临床证型分布中共出现74个证型,证型中所占比例在5%以上的为:气虚血瘀证、痰瘀互阻证、气虚兼痰瘀互阻证、气阴两虚兼痰瘀互阻证;分类证型分布中虚证占5.2%,实证占30.9%,虚实夹杂占63.9%。住院期间AMI总病死率14.0%。证素中血虚证、阳虚证、阴虚证的患者死亡风险较高,而以血虚证为最。气虚血瘀证,血瘀痰阻证,气虚兼痰瘀互阻证,气阴两虚兼痰瘀互阻证4个临床证型与死亡风险无明显相关性。分类证型中虚证与死亡具有相关性,是死亡的危险因素。结论:从基本证素分析,以气虚、血瘀所占比例最高;临床实际证型过多;分类证型显示虚实夹杂证为主。证素及分类证型研究结果均提示虚证与死亡有相关性,其中以血虚证为最。提示虚证是AMI死亡的危险因素,治疗上应注重标本兼顾。临床实际证型与病死率无明显相关性,可能与中医证候诊断标准化不足有关。Objective： To Survey the patients of acute myocardial infarction （AMI） with the characteristics of TCM syndromes and its relationship with mortality in Beijing area. Methods：Using the clinical questionnaire to investigate AMI patients on January 1, 2002 -2005 in December 31 in Beijing 14 of hospitals for Chinese medicine. Using ACCESS to establish a database and SPSS statistical software for TCM syndrome and its relationship with mortality analysis. Results： The ratio of sick men and women in 1124 cases of AMI patients were 1.75 ： 1, the average age of patients were 66.7 ~ 12. 3 years old. By Su -certification, clinical type of syndrome and classificated type of syndrome to study the distribution of Syndromes, Qi deficiency in the proportion of Deficiency in Su -certification is accounted for a maximum （58.1%）, the proportion of positive to a maximum of Blood stasis （85.1%）. There were 74 types of syndrome appeared in clinical type of syndrome distribution , of which a single type of syndrome is 8, about a total of 129 cases （ 11.5 % ） ; complex type of syndrome is 66, about a total of 995 cases （88.5%）, there were 4 types of syndrome took the proportion of type certi- fication in more than 5% ： Qi deficiency and blood stasis syndrome; Phlegm and blood stasis obstructing each other syn- dreme; Qi - deficiency, phlegm and blood stasis obstructing each other syndrome, both Qi and Yin deficiency and phlegm and blood stasis obstructing each other syndrome. In category Syndromes distribution the deficiency syndrome account for 5.2%, the positive syndrome account for 30.9% ,the Deficiency -excess mixing syndromes account for 63.9%. The to- tal AMI case -fatality rate during hospitalization were 14.0%. IN Su - certification patients with the blood, Yang and Yin - deficiency Syndromes bad higher risk of death, especially were the blood - deficiency. Qi deficiency and blood stasis syndrome; phlegm and blood stasis obstructing each other syndrome; Qi -deficiency, phlegm and blood stasis obstru

关 键 词：急性心肌梗死 中医证候 病死率 

分 类 号：R542.2[医药卫生—心血管疾病]