冠心病中医证型与冠状动脉造影的相关性研究  

Correlation of CHD Clinical Index with Traditional Chinese Medicine's Differentiation of Symptoms and Signs for Classification of Syndrome

作　　者：朱萱萱[1] 王广基[2] 达庆国[1] 郝海平[2] 秦晓康[3] 

机构地区：[1]江苏省中医院药理室,江苏南京210029 [2]中国药科大学药学院药代动力学实验室,江苏南京210038 [3]南京中医药大学药学院,江苏南京210029

出　　处：《中华中医药学刊》2010年第8期1579-1581,共3页Chinese Archives of Traditional Chinese Medicine

基　　金：南京市科技局资助课题(200605012)

摘　　要：目的:探讨冠心病(CHD)常见中医证型与冠状动脉造影(CAG)等相关临床指标之间的关系。方法:对312例冠脉造影确诊为CHD的患者进行同步冠心病中医辨证,观察冠心病中医辨证各证型的分布和各证型冠脉造影的病变程度。结果:CHD患者中医证型中痰阻心脉证比例最大,134例(42.95%),其次为气虚血瘀证,83例(26.60%),再次为气阴两虚证,54例(17.31%),阴寒凝滞证临床较为少见,仅4例(1.28%),其余各证型较为分散,气滞血瘀证、心血瘀阻证以及阳气虚衰证分别占5.77%、3.85%和2.24%。气虚血瘀证、痰阻心脉证和心血瘀阻证多为三支病变,气阴两虚证多为双支病变,气滞血瘀证则多发单支病变。气阴两虚证和阳气虚衰证平均狭窄程度最重,分别为77.8%和78.0%,气滞血瘀证病变程度最轻,为55.0%,且与气虚血瘀证、气阴两虚证和阳气虚衰证有显著差别。各个证型的甘油三酯(TG)均显著高于正常对照组,其余血脂、脂蛋白水平基本正常。结论:随冠脉病变部位及程度不同,CHD的证型分布各有特点,CAG结果与中医证型有一定的相关性。Objective：To study the correlation between different type of syndrome in traditional Chinese medicine of CHD and clinical index such as coronary arteriongraphy and blood fat. Methods：Find 312 CHD patients,carry out coronary arteriongraphy,differentiate type of syndrome,detect blood fat and analyze these results.Results：Type of stagnation of phlegm occupy 42.95 percent,deficiency of vital energy and blood stasis occupy 26.60 percent,deficiency of both vital energy and yin occupy 17.31 percent,stagnation of yin-cold occupy 1.28 percent,qi-stagnancy and blood stasis occupy 5.77 percent,cariac blood stasis occupy 3.85 percent,deficient and weak YANG QI occupy 2.24 percent. Most of deficiency of vital energy and blood stasis,stagnation of phlegm ,cariac blood stasis and stagnation of yin-cold are three or one rami pathological changes in aeteria coronaria.Most of weak YANG QI are two rami pathological changes. Most of qi-stagnancy and blood stasis and deficiency of both vital energy and yin are one ramus pathological changes. The mean extent of angusty in deficient and weak YANG QI is 78.0 percent,deficiency of both vital energy and yin is 77.8 percent,qi-stagnancy and blood stasis is 55.0 percent and this has conspicuous difference with the type of deficiency of vital energy and blood stasis,deficiency of both vital energy and yin and stagnation of phlegm. Triglyceride of all types have conspicuous difference with normal control and most of the rest blood fat index is normal.Conclusion：With the difference of diseased region and extent of aeteria coronaria,the distribution of different type of syndrome has its＇ characteristic. There is some dependability between different type of syndrome and clinical index.

关 键 词：冠心病 辨证分型 临床指标 冠状动脉造影 血脂 

分 类 号：R2-03[医药卫生—中医学]