1001例冠心病介入术后患者中医证候调查  

Study on the TCM Syndromes of the 1001 Patients with Coronary Heart Disease after Percutaneous Coronary Intervention

作　　者：孙春霞[1] 颜乾麟[1] 黄书慧[1] 景龙[1] 

机构地区：[1]同济大学中医研究所,上海市四平路1239号200092

出　　处：《中医杂志》2010年第9期827-829,共3页Journal of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划("973"计划)资助项目(2006CB504810)

摘　　要：目的了解冠心病介入术后(PCI)患者中医证候的分布情况。方法 1001例PCI术后患者包括前瞻性病例412例、回顾性病例589例,根据中医证候调查表,对前瞻性病例采用现场调查、后期随访(分别为术后1个月、2个月、3个月);对于回顾性病例进行定期随访(时间同上)。调查结束后,统计患者证型分布,并分析证候分布与性别、年龄的相关性。结果 1001例患者中各证型所占比例从高到低依次为阳虚血瘀证>气滞痰浊证>气滞血瘀证>痰瘀交阻证>气虚血瘀证>寒凝气滞证>阳虚寒凝证>气阴两虚证>寒痰凝滞证>寒瘀内结证,其中阳虚血瘀证所占比例最多,共261例,占26.1%;其次为气滞痰浊证,共218例,占21.8%。组间比较,阳虚血瘀证与气滞痰浊证所占比例无统计学差异(P>0.05),与其他证型所占比例比较均有统计学差异(P<0.05或P<0.01)。各证型在不同性别、不同年龄阶段的分布差异无统计学意义(P>0.05)。结论 PCI术后病机复杂,虚实并见,其中阳虚血瘀为PCI术后术后再狭窄的重要病机之一。Objective To study the distribution laws of TCM syndromes of the patients with coronary heart disease （CHD） after pereutaneous coronary intervention （PCI）. Methods We observed 1001 CHD patients after PCI included the prospective 412 cases and retrospective 589 cases. Based on the TCM Syndrome Questionnaire, the on-the-spot investigation and after-follow-up （1, 2, and 3 months after operation respectively） were adopted for the prospective cases, and the regular follow-up was adopted for the retrospective cases （the same time points as mentioned above）. After investigation, the distribution of TCM syndromes was studied, and the distribution law and its correlation with sex and age were analyzed. Results The occurance rate of TCM syndromes in the 1 001 pa- tients were listed in an order from high to low is as following.. Yang deficiency and blood stasis → Qi stagnation and phlegm turbidity Qi stagnation and blood stasis → Combination of phlegm and blood stasis → Qi deficiency and blood stasis→ Cold coagulation and qi stagnation →Yang deficiency and cold coagulation →Both qi and yin deficiency →Cold phlegm coagulation → Retention of cold and blood stasis, of which, the Yang deficiency and blood stasis was the highest in percentage, 261 cases, 26.1%, then, the Qi stagnation and phlegm turbidity was the second, 218 cases, 21.8%. The between-group comparison showed no statistical difference between the syndrome of Yang deficiency and blood stasis and the syndrome of Qi stagnation and phlegm turbidity （P〉0. 05）, but a statistical difference with the other syndromes was found （P〈0.05 or P〈0. 01）. The distribution of syndromes was not statistically different depending on sexes and ages（P〉0.05）. Conclusion The pathogenesis of the pathological condition after PCI was complicated with a mixed deficiency and excess, of which, the Yang deficiency and blood stasis is one of the important pathogenesis of the restenosis patients after PCI.

关 键 词：冠心病 介入治疗 中医证候 流行病学 

分 类 号：R259[医药卫生—中西医结合]