冠心病心衰患者心功能分级与中医四诊及证候要素分布的研究  

Study on NYHA cardiac function classification and distribution characteristics of TCM four diagnostic and TCM Syndrome elements in patients with heart failure of coronary heart disease

作　　者：陈婵[1] 张鹏[1] 陈建新[1] 赵慧辉[1] 王娟[1] 孟永梅[1] 王伟[1] 

机构地区：[1]北京中医药大学,北京100029

出　　处：《中华中医药杂志》2011年第4期870-872,共3页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:探讨心功能不同分级下,冠心病心衰患者的中医四诊及证候要素的分布特点。方法:临床流行病学方法采集200例冠心病心衰患者的人口学资料和中医四诊信息,应用一般统计学方法和熵聚堆法对数据进行分析。结果:冠心病心衰心功能Ⅱ级至Ⅳ级的转变中,水停类、痰浊类、血瘀类、阳虚类症状呈递增趋势,且变化显著;心功能Ⅱ级以气虚和气虚阴虚为主,兼夹血瘀或水停,证候要素组成较为单一;心功能Ⅲ级时常见气虚、阴虚的基础上兼夹痰浊、血瘀、水停;心功能Ⅳ级多见阳虚兼夹痰、水和瘀,证候要素构成最为复杂。结论:冠心病心衰不同的心功能阶段的证候要素具有一定的演变规律,临床诊治时应有所侧重。Objective：To study the distribution characteristics of TCM four diagnostic and syndrome of in patients with heart failure of coronary heart disease in different NYHA cardiac function stage.Methods：The data of 200 patients were obtained by clinical epidemic study,then descriptive statistics and entropy clustering method were adopted for data analyzing.Results：The water retention,turbid phlegm,blood stasis and yang deficiency symptoms showed a increasing tendency and varied significantly from NYHA class Ⅱ to class Ⅳ in ischemic heart failure patients.Qi deficiency or qi deficiency plus yin deficiency were in common,complicated blood stasis or water retention,TCM syndrome elements combinations were single in NYHA class Ⅱ.Qi deficiency plus yin deficiency complicated blood stasis,water retention and turbid phlegm were familiar in NYHA class Ⅲ.The yang deficiency complicated blood stasis,water retention and turbid phlegm turned a high frequency in NYHA class Ⅳ,TCM syndrome elements combinations were the most complicated.Conclusion：The pathogenesis has certain variation regularity during different NYHA cardiac function stage in ischemic heart failure,therefore,it should be paid special emphasis before clinical diagnosis and treatment.

关 键 词：冠心病心衰 熵聚堆法 心功能分级 证候要素 

分 类 号：R259[医药卫生—中西医结合]