630例慢性心衰患者中医证候分布规律研究  

Distribution of TCM syndromes in 630 patients with chronic heart failure

作　　者：王娟[1] 陈婵[2] 张鹏[3] 赵慧辉[1] 陈建新[1] 罗良涛[1] 徐学功[1] 张理[1] 张军鹏[1] 王伟[1] 

机构地区：[1]北京中医药大学,北京100029 [2]浙江省杭州市萧山区中医院 [3]湖北省武汉市中医院

出　　处：《北京中医药大学学报》2013年第8期567-571,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：北京中医药大学校级课题(No.2013-X-064)

摘　　要：目的利用临床流行病学调查方法研究慢性心衰患者中医证候分布特点和组合规律。方法通过临床横断面调查研究,收集630例符合纳入标准的慢性心力衰竭患者人口学资料、现病史及中医四诊信息,对其进行证候属性判别后,采用描述性统计法对结果进行分析。结果 630例慢性心衰患者以男性居多;55岁以上患者占85.08%;原发病因以冠心病最多;心功能分级以Ⅲ级最多;常见的合并症依次有高血压病、心律失常、糖尿病、脑血管意外等。证候的组合方式有单一证候、两证组合、三证组合、四证组合、五证组合以及六证组合等证候组合方式。其中以三证组合方式为最常见,其次是四证组合和两证组合,再次为五证组合,而单证和六证组合的方式相对较少。单一证候中以气虚最为常见,二证组合以气虚血瘀证最常见,三证组合以气虚血瘀水停证最常见,四证组合以气虚血瘀阳虚水停最多,而五证组合以气虚血瘀水停兼夹痰浊证、阳虚证最为常见,六证组合相对较少,以气阴两虚、阳虚水停兼痰瘀互阻为组合形式。结论探讨慢性心力衰竭的中医证型分布规律,对应用中医药防治心力衰竭、降低患者再住院和死亡率具有重要的实际意义。Objective To study the distribution features and combination law of TCM syndromes in 630 patients with chronic heart failure （CHF） by using the method of clinical epidemiology.Methods The patients according with the inclusion criteria of CHF （n =630） were collected through cross-sectional study,and the data on demographic information,history of present illness,and TCM four diagnosis were analyzed by the descriptive statistical methods.Results In 630 patients,most of them were male,and 85.08％ aged over 55 years old.Coronary heart disease was the main original cause of CHF,and most patients reached to grade Ⅲ of NYHA grading.The common complications successively were hypertension,arrhythmia,diabetes and cerebrovascular accidents.There were six kinds of syndrome combinations,from single syndromes to six-syndrome combinations,among them 3-syndrome combinations were common,then 4-syndrome combinations,2-syndrome combinations and 5-syndrome combinations,and single syndromes and 6-syndrome combinations were less.The syndrome of qi deficiency was the most common one in single syndromes,syndrome of qi deficiency and blood stasis was the most common one in 2-syndrome combinations,syndrome of qi deficiency,blood stasis and water retention was the most common one in 3-syndrome combinations,syndrome of qi deficiency,blood stasis,yang deficiency and water retention was the most common one in 4-syndrome combinations,and syndrome of qi deficiency,blood stasis,water retention combining phlegm turbid and yang deficiency was the most common one in 5-syndrome combinations.6-syndrome combinations were mostly syndrome of dual deficiency of qi and yin or yang deficiency and water retention combining phlegm-stasis obstructing mutually.Conclusion It is important to study the distribution features of TCM syndromes for preventing heart failure and reducing mortality and re-hospitalization rate in the patients with CHF.

关 键 词：慢性心衰 证候分布 补充 

分 类 号：R256.241[医药卫生—中医内科学]