冠心病心绞痛中医证候规范及心血瘀阻证计量研究  

Standard of Traditional Chinese Medicine Syndromes of Angina Pectoris of Coronary Heart Disease and Measurement Research of Blood Stasis Syndrome

作　　者：李艳娟[1,2] 王凤荣[3] 陈星 王蕾[2] 王丹[2] 李重阳[1] 

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]沈阳市第二中医医院,辽宁沈阳110101 [3]辽宁中医药大学附属医院,辽宁沈阳110032 [4]营口出入境检验检疫局,辽宁营口115000

出　　处：《辽宁中医药大学学报》2016年第3期63-66,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省省直医院改革重点临床科室诊疗能力建设项目(LNCC-C01-2015)

摘　　要：目的：探讨冠心病心绞痛中医证候规范化及心血瘀阻证量化诊断方法。方法：该研究搜集了冠心病心绞痛相关二十年的论文,3090例患者的中医证候信息,运用频率、排序、Logistic逐步回归法最大似然法模型等统计方法,初步确定冠心病心绞痛最常见证型：心气亏虚证、心血瘀阻证、痰阻心脉证、心气阴两虚证、心阳亏虚证、寒滞心脉证、心阴亏虚证,而心阴亏虚证在冠心病心绞痛的临床证型中较少见。进一步采用单因素分析和logistic逐步回归法选定相关因素,应用条件概率换算方法对相关因素进行赋分,应用最大似然判别法确定量化诊断阈值,并对建立的冠心病心绞痛心血瘀阻证量化诊断标准进行回顾性检验,分别计算其敏感度、特异度、准确度、阳性预测值、阴性预测值。结果：冠心病心绞痛心血瘀阻证的中医证候量化诊断相关因素为心胸刺痛、固定不移、心悸、情绪诱发、两胁不适、舌紫黯、脉细,赋分为7~17分;心血瘀阻证的诊断阈值为24分;经进行回顾性检验,敏感度、特异度、准确度、阳性预测值、阴性预测值分别为78.73%、88.76%、86.41%、68.18%、93.17%。结论：以症状出现频次为基础,建立冠心病心绞痛中医证候量化标准的方法是可行的。Objective：Explore coronary heart disease angina pectoris specification of syndromes and Study the quantitative diagnosis method of blood stasis of heart. Methods：This study collected twenty years of papers of coronary heart disease associated with angina,and the informations of 3090 cases of TCM syndrome. Using frequency,sorting,Logistic stepwise regression method,the maximum likelihood model and other statistical methods. Preliminary determine the most common syndrome of angina pectoris of coronary heart disease：The heart enrages deficient deficiency,blood stasis of heart,phlegm heart vessel syndrome,Qi and Yin deficiency,Yang deficiency of heart,cold stagnation of heart vessel syndrome,Yin deficiency syndrome of heart. And Yin deficiency syndrome of heart in the clinical syndrome of angina pectoris of coronary heart disease is rare. Single factor analysis and logistic stepwise regression method was further used to select the relevant factors. Conditional probability conversion method was used to mark the related factors. Applying maximum likelihood discriminant method to determine the threshold of quantitative diagnosis. And do retrospectively testof standard quantitative diagnosis of deficiency syndrome of blood stasis of heart the establishment of the coronary heart disease and angina pectoris. Their sensitivity,specificity,accuracy,positive predictive value,and negative predictive value were calculated respectively.Results：The quantitative diagnosis related factors of Chinese medicine syndrome of blood stasis of heart of the coronary heart disease and angina pectoris was：The heart is tingling,fixed,heart palpitations,emotional,two threats,purple and dark tongue,pulse fine,the score was 7-17. The diagnostic threshold of Qi deficiency syndrome of Qi was 24. According to the retrospective test,sensitivity,specificity,accuracy,positive predictive value,and negative predictive value were 78.73%、88.76%、86.41%、68.18%、93.17%. Conclusion：Based on the frequency of symptoms,it is feasible to establi

关 键 词：冠心病心绞痛 中医证候 心血瘀阻证 计量学 

分 类 号：R256.22[医药卫生—中医内科学] R541.4[医药卫生—中医学]