冠心病中医证候血栓形成曲线图特征研究  

The Research on Thrombogenesis Graph of Coronary Htherosclerotic Heart Disease of Different TCM Syndromes

作　　者：张菀桐 胡元会[1] 褚瑜光[1] 朱宝琛[2] 商秀洋[1] 王师菡[1] 王欢[1] 贾岱琳[1] 

机构地区：[1]中国中医科学院广安门医院心内科,北京100053 [2]中国中医科学院西苑医院基础实验室,北京100091

出　　处：《世界中医药》2016年第1期71-74,共4页World Chinese Medicine

摘　　要：目的:运用血栓弹力图评价冠心病不同证候患者的血栓风险,指导冠心病临床防治。方法:172例冠心病患者,其中将患者分为痰瘀互阻证(TYHZ)52例、气滞血瘀证(QZXY)44例、气虚血瘀证(QXXY)42例、气阴两虚证(QYLX)35例。所有患者均进行血栓弹力图检测、凝血功能检测以及血小板参数检测,比较4组患者的TEG参数、凝血功能参数以及血小板参数以判断其凝血功能及血栓风险。结果:各组R值经比较发现,QYLX>QXXY>QZXY>TYHZ,P<0.01;各组K值比较,QXXY>QYLX、QYLX>QZXY、QYLX>TYHZ、QXXY>QZXY、QXXY>TYHZ,P<0.05;各组Angle值比较,QZXY>QYLX、TYHZ>QYLX,QZXY>QXXY、TYHZ>QXXY,P<0.05;各组MA值比较,QZXY>QYLX、TYHZ>QYLX,P<0.05;各组ADP值比较,QZXY>TYHZ,QZXY>QXXY,P<0.05;各组PT值比较QYLX>QXXY、QYLX>QZXY,QYLX>TYHZ,P<0.05;各组INR值比较,QYLX>QXXY、QYLX>QZXY,P<0.05,各组PLT值比较,QXXY>QYLX、QZXY>QYLX、TYHZ>QYLX,TYHZ>QZXY、TYHZ>QYLX,P<0.05;各组PCT值比较,QXXY>QYLX、YHZ>QYLX、TYHZ>QZXY、TYHZ>QYLX,P<0.05。EPL、LY30、AA、APTT、FIB、PDW、MPV以及P-LCR组间比较,P>0.05。结论:冠心病各个中医证候血栓形成风险不同,其中痰瘀互阻证患者血栓风险最高,应充分重视凝血功能的监测,积极应用抗凝、抗血小板药物及中医活血化瘀药物,以减少和预防血栓事件的发生。Objective：To discuss thrombogenesis risk in patients with coronaryatherosclerotic heart disease of different TCM Syn- dromes and provide advice for clinical treatment. Methods：The patients （n = 173 ） were chosen and divided into CHD of phlegm and blood stasis group （TYHZ group, n = 51 ）, CHD of qi-stagnancy and blood stasis group （QZXY group, n = 55）, CHD of qi- deficiency and blood stasis group （ QXXY group, n = 42） and CHD of deficiency of both qi and yin group （ QYLX group, n = 35 ）. All patients were given detection of thromboela-stogram and detection of routine haemostatic. Differences in thromboela-stogram in- dexes, coagulation parameters were compared. Results： R level in the four groups were QYLX 〉 QXXY 〉 QZXY 〉 TYHZ, P 〈 0. 01 ; K level in the four groups were QXXY 〉 QYLX, QYLX 〉 QZXY, QYLX 〉 TYHZ, QXXY 〉 QZXY, QxxY 〉 TYHZ, P 〈 0.05; Angle level in the four groups were QZXY 〉 QYLX, TYHZ 〉 QYLX, QZXY 〉 QXXY, TYHZ 〉 QXXY, P 〈 0. 05 ; MA lev- el in the four groups were QZXY 〉 QYLX, TYHZ 〉 QYLX, P 〈 0. 05 ; ADP level in the four groups were QZXY 〉 TYHZ, QZXY 〉 QXXY, P 〈 0.05 ; PT level in the four groups were QYLX 〉 QXXY, QYLX 〉 QZXY, QYLX 〉 TYHZ, P 〈 0. 05 ; INR level in the four groups were QYLX 〉 QXXY, QYLX 〉 QZXY, P 〈 0. 05 ; PLT level in the four groups were QXXY 〉 QYLX, QZXY 〉 QYLX, TYHZ 〉 QYLX, TYHZ 〉 QZXY, TYHZ 〉 QYLX, P 〈 0. 05 ; PCT level in the four groups were QXXY 〉 QYLX, YHZ 〉 QYLX, TYHZ 〉QZXY, TYHZ 〉 QYLX, P〈0.05. EPL, LY30, AA, APTY, FIB, PDW, MPV and P-LCR showed no signifi- cant differences among these four groups, P 〉 0. 05. Conclusion： It is significant to evaluate coagulation function of patients with coronaryatheroscleroticheart disease, especially of phlegm and blood stasis, then to apply anti-platelet medicine and to employ the blood-activating and stasis-dispelling herb. This is because these patients are more likely to have thrombogenesis, and it is the ef- fective treatment

关 键 词：冠心病 中医证候 血栓弹力图 凝血功能 血小板 

分 类 号：R241[医药卫生—中医诊断学] R541.4[医药卫生—中医临床基础]