924例PCI术患者病变血管情况与中医证候分布关系调查  

Investigation on Correlation between Lesion Vessels and Distribution of Chinese Medicine Syndrome in Patients Received PCI: A Report of 924 Cases

作　　者：孙春霞[1,2] 颜乾麟[1] 王俊丽[3] 胡晓贞[1] 陈丽娟[1] 李青卿[1] 

机构地区：[1]同济大学中医研究所,上海200092 [2]同济大学附属同济医院分院,上海200092 [3]同济大学电子与信息工程学院,上海200092

出　　处：《新中医》2017年第9期20-24,共5页New Chinese Medicine

基　　金：国家重点基础研究计划(973计划)中医专项(2006CB504810);中央高校基本科研业务费专项资金项目(同济大学);上海市卫生局中医药科研基金项目(2012L013A)

摘　　要：目的:观察冠心病介入术患者的病变血管情况与中医证候分布的关系。方法:对924例冠心病介入术患者的病变血管数目、狭窄程度及中医证候学数据进行前瞻性及回顾性调查。结果:(1)与病变血管数目的相关性:标实证和本虚证与病变血管数目有正相关关系。标实证中,心血瘀滞、气机郁滞、阴寒凝滞与病变血管数目均呈正相关,其中相关性最强的是心血瘀滞证。本虚证中,阳虚和肝肾阴虚与病变血管数目有正相关关系,相关性最强的是阳虚证。9项兼证均与病变血管数目有正相关关系,阳虚合并阴寒凝滞及心血瘀滞与病变血管数目的相关性最强。(2)与病变血管狭窄程度的相关性:未发现与左主干(LMCA)狭窄程度有正相关关系的中医证候。标实证与左前降支(LAD)狭窄程度有正相关关系,其中心血瘀滞与LAD狭窄程度有正相关关系。本虚证与LAD狭窄程度无相关关系。兼证中,心阳虚合并心血瘀滞与LAD狭窄程度有正相关关系。心阳虚与左回旋支(LCX)狭窄程度有正相关关系。其余证候与LCX狭窄程度无正相关关系。标实证与右冠状动脉(RA)狭窄程度有正相关关系,其中心血瘀滞、痰浊壅滞、气机郁滞与RA狭窄程度均有正相关关系,其中心血瘀滞与RA狭窄程度的相关性最强。本虚证与RA狭窄程度无相关关系。兼证中,阳虚合并心血瘀滞、心阳虚合并心血瘀滞、心气虚合并心阳虚及心血瘀滞、阳虚合并阴寒凝滞及心血瘀滞与RA狭窄程度均有正相关关系。结论:阳虚血瘀证与冠心病介入术患者的病变血管数目、病变血管狭窄程度均有正相关关系,且相关性强、相关系数较大,验证了颜德馨教授关于"阳虚血瘀乃冠心病介入术后再狭窄的基本病机"这一假说的正确性。Objective： To observe the correlation between lesion vessels and distribution of Chinese medicine syndrome in patients received percutaneous coronary intervention（PCI）. Methods： A prospective and retrospective investigation was conducted on 924 patients that received PCI so as to collect data of the number of lesion vessels, stenosis degree of lesion vessels and Chinese medicine syndrome. Results： Correlation with the number of lesion vessels： There was positive correlation between incidental excess syndrome, deficient fundamental syndrome and the number of lesion vessels in patients received PCI. In the incidental excess syndrome, there was positive correlation between heart blood stasis, stagnation of qi,stagnation of yin-cold and the number of lesion vessels. Among them, correlation between heart blood stasis and the number of lesion vessels was the highest. In deficient fundamental syndrome, there was positive correlation between Yang deficiency,Yin deficiency of liver and kidney and the number of lesion vessels. Among them, correlation between Yang deficiency and the number of lesion vessels was the highest. There was positive correlation between the nine accompanying syndromes and the number of lesion vessels. Among them, correlation between Yang deficiency with stagnation of yin-cold, heart blood stasis and the number of lesion vessels was the highest. Correlation with stenosis degree of lesion vessels： No Chinese medicine syndrome was found to have positive correlation with stenosis degree of left main coronary arteries（LMCA）. There was positive correlation between stenosis degree of left anterior descending（LAD） and incidental excess syndrome such as heart blood stasis. No deficient fundamental syndrome was found to have positive correlation with LAD. Among the accompanying syndromes, there was positive correlation between heart-yang deficiency with heart blood stasis and stenosis degree of LAD,there was positive correlation between heart-yang deficiency and stenosis degree of left

关 键 词：经皮冠状动脉内介入治疗(PCI) 中医证候 相关性 病变血管数目 病变血管狭窄程度 阳虚血瘀 颜德馨 

分 类 号：R541.4[医药卫生—心血管疾病] R619[医药卫生—内科学]