冠心病现代中医证候特征的临床流行病学调查  

Clinical Epidemiological Investigation on Current Syndrome Characteristics of Coronary Heart Disease in Chinese Medicine

作　　者：毕颖斐[1] 王贤良[1] 赵志强[1] 侯雅竹[1] 王帅[1] 赵国元[1] 毛静远[1] 张伯礼[1,2] 

机构地区：[1]天津中医药大学第一附属医院 [2]中国中医科学院

出　　处：《中医杂志》2017年第23期2013-2019,共7页Journal of Traditional Chinese Medicine

基　　金：国家中医临床研究基地业务建设科研专项(JDZX2012136);教育部"创新团队发展计划"(IRT-16R54);天津市科技计划项目(15ZXLCSY00020)

摘　　要：目的探讨目前我国冠心病患者中医证候学特征。方法运用临床流行病学调查方法,对来自全国21个省、市、自治区40家三级中医或中西医结合医院的8129例冠心病患者中医证候特征进行临床横断面调查建立冠心病中医诊疗信息数据库,运用频数分析及关联规则等方法进行数据处理。结果冠心病中医证候多属本虚标实、虚实夹杂的复合证型,本虚以气虚(67.17%)为主,标实以血瘀(77.89%)、痰浊(43.97%)为主,同时可兼见阴虚(28.97%)、气滞(19.60%)、阳虚(17.39%)等证候要素;其中气虚、血瘀、痰浊之间关联度最强;证候类型以气虚血瘀(15.06%)、气虚痰瘀(10.95%)、气阴两虚血瘀(9.28%)、痰瘀互结(8.75%)最为多见;男性与女性的证候要素常见度排序基本一致,男性较女性更多见血瘀(78.81%/76.19%)、痰浊(46.79%/39.00%)、热蕴(9.70%/8.27%),女性则较男性多见气虚(74.74%/67.01%)、阴虚(32.21%/27.08%)、阳虚(18.45%/16.73%)、血虚(12.15%/8.01%);不同年龄段冠心病患者证候要素常见度分析,随着年龄增长(<45岁、45~60岁、61~75岁、>75岁),气虚(54.75%/60.38%/69.52%/73.88%)、血虚(5.57%/8.63%/9.40%/11.86%)、阴虚(23.93%/29.27%/28.69%/30.08%)、阳虚(12.13%/15.01%/17.33%/21.93%)以及水饮证(6.23%/7.21%/9.53%/13.24%)比例呈明显增长趋势。结论目前我国冠心病患者中医病机为"本虚标实",证候以气虚为本、血瘀或兼痰浊为标多见。Objective To explore the Chinese medicine syndrome characteristics in patients with coronary heart disease in China. Methods Using clinical epidemiological survey method,the Chinese medicine syndrome characteristics in 8129 cases of coronary heart disease patients from 40 tertiary Chinese medicine hospitals or integrated Chinese and western medicine hospitals in 21 provinces,municipalities and autonomous regions in China were investigated by clinical cross-sectional survey. Results Chinese medicine syndromes of coronary heart disease mostly were the compound syndromes of deficiency in root cause and excess in manifestation and intermingled deficiency and excess. Deficiency of Qi（ 67. 17%） was the main factor of deficiency in root cause. Blood stasis（ 77. 89%） and phlegm-turbidity（ 43. 97%） were the main factors of excess in manifestation. At the same time,the syndrome elements of Yin deficiency（ 28. 97%）,Qi stagnation（ 19. 60%） and Yang deficiency（ 17. 39%） might also appear.Among them,Qi deficiency,blood stasis and phlegm-turbidity had the highest correlation degree. The most common syndromes were blood stasis due to Qi deficiency（ 15. 06%）,phlegm and static blood due to Qi deficiency（ 10. 95%）,blood stasis due to deficiency of both Qi and Yin（ 9. 28%）,as well as intermingled phlegm and blood stasis（ 8. 75%）. The popularity of syndrome elements between male and female was basically the same. Blood stasis（ 78. 81%/76. 19%）,phlegm-turbidity（ 46. 79%/39. 00%） and heat amassment（ 9. 70%/8. 27%） were more common in males than those in females. The females were more likely to suffer from Qi deficiency（ 74. 74%/67. 01%）,Yin deficiency（ 32. 21%/27. 08%）, Yang deficiency（ 18. 45%/16. 73%） and blood deficiency（ 12. 15%/8. 01%） than males. According to syndrome element popularity analysis in patients with coronary heart disease at different ages,the proportions of Qi deficiency（ 54. 75%/60. 38%/69. 52%/73. 88%）,blood deficiency（ 5. 57%/8. 63%/9. 40%/

关 键 词：冠心病 证候特征 流行病学调查 阳微阴弦 

分 类 号：R259[医药卫生—中西医结合]