国医大师诊治冠心病心绞痛临证医案证机分析  

Case Analysis on Angina Pectoris of Coronary Heart Disease Treated by the Medical Masters

作　　者：郑昭瀛[1] 刘刃[1] 江丽杰[2] 吴朦 胡镜清[2] 

机构地区：[1]中国中医科学院广安门医院,北京100035 [2]中国中医科学院基础理论研究所,北京100700

出　　处：《世界中西医结合杂志》2017年第10期1349-1354,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：国家重点基础研究发展计划(973计划)(2014CB542900)

摘　　要：目的明确国医大师临证医案中对冠心病心绞痛的证机认识。方法采用文献研究方法,从已发表论文及专著中收集国医大师诊治冠心病心绞痛的临床医案,构建国医大师冠心病心绞痛临证医案数据库。联合应用描述性统计、主成分分析、因子分析,对冠心病心绞痛医案中的一般资料、临床症状、舌脉信息、辨证进行统计分析,获得其证机特点。结果累计检索60位国医大师公开发表文献5967篇,出版书籍330本,最终纳入国医大师诊治冠心病心绞痛临床病例166则。其主症以"胸闷"最为多见,其次为"胸痛"和"心前区刺痛",构成比分别为54.82%、23.49%、10.24%;血瘀、气虚、痰、阴虚、气滞、阳虚、浊、热为累计频率>10%的证候要素。结论冠心病心绞痛患者总体呈现"虚实夹杂、本虚标实"的证候特征,其中,"血瘀""痰""湿"为其常见的实性证候要素、"气虚""阳虚""阴虚"为其常见的虚性证候要素,此研究为临床诊治本病提供到了可靠依据。Objective To determine the recognition on the pathogenesis of angina pectoris of coronary heart disease treated by the medical masters. Methods The literature review was adopted. The clinical cases of angina pectoris of coronary heart disease treated by the medical masters were collected from the published books and papers to set up the database. Using the descriptive statistics,principal component analysis and factor analysis,the analysis was done on the general data,clinical symptoms,tongue and pulse information and pattern/syndrome differentiation of the cases. Results A total of 5967 papers and 330 books with 60 medical masters involved were retrieved. 166 cases were collected. The chest suffocation is the most common symptom,and chest pain and precardiac pricking pain are of the secondary importance,accounting for 54. 82%,23. 49% and 10. 24% separately. By taking the accumulative frequency rate 10%,the symptom elements are blood stagnation,qi deficiency,phlegm,yin deficiency,qi stagnation,yang deficiency,turbidity and heat. Conclusion In general,angina pectoris of coronary heart disease is characterized as the mixture of deficiency and excess,and the deficiency of the root and the excess of the secondary. Blood stagnation,phlegm and damp are the common elements of excess nature; and qi deficiency,yang deficiency and yin deficiency are of deficiency nature. This study provides the reliable evidence for the clinical diagnosis and treatment of the disease.

关 键 词：国医大师 冠心病心绞痛 临证医案 证候要素 病机 

分 类 号：R541.4[医药卫生—心血管疾病]