262例冠心病稳定性心绞痛患者中医证型聚类分析  

Cluster analysis of TCM syndromes in 262 patients with coronary heart disease stable angina

作　　者：王瑞雪[1] 刘妍[1] 范新发[2] 张树峰 

机构地区：[1]承德医学院 [2]河北省保定市第一中医院心血管科,河北保定071000 [3]承德医学院中医学院,河北承德067000

出　　处：《河北中医》2018年第1期42-45,51,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的应用变量聚类分析法对冠心病稳定性心绞痛(SA)患者进行中医辨证分型探讨。方法共收集到2014-01—2016-01河北省保定市第一中医院心血管科门诊就诊的冠心病SA患者262例,根据SA患者中医四诊病症信息(包括一般情况症状、体征、舌象、脉象等)设计调查表,统计各个病症出现的频次和频率,对患者中医四诊病证信息进行聚类分析,并结合临床专业知识归纳总结冠心病SA患者的中医证型。结果 262例SA患者临床表现主要以胸痛(闷)、气短为突出,常伴随倦怠乏力、脘痞胀满、头晕、少寐等症状,舌象多见舌下瘀血、舌红、少苔、苔白、苔白腻等,脉象多见脉弦滑、脉细数等。聚类结果分析显示,SA患者可分为湿热郁阻证、气虚血瘀证、痰浊内阻证、心肾阴虚证、气滞血瘀证、气阴两虚证及心肾阳虚证7种证型,以湿热郁阻证最常见,所有类别患者均有不同程度的胸痛(闷)、气短表现。结论采用聚类分析法可将冠心病SA患者分为7种证型,与既往临床研究结果较一致,其中湿热郁阻证型患者最多,颇具研究意义。Objective To investigate the TCM syndrome differentiation of stable angina( SA) by variable cluster analysis method. Methods A total of 262 SA patients were enrolled in cardiovascular clinic of First Hospital of Traditional Chinese Medicine in Baoding City,Hebei Province,from 2014-01 to 2016-01. The questionnaire was designed according to the four diagnostic informations of TCM syndromes of SA patients( including general symptoms,signs,tongue picture,pulse condition). The occurrence and frequency of each syndrome were evaluated. Cluster analysis was carried out on the four diagnostic information of TCM syndromes SA of patients,and combined with clinical expertise to summarize the TCM syndromes of patients with coronary heart disease. Results The clinical manifestations of 262 angina patients were mainly chest pain( stuffy),shortness of breath as the highlight,often accompanied by lassitude,abdominal distension,dizziness,insomnia and other symptoms,tongue picture is more than sublingual vein cyanosis,red tongue,less moss and white-greasy moss,pulse condition is more than st ring and slippery pulse,thready and counting pulse. Cluster analysis showed that SA patients can be divided into dampness-heat stagnation syndrome,qi deficiency and blood stasis syndrome,phlegm obstruction syndrome,yin deficiency syndrome of heart and kidney,qi stagnation and blood stasis syndrome,qi-yin deficiency syndrome and yang deficiency syndrome of heart and kidney,and the most common type was dampness-heat stagnation syndrome,all types of patients have varying degrees of chest pain( stuffy) and shortness of breath. Conclusion The coronary heart disease patients with SA can be divided into 7 kinds of syndromes by using cluster analysis and consistent with the results of previous clinical studies,and the patients with dampness-heat stagnation syndrome are the most,which has great research significance.

关 键 词：心绞痛 冠心病 胸痹 辨证分型 聚类分析 

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