甲状腺机能亢进性心脏病临床研究分析  

A clinical analysis of treating hyperthyroid heart disease

作　　者：赵晓华 蒋子云 范冠杰[2] Zhao Xiaohua

机构地区：[1]广州中医药大学深圳医院(福田),广东深圳518000 [2]广东省中医院,广东广州510405

出　　处：《中医临床研究》2019年第25期53-55,共3页Clinical Journal Of Chinese Medicine

摘　　要：目的:探讨甲状腺功能亢进性心脏病患者的发病特点和中医证候规律,以期对今后甲亢性心脏病的诊治提供科学的、客观的临床循证医学证据。方法:通过对三甲中医院43例第一诊断为甲亢性心脏病患者的临床资料进行回顾性分析,运用频数统计方法对其临床发病特点,中医证候、证素等进行统计分析。结果:纳入的43例甲亢性心脏病患者中以女性患者多见,发病年龄以中年人居多,甲亢病史7d^30年,平均住院时间10d;心脏彩超提示最常见的是全心扩大,左心室扩大以及二尖瓣三尖瓣重度关闭不全;心电图常见表现是心房颤动和窦性心动过速;胸片常见表现是心影扩大和肺动脉高压,以及肺瘀血;甲状腺彩超发现超过一半患者提示结节性甲状腺肿;甲亢性心脏病常见的合并疾病前五位是心律失常,慢性甲状腺炎,心功能不全,高血压,高尿酸血症;常见的前6位证素是血瘀,气虚,痰,阴虚,湿以及热;常见的中医证候主要是气阴两虚,气虚痰瘀阻络,湿热瘀阻,肝郁脾虚。结论:甲亢性心脏病的发生不分年龄、性别、病程,临床表现以心脏的主要表现为主,合并心律失常,慢性甲状腺炎患者居多,中医证候及证素分析提示以气阴两虚、湿热瘀阻为主。Objective: To investigate the characteristics of hyperthyroid heart disease, in order to provide scientific and objective evidence of clinical evidence-based medicine for the diagnosis and treatment. Methods: The clinical data of 43 patients with first-on diagnosis of hyperthyroid heart disease were retrospectively analyzed, and their clinical features, TCM syndromes were statistically analyzed by frequency statistics. Results: Among the 43 patients with hyperthyroid heart disease, female patients were more common. The age of onset was mostly middle-aged. The history of hyperthyroid heart disease ranged from 7 days to 30 years, and the average length of hospital stay was 10 days. The most common symptoms of cardiac color Doppler ultrasound are full heart enlargement, left ventricular enlargement, and severe mitral tricuspid regurgitation. Common manifestations of electrocardiogram are atrial fibrillation and sinus tachycardia. Common manifestations of chest radiographs are enlarged heart and pulmonary hypertension, as well as pulmonary congestion. Thyroid color Doppler ultrasound can be found in more than half of patients suggesting nodular goiter. The top five common complications of hyperthyroid heart disease are arrhythmia, chronic thyroiditis, cardiac insufficiency, hypertension, and hyperuricemia. The common top 6 syndromes are Xueyu (血瘀), Qixu (气虚), Tan (痰), Yinxu (阴虚), Shi (湿) and Re (热). Common TCM syndromes are mainly Qiyin Liangxu (气阴两虚), Qixu Tanyu Zuluo (气虚痰瘀阻络), Shire Yuzu (湿热瘀阻), Ganyu Pixu (肝郁脾虚). Conclusion: The occurrence of hyperthyroid heart disease is irrespective of age, regardless of gender, regardless of the course of the disease. The clinical manifestations are mainly the main manifestations of the heart. Patients with arrhythmia and chronic thyroiditis are mostly present. TCM syndromes and syndrome analysis suggest that both Qiyin Liangxu and Shire Yuzu are dominant.

关 键 词：甲状腺机能亢进性心脏病 临床研究 证候规律 

分 类 号：R581.1[医药卫生—内分泌]