高血压病合并冠心病患者不同中医证型与心电图关系分析  

Analysis of Relationship Between Different Chinese Medicine Syndrome Types and Electrocardiogram in Patients with Hypertension Complicated with Coronary Heart Disease

作　　者：舒孝萧 吕文明 SHU Xiaoxiao;LYU Wenming

机构地区：[1]宁波市鄞州人民医院特检科,浙江宁波315040

出　　处：《新中医》2021年第11期77-79,共3页New Chinese Medicine

摘　　要：目的:分析高血压病合并冠心病患者不同中医证型与心电图的关系。方法:首先对2018年6月—2019年6月纳入高血压病合并冠心病的患者进行中医辨证分型,直到满足6个组且每组不少于20例为止停止分型,再参考抽签法获得每组20例,并以12导联心电图机完成相关检测,比对各相关指标以及不同中医证型之间存在的关系。结果:120例高血压病合并冠心病临床患者中,心肌缺血41.67%(50/120)、心律失常28.33%(34/120)、左室高电压19.17%(23/120)、左室肥大10.83%(13/120)。其中心肌缺血主要涉及瘀血闭阻型、寒凝心脉型、心气亏虚型、痰浊内阻型,依次占据65.00%、50.00%、50.00%、45.00%。心律失常的每个证型占据20.00%~35.00%。左室高电压以心肾阳虚型(30.00%)、心肾阴虚型(35.00%)为主。左室肥大以痰浊内阻型(20.00%)、心肾阳虚型(15.00%)、心肾阴虚型(15.00%)为主。Q-T间期延长阳性者34.17%(41/120),S-T段下移阳性者42.50%(51/120),Q-T间期延长阳性者以瘀血闭阻型为主,S-T段下移也以瘀血闭阻型为主。QRS波群离散度对比,从高至低分别是瘀血闭阻型>痰浊内阻型>心肾阳虚型>寒凝心脉型>心气亏虚型>心肾阴虚型(P<0.05)。结论:在以心肌缺血为主的高血压病合并冠心病临床患者中,不同的中医证型、心电图之间相互关联。主要证型为瘀血闭阻型,而心电图则是表现为Q-T间期延长或是S-T段下移乃至QRS波群离散度增强。Objective: To analyze the relationship between different Chinese medicine syndrome types and electrocardiogram in patients with hypertension complicated with coronary heart disease. Methods:First of all,the patients with hypertension and coronary heart disease from June 2018 to June 2019 were classified according to TCM syndrome differentiation until they met the requirements of 6 groups with no less than 20 cases in each group,each group had 20 cases.Relevant examination was conducted through 12-lead electrocardiograph.Relevant indexes and relationship between different Chinese medicine syndrome types were compared. Results: Among 120 cases of clinical patients with hypertension complicated with coronary heart disease,myocardial ischemia,arrhythmia,left ventricular high voltage,and left ventricular hypertrophy accounted for 41.67%(50/120), 28.33%(34/120), 19.17%(23/120), and 10.83%(13/120) respectively.Myocardial ischemia was mainly related to obstruction of static blood type(65.00%), cold congealing in the heart vessel type(50.00%), the heart qi deficiency type(50.00%), and internal obstruction of phlegm turbidity type(45.00%). The proportion of each syndrome type of arrhythmia ranged from 20.00% to 35.00%.Left ventricular high voltage was mainly related to heart-kidney yang deficiency type(30.00%) and heart-kidney yin deficiency type(35.00%). Left ventricular hypertrophy was mainly related to internal obstruction of phlegm turbidity type(20.00%), heart-kidney yang deficiency type(15.00%), and heart-kidney yin deficiency type(15.00%).Obstruction of static blood type was the most common in positive patients with prolonged Q-T interval accounting for 34.17%(41/120) and positive patients with S-T segment depression accounting for 42.50%(51/120). The QRS complex dispersion of different Chinese medicine syndrome types from high to low was as follows:obstruction of static blood type,internal obstruction of phlegm turbidity type,heart-kidney yang deficiency type,cold congealing in the heart vessel type,heart qi defici

关 键 词：高血压病 冠心病 中医证型 心电图 瘀血闭阻型 QRS波群离散度 Q-T间期延长 S-T段下移 

分 类 号：R541.3[医药卫生—心血管疾病] R540.4[医药卫生—内科学]