冠心病伴慢性肾功能不全病人不同中医证型的冠状动脉病变特征分析  

The Characteristics of Coronary Artery Lesions in Patients with Coronary Heart Disease Combined with Chronic Renal Insufficiency in Different TCM Syndromes

作　　者：李天力 王显[1] 李本志[1] 常佩芬[1] LI Tianli;WANG Xian;LI Benzhi;CHANG Peifen(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院,北京100700

出　　处：《中西医结合心脑血管病杂志》2022年第24期4425-4428,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金项目(No.8177140333);国家中医药管理局2015年度国家中医临床研究基地业务建设科研专项课题(No.JDZX2015009)。

摘　　要：目的 探讨不同肾功能冠心病病人中医证型分布、冠状动脉病变程度及预后的差异。方法 选取2019年1月-2019年8月在北京中医药大学东直门医院心内科住院且诊断为冠心病的病人241例,根据估算肾小球滤过率将病人分为正常组与异常组,比较两组临床资料。结果 正常组心血瘀阻证比例高于异常组,异常组痰阻心脉证及阳气虚衰证比例高于正常组,差异均有统计学意义(P<0.05)。冠心病病人冠状动脉病变相对较重的两种中医证型分别为痰阻心脉证与阳气虚衰证,冠状动脉病变最轻的中医证型为心血瘀阻证。异常组Gensini积分高于正常组,差异均有统计学意义(P<0.05);异常组住院期间急性心力衰竭发生率及30 d再住院率高于正常组,差异有统计学意义(P<0.05)。结论 不同肾功能冠心病病人中医证型分布、冠状动脉病变程度及预后存在差异。Objective To investigate the traditional Chinese medicine(TCM) syndrome distribution, severity of coronary prognosis in patients with coronary heart disease(CHD) complicated chronic renal insufficiency.Methods Two hundred and forty-one patients were divided into normal group and abnormal group according to the glomerular filtration rate(GFR),and the clinical data of the two groups were compared and analyzed.Results The proportion of heart blood stasis syndrome in the normal group was higher than that in the abnormal group, and the proportion of phlegm blocking heart vessel syndrome and Yang Qi deficiency syndrome in the abnormal group was higher than that in the normal group, and the differences were statistically significant(P<0.05).The TCM syndromes with relatively severe coronary artery disease in patients with CHD were phum-blocking heart vessel syndrome and Yang Qi deficiency syndrome, while the lightest TCM syndrome was heart blood stasis syndrome.The Gensini score in the abnormal group were higher than those in the normal group, and the differences were statistically significant(P<0.05).The incidence of acute heart failure during hospitalization and the 30 day rehospitalization rate in the abnormal group were higher than those in the normal group, and the differences were statistically significant(P<0.05).Conclusion There were differences in the distribution of TCM syndromes in patients with CHD Complicated with chroic renal insufficiency.It was related the severity of coronary artery lesions and the prognosis of CHD patients with different renal function.

关 键 词：冠心病 肾功能不全 中医证型 临床研究 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]