慢性心力衰竭的中医证素分布及与危险因素的相关性研究  

Correlation of the Distribution of Traditional Chinese Medicine Syndrome Elements with Risk Factors in Chronic Heart Failure

作　　者：罗晓君 梁宏宇[2] 陈丽芳 邓欢 LUO Xiao-Jun;LIANG Hong-Yu;CHEN Li-Fang;DENG Huan(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou510095 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2023年第4期795-801,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(粤办函[2017]267号)。

摘　　要：【目的】探讨慢性心力衰竭(CHF)患者的中医证素分布规律及其与CHF危险因素的相关性。【方法】采用回顾性研究方法,采集282例CHF患者的症状、舌脉象、中医证型、心功能以及合并病等相关信息,并对收集到的数据进行统计分析,探讨中医证素分布规律及其与危险因素的相关性。【结果】(1)CHF最常见的症状为气促(75.89%),最常见的舌象为舌淡暗(46.81%),最常见的苔象为苔白(44.68%),最常见的脉象为脉细(39.72%)。(2)病位证素方面,CHF的最主要病位证素为心(90.78%),其他分别为肺(61.35%)、肾(55.67%)、脾(48.94%)、肝(31.91%);病性证素方面,以气虚(82.57%)和阳虚(63.12%)为主要的本虚证素,以血瘀(85.11%)和水饮(48.94%)为主要的标实证素。(3)CHF患者的血瘀证素与冠心病和心律失常呈正相关(P<0.05或P<0.01);气虚证素与高血压、冠心病、心脏瓣膜病呈正相关(P<0.05或P<0.01);阳虚证素与高血压、扩张型心肌病呈正相关(P<0.05)。【结论】CHF的病位在心,而与五脏相关,总的病机特点为本虚标实,气虚和阳虚为本,血瘀和水饮为标;CHF合并冠心病和心律失常的患者更容易出现血瘀,合并高血压、冠心病和心脏瓣膜病的患者更容易出现气虚,合并高血压和扩张型心肌病的患者更容易出现阳虚。Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome pattern in patients with chronic heart failure(CHF) and to explore its correlation with CHF risk factors. Methods A retrospective study was conducted in 282 patients with CHF. The information related to symptoms, tongue and pulse signs, TCM syndrome patterns, cardiac function and comorbidities of the patients were collected for statistically analysis. And then the distribution of TCM syndrome elements and the correlation of syndrome elements with risk factors were explored. Results(1)Shortness of breath(75.89%)was the most common symptom of CHF,pale and dark tongue(46.81%)was most frequently seen in the tongue sign,white coating(44.68%)was the predominant coating, and thin pulse(39.72%)was frequently seen in the pulse sign.(2)The most common disease-location syndrome element in CHF was heart(90.78%),and then came by the lung(61.35%),kidney(55.67%),spleen(48.94%)and liver(31.91%). Qi deficiency(82.57%)and yang deficiency(63.12%)were the main disease-nature syndrome elements of deficiency in the origin, and blood stasis(85.11%)and fluid retention(48.94%)were the main syndrome elements of excess in the superficiality.(3)Blood stasis syndrome element was positively correlated with coronary heart disease(CHD)and arrhythmia in CHF patients(P<0.05 or P<0.01);qi deficiency syndrome element was positively correlated with hypertension,CHD and valvular heart disease(P<0.05 or P<0.01);yang deficiency syndrome element was positively correlated with hypertension and dilated cardiomyopathy(P<0.05). Conclusion CHF mainly involves the heart and is associated with the five viscera. The general pathogenesis of CHF is characterized by deficiency in the origin and excess in the superficiality,i.e.,deficiency of qi and deficiency of yang in the origin,blood stasis and fluid retention in the superficiality. CHF patients complicated with CHD and arrhythmias are more likely to have blood stasis syndrome element,CHF patients complicated with hypertensio

关 键 词：慢性心力衰竭 中医证素 气虚 阳虚 血瘀 危险因素 

分 类 号：R259.416[医药卫生—中西医结合]