冠心病患者中医证素与危险因素的相关性研究  

Study on the Correlation Between Traditional Chinese Medicine Syndrome Elements and Risk Factors in Patients with Coronary Heart Disease

作　　者：陈丽芳 梁宏宇[2] 罗晓君 徐槐敏 李雪娇 邓欢 刘文甜 CHEN Li-Fang;LIANG Hong-Yu;LUO Xiao-Jun;XU Huai-Min;LI Xue-Jiao;DENG Huan;LIU Wen-Tian(Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China)

机构地区：[1]广州中医药大学,广东广州州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10期2424-2430,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医临床优秀人才项目(编号:粤办函【2017】267号)。

摘　　要：【目的】探讨冠状动脉粥样硬化性心脏病(简称冠心病,CHD)患者中医证素与危险因素的相关性。【方法】回顾性分析216例CHD患者的病历资料,统计中医证素分布,分析不同证素与年龄、性别、吸烟史、高血压、糖尿病以及血脂异常等危险因素的相关性。【结果】(1)216例CHD患者中,涉及病位证素有心214例(99.09%)、肺139例(64.35%)、脾104例(48.14%)、肝66例(30.56%)、肾61例(28.24%);病性证素有血瘀206例(95.37%)、气虚163例(75.46%)、痰141例(65.27%)、阴虚53例(24.54%)、阳虚38例(17.59%)、水饮13例(6.01%)、热9例(4.17%)、气滞3例(1.39%)。(2)性别方面,男性118例(54.63%),女性98例(45.37%),男性多于女性;年龄方面,主要集中于50岁以上的中老年人,其中,小于50岁8例(3.70%),51~60岁30例(13.89%),61~70岁58例(26.85%),71~80岁65例(30.09%),大于80岁55例(25.46%)。(3)中医证素与危险因素相关性的Logistics回归分析结果显示:在CHD患者中,吸烟与气滞[OR=2.074,95%CI(1.051-4.093)]、血瘀[OR=2.074,95%CI(1.051-4.093)]正相关,血脂异常与痰[OR=4.199,95%CI(1.457-12.101)]正相关,高血压与气虚[OR=4.533,95%CI(1.071-19.188)]、阳虚[OR=8.257,95%CI(2.020-33.785)]正相关,糖尿病与血瘀[OR=5.840,95%CI(2.134-15.983)]、气虚[OR=2.259,95%CI(1.622-3.145)]、阴虚[OR=2.998,95%CI(1.176-7.639)]正相关,性别与血瘀[OR=2.152,95%CI(1.139-4.082)]正相关,差异均有统计学意义(P<0.05或P<0.01)。【结论】CHD的病位在心,涉及五脏,与肺关系密切,总的病机特点是本虚标实,以气虚、阳虚为本,以血瘀、痰为标。在CHD患者中,吸烟者更容易出现气滞和血瘀,血脂异常者更容易出现痰证,患有高血压病者更容易出现气虚及阳虚,患有糖尿病者更容易出现血瘀、气虚、阴虚,男性患者更容易出现血瘀。Objective To investigate the correlation between traditional Chinese medicine(TCM)syndrome elements and risk factors in patients with coronary atherosclerotic heart disease,generally shortened to coronary heart disease(CHD).Methods The medical records of 216 patients with CHD were retrospectively analyzed,and then the correlation of syndrome elements with the risk factors of age,gender,smoking history,hypertension,diabetes mellitus and dyslipidaemia was explored.Results(1)Among the 216 patients with CHD,the diseases-location syndrome elements were heart in 214 cases(99.09%),lung in 139 cases(64.35%),spleen in 104 cases(48.14%),liver in 66 cases(30.56%)and kidney in 61 cases(28.24%);the disease-nature syndrome elements were blood stasis in 206 cases(95.37%),qi deficiency in 163 cases(75.46%),phlegm in 141 cases(65.27%),yin deficiency in 53 cases(24.54%),yang deficiency in 38 cases(17.59%),fluid retention in 13 cases(6.01%),heat in 9 cases(4.17%)and qi stagnation in 3 cases(1.39%).(2)In terms of the distribution of the gender,118 cases(54.63%)were male and 98 cases(45.37%)were female,the male being more than the female.For the distribution of age groups,CHD were commonly seen in middle-aged and elderly population aged50 years or above.Of the 216 patients with CHD,8 cases(3.70%)were younger than 50 years old,30 cases(13.89%)were between 51 and 60 years old,58 cases(26.85%)were between 61 and 70 years old,65 cases(30.09%)were between 71 and 80 years old,and 55 cases(25.46%)were over 80 years old.(3)Logistic regression analysis of the correlation between TCM syndrome elements and risk factors of CHD patients showed that smoking was positively correlated with qi stagnation[OR=2.074,95%CI(1.051-4.093)]and blood stasis[OR=2.074,95%CI(1.051-4.093)],dyslipidemia was positively correlated with phlegm[OR=4.199,95%CI(1.457-12.101)],hypertension was positively correlated with qi deficiency[OR=4.533,95%CI(1.071-19.188)]and yang deficiency[OR=8.257,95%CI(2.020-33.785)],diabetes was positively correlated with blood stasis[OR=5.84

关 键 词：冠心病 中医证素 气虚 阳虚 血瘀 痰 危险因素 相关性 回顾性研究 

分 类 号：R259.414[医药卫生—中西医结合]