高原地区冠心病的中医辨证与证素分布规律研究  

Research on Traditional Chinese Medicine Syndrome Differentiation and Distribution of Syndrome Elements in Coronary Heart Disease in Plateau Areas

作　　者：赵志伟 邢志政 孙晨格 崔梁瑜 任聪 李玉坤 罗玮伯 吕诚[1] 韩学杰[1] 刘大胜[1] ZHAO Zhiwei;XING Zhizheng;SUN Chen'ge;CUI Liangyu;REN Cong;LI Yukun;LUO Weibo;LYU Cheng;HAN Xuejie;LIU Dasheng(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Air Force Medical University,Xi'an Shaanxi 710068,China;Shaanxi University of Chinese Medicine,Xi'an Shaanxi 712046,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]空军军医大学,陕西西安710068 [3]陕西中医药大学,陕西西安712046 [4]北京中医药大学东直门医院,北京100700

出　　处：《中医药导报》2024年第10期96-102,共7页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金青年科学基金项目(82205320);中国中医科学院中医临床基础医学研究所516专项(516-2);中国中医科学院优秀青年科技人才培养专项(ZZ16-YQ-035)。

摘　　要：目的:探究高原地区冠状动脉粥样硬化性心脏病(冠心病)患者的中医辨证、证素分布规律,以期为冠心病的中医论治提供参考。方法:以2021年5—6月、2022年7—8月在西藏、新疆的边疆高原地区就诊并经冠状动脉增强CT或冠脉造影术检查确诊为冠心病的患者为研究对象,借助数据挖掘技术,采用频率分析与关联规则分析的方法对冠心病患者的性别、年龄、生活地区海拔高度、中医辨证、证素等进行统计分析。结果:共纳入182例冠心病有效病例。男性患者占89.56%,女性患者占10.44%;海拔500~4500 m之间者占比最多(49.45%)。共涉及中医辨证72种,频数居前3位的中医辨证为心脉瘀阻证、心肾不交证、心脾亏虚证。共涉及14个病位证素,其中心(111)、肾(69)、脾(56)是频数最高的3个证素。共涉及13个病性证素,前3位为气虚(47.80%)、血瘀(41.21%)、气滞(39.01%)。在证素关联分析中,心-肾、气滞-血瘀、脾-气虚支持度最高。高原地区冠心病的常见合并病有睡眠障碍、胃炎等。结论:气虚证素作为高原地区冠心病的首要证素贯穿始终,其中以心、脾、肾脏腑亏虚为主;血瘀为高原地区冠心病的重要实性证素,痰瘀互结证为高原地区冠心病常见证候类型。Objective:To explore the TCM syndrome differentiation and distribution of syndrome elements in patients with coronary atherosclerotic heart disease(CHD)in plateau area,so as to provide reference for TCM treatment of CHD.Method:The patients who were diagnosed as coronary heart disease by coronary artery enhanced CT or coronary angiography in Xizang and Xinjiang border plateau regions from May to June 2021 and from July to August 2022 were taken as the research objects.With the help of data mining technology,frequency analysis and association rule analysis were used to statistically analyze the gender,age,altitude of living area,TCM syndrome differentiation and syndrome elements of coronary heart disease patients.Results:A total of 182 effective cases of coronary heart disease were included.Male patients account for 89.56%,while female patients account for 10.44%.The highest proportion was between 500 and 4500 meters above sea level(49.45%).There were a total of 72 types of traditional Chinese medicine syndromes involved,with the top three frequent being heart meridian stasis syndrome,heart kidney non intersection syndrome,and heart spleen deficiency syndrome.There were a total of 14 syndrome elements involved,with the heart(111),kidney(69),and spleen(56)being the three most frequent syndrome elements.There were a total of 13 pathological syndrome elements involved,with the top 3 being Qi deficiency(47.80%),blood stasis(41.21%),and Qi stagnation(39.01%).In the pathological correlation analysis,the support of heart-kidney,qi stagnation-blood stasis,and spleen-qi deficiency were the highest.Common comorbidities of coronary heart disease included sleep disorders,gastritis,etc.Conclusion:Qi deficiency syndrome elements are the primary syndrome elements for coronary heart disease in plateau areas,with deficiency in the heart,spleen,and kidney organs being the main ones.Blood stasis is an important solid syndrome element of coronary heart disease,and phlegm stasis syndrome is a common syndrome type of coronary heart dise

关 键 词：冠心病 高原地区 中医辨证 证素 气虚 关联规则 共现网络 

分 类 号：R241[医药卫生—中医诊断学]