心力衰竭合并缺血性脑卒中的中医证型及用药  

TCM syndromes and medication selection of heart failure patients complicated with ischemic stroke

作　　者：许佳颖 孟真 唐文雄[3] 任景怡[2] XU Jia-ying;MENG Zhen;TANG Wen-xiong(School of Clinical Medicine,Beijing University of Chinese Medicine.Beijing 100105.China)

机构地区：[1]北京中医药大学,北京100029 [2]中日友好医院心脏科,北京100029 [3]中日友好医院神经科,北京100029

出　　处：《中日友好医院学报》2025年第1期24-27,34,共5页Journal of China-Japan Friendship Hospital

基　　金：高水平医院临床业务费专项临床项目(2022-NHLHCRF-LX-02-0102)。

摘　　要：目的:探索心力衰竭(HF)合并缺血性脑卒中(IS)的中医证型及用药现状。方法:回顾性分析2015年1月1日—2022年8月31日在中日友好医院心脏科住院治疗的413例HF患者(合并IS118例,不伴IS295例)的临床资料、中医证型证素、中药信息,总结其中医证型及用药特征。结果:在HF患者中,合并IS与不伴IS组气虚血瘀证均最为常见,分别占31.4%和33.6%。在中药应用方面,HF总体人群及HF合并IS组中最为常见的治疗药物均为益气药和活血药,HF合并IS患者在益气药(71.2%vs.49.2%)、温阳药(45.8%vs.30.2%)、养阴药(51.7%vs.27.1%)、化痰药(50.0%vs.25.5%)及活血化瘀药(53.4%vs.34.6%)的使用比例上均较HF不伴IS的患者更高(均P<0.05)。结论:HF合并IS患者最常见的中医证候为气虚血瘀证,最常见的治疗药物为益气药和活血药。Objective:To explore the TCM syndrome types and medication status of heart failure(HF)patients complicated with ischemic stroke(IS).Methods:The clinical data,TCM syndrome types and elements,and medication information of 413 HF patients(118 cases with IS,295 cases without IS)hospitalized in China-Japan Friendship Hospital from January 1,2015 to August 31,2022 were retrospectively analyzed,and the TCM syndrome types and medication characteristics were summarized.Results:In HF patients,the most common type of syndrome(32.9%)was Qi deficiency and blood stasis between the two groups with and without IS.In terms of the application of traditional Chinese medicine,the most common therapeutic drugs are Qi-supplementing drugs and blood-activating drugs.The proportion of Qi-supplementing drugs(71.2%vs.49.2%),yang-warming drugs(45.8%vs.30.2%),yin-nourishing drugs(51.7%vs.27.1%),phlegm-resolving drugs(50.0%vs.25.5%)and blood-activating drugs(53.4%vs.34.6%)used in HF patients with IS was higher than that in HF patients without IS(P<0.05).Conclusion:The most common TCM syndrome in HF patients with IS is Qi deficiency and blood stasis,and the most common treatment drugs are qi tonifying and blood activating drugs.

关 键 词：缺血性脑卒中 心力衰竭 证候要素 中药 中医证型 

分 类 号：R256.29[医药卫生—中医内科学]