冠心病证候要素分析及伏邪与冠脉病变程度相关性研究
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摘要
目的采用流行病学方法研究冠心病证候要素与冠状动脉病变程度的相关性,探索伏邪致病特点。方法通过前瞻性调查方法收集冠心病心绞痛(冠脉造影术后)患者120例临床资料,结合指标描述性分析、多元线性回归分析等分析方法,总结证候要素与冠状动脉病变程度及范围的内在联系。结果痰浊+血瘀、气虚+血瘀是冠心病心绞痛中出现频率最高的内在组合。血瘀、痰浊、阳虚、气虚与Gensini积分正性相关,血瘀、痰浊、阴虚、气虚与冠脉病变血管支数正性相关。结论痰浊和血瘀是引起冠脉病变程度和范围加重的重要因素。
Objective: To research the correlation between TCM syndrome factors of CHD and degree of coronary lesions,and to explore the characteristics of insidious pathogen with epidemiological methods. Methods: The clinical data of 120 patients with angina pectoris(postoperative coronary angiography) were collected by prospective investigation. The descriptive analysis and multiple linear regression analysis were used to summarize the intrinsic relationship between syndrome factors and coronary lesions. Results: The phlegm+blood stasis and Qi deficiency +blood stasis was the most common combination of coronary heart disease angina. The blood stasis,phlegm,Yang deficiency and Qi deficiency were all positively correlated to the total grades of Gensini. The bloodstasis,phlegm,Yin deficiency and Qi deficiency were all positively correlated to the pathologic number of the coronary artery. Conclusion: The phlegm + blood stasis is an pivotal factor factor causing the severity and extent of coronary lesions.
Objective: To research the correlation between TCM syndrome factors of CHD and degree of coronary lesions,and to explore the characteristics of insidious pathogen with epidemiological methods. Methods: The clinical data of 120 patients with angina pectoris(postoperative coronary angiography) were collected by prospective investigation. The descriptive analysis and multiple linear regression analysis were used to summarize the intrinsic relationship between syndrome factors and coronary lesions. Results: The phlegm+blood stasis and Qi deficiency +blood stasis was the most common combination of coronary heart disease angina. The blood stasis,phlegm,Yang deficiency and Qi deficiency were all positively correlated to the total grades of Gensini. The bloodstasis,phlegm,Yin deficiency and Qi deficiency were all positively correlated to the pathologic number of the coronary artery. Conclusion: The phlegm + blood stasis is an pivotal factor factor causing the severity and extent of coronary lesions.
引文
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[12]张敏州,丁邦晗,张维东,等.375例胸痹心痛患者冠状动脉造影结果与中医证型的对比研究[J].中国中西医结合急救杂志,2004,2(2):115-117.
[13]曹洪欣,张华敏.冠心病痰瘀同治的临床应用[J].中医药学报,2001,29(1):1-2.
[14]曹洪欣,张华敏.痰瘀互结与冠心病发病机理辨识[J].中医药学刊,2001,19(6):544-545.
[15]任继学.伏邪探微[J].中国中医药现代远程教育,2003,1(2):8-9.
[16]王昀,季蓓.探讨痰浊血瘀与心血管病相关性的思路[J].安徽中医学院学报,2007,26(3):1-3.
[17]邓悦,郭家娟,李红光,等.从中医伏邪病因论治冠心病的思考[J].长春中医药大学学报,2007,23(6):1-2.
[18]于丹.从痰瘀浅析冠心病[J].辽宁中医药大学学报,2012,14(6):208-209.
[19]邓悦,吴宗贵,陈颖,等.痰瘀伏络是心血管疾病链的主要机制[J].中医杂志,2011,52(20):1733-1735.
[2]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.不稳定性心绞痛诊断和治疗建议[J].中华心血管病杂志,2000,28(6):409-410.
[3]中华医学会心血管病学分会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12):710-712.
[4]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[5]朱文峰.中医诊断学[M].北京:中国中医药出版社,2007:154,158-167.
[6]周仲琪.中医内科学[M].北京:中国中医药出版社,2007:135-146.
[7]Gensini GG.A more meaning scoring system for determining the severity of coronary heart disease[J].AM J Cardiol,1994,47:37-43.
[8]王永炎,张志斌.再议完善辨证方法体系的几个问题[J].天津中医药,2007,24(1):1-4.
[9]李东涛,李洁,王剑,等.冠心病病中医证候诊断规范研究[J].山东中医药大学学报,2011,35(2):117-120.
[10]李月娟,毛静远.冠心病中医证候特点的研究进展[J].浙江中医药大学学报,2012,36(7):841-844.
[11]管昌益,张文高,崔连群,等.冠心病本虚标实证冠状动脉造影结果分析[J].山东中医药大学学报,2000,24(1):28-30.
[12]张敏州,丁邦晗,张维东,等.375例胸痹心痛患者冠状动脉造影结果与中医证型的对比研究[J].中国中西医结合急救杂志,2004,2(2):115-117.
[13]曹洪欣,张华敏.冠心病痰瘀同治的临床应用[J].中医药学报,2001,29(1):1-2.
[14]曹洪欣,张华敏.痰瘀互结与冠心病发病机理辨识[J].中医药学刊,2001,19(6):544-545.
[15]任继学.伏邪探微[J].中国中医药现代远程教育,2003,1(2):8-9.
[16]王昀,季蓓.探讨痰浊血瘀与心血管病相关性的思路[J].安徽中医学院学报,2007,26(3):1-3.
[17]邓悦,郭家娟,李红光,等.从中医伏邪病因论治冠心病的思考[J].长春中医药大学学报,2007,23(6):1-2.
[18]于丹.从痰瘀浅析冠心病[J].辽宁中医药大学学报,2012,14(6):208-209.
[19]邓悦,吴宗贵,陈颖,等.痰瘀伏络是心血管疾病链的主要机制[J].中医杂志,2011,52(20):1733-1735.