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  本文關(guān)鍵詞： 冠心病高血壓中 醫(yī) 證型　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:總結(jié)冠心病高血壓患者與冠心病患者中醫(yī)證型分布特點及冠心病高血壓患者中醫(yī)證型與冠脈病變的相關(guān)性。方法:納入行冠脈造影檢查的冠心病患者92例,冠心病高血壓患者103例為研究對象。采集兩組患者的一般資料、既往史、中醫(yī)證候表現(xiàn)及冠狀動脈造影結(jié)果,填寫臨床觀察表,所有數(shù)據(jù)錄入Excell表格建立數(shù)據(jù)庫。將所有納入病例根據(jù)中醫(yī)證候表現(xiàn)確定其相應(yīng)中醫(yī)證型,并觀察所有患者冠脈病變情況。采用SPSS17.0軟件進(jìn)行統(tǒng)計分析,計數(shù)資料采用χ2檢驗,計量資料兩組間比較采用t檢驗,多組間比較采用單因素方差分析,冠心病高血壓組與中醫(yī)證型的相關(guān)性采用logistic回歸分析。結(jié)果:1、一般資料:兩組患者性別、年齡、體質(zhì)指數(shù)、煙酒史、糖尿病病程、冠心病病程比較,均無統(tǒng)計學(xué)差異(P0.05)。2、血脂、血糖、血壓:兩組患者TC、TG、HDL-C、LDL-C、血糖比較,均無統(tǒng)計學(xué)意義(P0.05)。冠心病高血壓組患者收縮壓、舒張壓均高于冠心病組患者,有統(tǒng)計學(xué)意義(P0.05)。3、冠脈病變特點:冠心病高血壓組以冠脈多支病變居多,冠心病組以冠脈單支病變居多,兩組比較有統(tǒng)計學(xué)意義(P0.05)。冠心病高血壓組冠脈狹窄程度以4級居多,冠心病組冠脈狹窄程度以2級、3級居多,兩組比較有統(tǒng)計學(xué)意義(P0.05)。冠心病高血壓組Gensini評分明顯高于冠心病組Gensini評分,有統(tǒng)計學(xué)意義(P0.05)。4、冠脈病變情況與血壓分級的關(guān)系:冠心病高血壓3級組Gensini評分明顯高于冠心病高血壓1級組、2級組Gensini評分,有統(tǒng)計學(xué)意義(P0.05)。5、中醫(yī)證型分布特點:冠心病高血壓組以氣滯心胸證、心血瘀阻證、痰阻心脈證為主,其中氣滯心胸證、心血瘀阻證與冠心病高血壓的關(guān)系最為密切。冠心病組主要以心氣虧虛證和心血瘀阻證為主。兩組中醫(yī)證型分布比較,有統(tǒng)計學(xué)意義(P0.05)。6、冠脈病變特點與中醫(yī)證型組合的關(guān)系:與冠心病高血壓組相比,單一證型、兼夾證型的Gensini評分均高于冠心病組,有統(tǒng)計學(xué)意義(P0.05)。7、冠心病高血壓組冠脈病變情況與中醫(yī)證型關(guān)系:單支組、雙支組、多支組病變的冠脈均以氣滯心胸證、心血瘀阻證和痰阻心脈證所占比例居多,其中氣滯心胸證所占比例最大。但三組中醫(yī)證型在病變冠脈支數(shù)上的分布無統(tǒng)計學(xué)意義(P0.05)。冠脈狹窄2級組、3級組、4級組均以氣滯心胸證占有比例最大。但三組中醫(yī)證型在病變冠脈狹窄程度上的分布無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1、冠心病高血壓組的冠脈病變以多支病變、4級程度狹窄為主,并且冠心病高血壓組Gensini評分明顯高于冠心病組。冠脈病變程度與血壓分級成正相關(guān)。2、冠心病高血壓組與氣滯心胸證、心血瘀阻證關(guān)系最為密切。冠心病組主要以心氣虧虛證、心血瘀阻證為主。3、冠心病高血壓組單一證型、兼夾證型的冠脈病變程度均重于冠心病組。兼夾證型表現(xiàn)的冠心病高血壓組冠脈病變程度較重。
[Abstract]:Objective: to summarize the distribution characteristics of TCM syndromes in patients with coronary artery disease (CHD) and patients with coronary heart disease (CHD) and the correlation between TCM syndromes and coronary lesions in patients with CHD. Methods: 92 cases of coronary artery disease (CHD) were examined by coronary angiography. 103 patients with coronary heart disease and hypertension were studied. The general data, past history, TCM syndromes and coronary angiography results were collected, and the clinical observation forms were filled out. All the data were input into the Excell form to establish the database. According to the syndromes of TCM, all the cases were selected to determine their corresponding TCM syndromes, and the coronary lesions of all patients were observed. The statistical analysis was carried out by SPSS17.0 software, and the count data were analyzed by 蠂 2 test. The correlation between CHD and TCM syndromes was analyzed by logistic regression analysis. Results: 1. General data: sex, age, body mass index of the two groups. There was no significant difference in the history of tobacco and alcohol, the course of diabetes, and the course of coronary heart disease (P 0.05). Diastolic blood pressure (DBP) was significantly higher than that in coronary heart disease (CHD) group (P 0.05). The characteristics of coronary artery disease were as follows: coronary artery disease was more common in hypertension group and single coronary artery disease in coronary heart disease group. There was significant difference between the two groups (P 0.05). The degree of coronary artery stenosis in CHD hypertension group was mostly grade 4, and that in coronary heart disease group was grade 2 and grade 3, and the degree of coronary artery stenosis in coronary heart disease group was higher than that in coronary artery disease group. There was significant difference between the two groups (P 0.05). The Gensini score of CHD hypertension group was significantly higher than that of CHD group Gensini score. The relationship between coronary artery disease and blood pressure grade: the Gensini score of coronary artery disease grade 3 group was significantly higher than that of coronary heart disease grade 1 hypertension grade 2 group, Gensini score was significantly higher than that of coronary artery disease grade 1 group and grade 2 group. The distribution characteristics of TCM syndromes were as follows: Qi stagnation heart and chest syndrome, heart blood stasis syndrome, phlegm blocking heart vein syndrome, and qi stagnation heart and chest syndrome. The relationship between heart blood stasis syndrome and coronary heart disease hypertension is most close. In coronary heart disease group, heart qi deficiency syndrome and heart blood stasis syndrome are the main factors. The relationship between the characteristics of coronary artery disease and the combination of TCM syndromes: compared with the coronary hypertension group, the Gensini scores of the single syndrome type and the clipping type were higher than that of the coronary heart disease group. The relationship between coronary artery disease and TCM syndromes in coronary heart disease and hypertension group was as follows: single vessel group, double vessel group and multi-vessel group all had Qi stagnation heart chest syndrome, heart blood stasis syndrome and phlegm blocking heart vein syndrome. The proportion of qi stagnation cardiothoracic syndrome was the largest, but the distribution of TCM syndrome type in the number of coronary artery branches in the three groups was not statistically significant (P 0.05). The proportion of Qi stagnation cardiothoracic syndrome was the largest in grade 2, grade 3, grade 3 and grade 4 of coronary stenosis group, but in the three groups, the proportion of Qi stagnation cardiothoracic syndrome was the largest. There was no significant difference in the distribution of the degree of coronary stenosis between the two groups (P 0.05). Conclusion the coronary artery disease in the group of coronary heart disease and hypertension is mainly composed of multi-vessel stenosis and grade 4 stenosis. The Gensini score of coronary artery disease hypertension group was significantly higher than that of coronary heart disease group. The degree of coronary artery disease was positively correlated with blood pressure grade. The relationship between coronary heart disease hypertension group and qi stagnation heart blood stasis syndrome was the most close. The degree of coronary artery disease in CHD hypertension group was more serious than that in coronary heart disease group, and the coronary artery lesion degree in CHD hypertension group was more serious than that in coronary heart disease group.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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