本文選題：冠心病穩(wěn)定型心絞痛　切入點：中醫(yī)證型　出處：《云南中醫(yī)學院》2017年碩士論文　論文類型：學位論文

【摘要】：目的:通過檢測冠心病穩(wěn)定型心絞痛患者的動脈彈性指標:踝臂指數(shù)(ABI)和肱踝脈搏波傳導速度(BaPWV),結(jié)合祖國醫(yī)學的理論,分析ABI及BaPWV與冠心病穩(wěn)定性心絞痛部分中醫(yī)證型的相關(guān)性,進而為中西結(jié)合防治冠心病提供新的思路,同時,分析ABI及BaPWV的影響因素,為早期發(fā)現(xiàn)和干預外周動脈疾病,預防心血管事件的發(fā)生提供新的方向。方法:選取符合標準的120例冠心病穩(wěn)定性心絞痛患者,年齡為45~75歲,其中男性患者64例,女性患者56例,男女比例約1.14:1。在簽署知情同意書之后,按照統(tǒng)一制定的調(diào)查表,以問卷調(diào)查的形式,收集每位患者的四診資料及一般情況。四診資料包括:癥狀、脈象、舌象,歸納中醫(yī)證型。一般情況包括:性別、年齡、吸煙史、心血管病家族史、既往史、身高和體重(計算出體重指數(shù)BMI)、收縮壓和舒張壓(計算出脈壓差)、總膽固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、空腹血糖(GLU)。采用日本科林公司的全自動動脈硬化檢測儀BP-203RPEⅡ(VP-1000)采集ABI、BaPWV數(shù)值。結(jié)果:(1)本研究共納入四個證型的冠心病穩(wěn)定型心絞痛患者,四個證型所占比例依次為痰阻心脈證,占31.67%;氣陰兩虛證,占25.83%;心血瘀阻證,占22.5%;陽氣虛衰證,占20%。其中,痰阻心脈證所占比例最高;所納四個證型組痰阻心脈證、氣陰兩虛證、心血瘀阻證、陽氣虛衰證組間男女比例依次為1:1.38,1.21:1,1.45:1,1.67:1。(2)各證型組間一般情況的比較:冠心病穩(wěn)定型心絞痛痰阻心脈證患者的BMI值明顯高于心血瘀阻證、氣陰兩虛證、陽氣虛衰證的患者,收縮壓、舒張壓、脈壓差、TC、TG、LDL-C、HDL-C四組間比較均無統(tǒng)計學差異;(3)冠心病穩(wěn)定型心絞痛痰阻心脈證患者的ABI值低于氣陰兩虛證、心血瘀阻證、陽氣虛衰證的患者,差異有統(tǒng)計學意義(P0.05);冠心病穩(wěn)定型心絞痛痰阻心脈證患者的baPWV值高于其他三組,差異具有統(tǒng)計學意義(P0.05);(4)ABI的主要影響因素是性別與TG,TG與ABI呈負相關(guān);(5)baPWV的主要影響因素是年齡和收縮壓,且兩者都與baPWV呈正相關(guān)。結(jié)論:冠心病穩(wěn)定型心絞痛痰阻心脈證患者ABI值低于心血瘀阻證、氣陰兩虛證、陽氣虛衰證的患者,而baPWV值則高于其他三組證型的患者;冠心病穩(wěn)定型心絞痛痰阻心脈證患者BMI高于其他三組證型的患者;ABI的主要影響因素是性別和TG,TG與ABI呈負相關(guān);baPWV的主要影響因素是年齡和收縮壓,且兩者都與baPWV呈正相關(guān);其中TG和收縮壓是可控因素,而性別、年齡是不可控因素。
[Abstract]:Objective: to study the arterial elasticity index (ABI) and brachial pulse wave velocity (BWV) in patients with stable angina pectoris of coronary heart disease (CHD), combined with the theory of traditional Chinese medicine. To analyze the correlation between ABI and BaPWV and some TCM syndromes of stable angina pectoris of coronary heart disease, and to provide a new idea for the prevention and treatment of coronary heart disease by combining Chinese and western medicine. At the same time, to analyze the influencing factors of ABI and BaPWV, so as to find and intervene in peripheral artery disease early. Methods: 120 patients with stable angina pectoris of coronary heart disease, aged 4575 years, including 64 male and 56 female, were selected to prevent cardiovascular events. The ratio of men to women is about 1.14: 1.After signing the informed consent form, according to the unified questionnaire, the data of four diagnoses and general information of each patient are collected in the form of questionnaire. The information of four diagnoses includes: symptoms, pulse, tongue, etc. Generalize TCM syndromes. General conditions include: sex, age, smoking history, family history of cardiovascular disease, past history, Height and weight (calculated body mass index BMIA, systolic blood pressure and diastolic pressure, calculated pulse pressure difference, total cholesterol TCU, triglyceride TGG, low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), high density lipoprotein (HDL-C), fasting blood glucose (GLU)). BP-203RPE 鈪，

本文編號：1642115