本文選題：胸痹 + 急性冠脈綜合征��； 參考：《南京中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:應用預先制備的臨床研究表,進行臨床病例資料收集,分析歸納急性冠脈綜合征的證候分布特點,探討急性冠脈綜合征(ACS)患者血運重建前后中醫(yī)證型變化特點,為中西結(jié)合治療急性冠脈綜合征提供參考依據(jù)。方法:納入符合診斷與研究標準的96例急性冠脈綜合征住院患者,于血運重建前、后分別根據(jù)中醫(yī)四診信息辨證分型,建立數(shù)據(jù)庫,進行統(tǒng)計學處理,分析急性冠脈綜合征患者的證候特點,并分析其血運重建前后的中醫(yī)證型的主要變化特點。結(jié)果:1.ACS患者血運重建治療以65～74歲年齡組最多,占研究病歷的34.3%。2.各年齡組患者血運重建前均以氣滯證最常見,其次為氣虛證及血瘀證。各年齡組兼證均以血瘀證最常見,其次為痰濁證。3.男性患者主證以氣滯證最常見,其次為痰濁證、氣虛證;女性患者主證也以氣滯證最常見,其次為血瘀證、氣虛證。4.有吸煙嗜好者主證以氣滯證最多見,其次為痰濁證;有飲酒嗜好者主證以氣滯證最多見,其次為氣虛證及寒凝證。5.各年齡組患者血運重建后均以氣虛證最常見,其中75歲年齡組患者術(shù)后主證氣虛證增多最顯著,增幅高達82.4%,其次為55～64年齡組,增幅為62.5%。6.各年齡組患者血運重建后兼證均有變化,兼血瘀證顯著減少,而陽虛證、陰虛證明顯增加。7.氣虛證在植入三個及以上支架的患者中比例最高,占83.3%。結(jié)論:血運重建前后,各年齡組ACS患者中醫(yī)辨證主證及兼證均發(fā)生變化,血運重建術(shù)前以氣滯證最多見,血運重建術(shù)后以氣虛證對多見,提示血運重建術(shù)影響患者的中醫(yī)癥候變化,中醫(yī)治療應在術(shù)后再次辨證診斷的基礎(chǔ)上實施。
[Abstract]:Objective: to use the pre prepared clinical study table, collect the clinical case data, analyze and summarize the characteristics of the syndrome distribution of acute coronary syndrome (ACS), and discuss the characteristics of TCM syndrome type changes before and after the reconstruction of acute coronary syndrome (ACS), and provide the reference basis for the combination of Chinese and Western combined with the treatment of acute coronary artery syndrome. In 96 patients with acute coronary syndrome, before the reconstruction of blood transport, a database was established according to the syndrome differentiation and classification of four diagnosis information of Chinese medicine. Statistical processing was carried out to analyze the syndrome characteristics of patients with acute coronary syndromes, and the main characteristics of TCM syndrome types before and after the reconstruction of blood transport were analyzed. Results: blood of 1.ACS patients. The most common 34.3%.2. age groups were qi stagnation and Qi deficiency syndrome and blood stasis syndrome. All age groups were the most common syndrome of blood stasis, followed by.3. male patients with phlegm syndrome, the most common syndrome was qi stagnation, followed by phlegm syndrome and Qi deficiency syndrome; The main syndrome of patients with qi stagnation is the most common, followed by blood stasis syndrome, Qi deficiency syndrome.4. has the main evidence of qi stagnation, the second is phlegm syndrome, and the main syndrome of drinking hobby is Qi stagnation, followed by qi deficiency syndrome and cold coagulating syndrome in.5. age group, the most common syndrome is Qi deficiency syndrome after 75 years old age group. The increase of qi deficiency syndrome in the post main syndrome was the most significant, up to 82.4%, followed by the 55~64 age group, the increase of the rate of 62.5%.6. in all age groups was changed, and the syndrome of blood stasis significantly decreased, but the deficiency of Yang deficiency syndrome, yin deficiency proved to increase.7. Qi deficiency with the highest proportion of the patients implanted with three or more stents, accounting for 83.3%. conclusion: blood transport weight Before and after construction, the syndrome differentiation and syndrome of ACS patients in all age groups were changed. The qi stagnation syndrome was most common before the reconstruction of blood transport, and the Qi deficiency syndrome was more common after the reconstruction of blood transport. It suggested that the reconstructive operation of blood affect the change of TCM syndrome. The treatment of Chinese medicine should be carried out on the basis of diagnosis and diagnosis again after the operation.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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