本文選題：急性心肌梗死 + 急性下壁心肌梗死��； 參考：《遼寧中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討及分析急性下壁心肌梗死(Acute Inferior Myocardial Infarction,AIMI)并發(fā)房室傳導(dǎo)阻滯(Atrioventricular Block,AVB)的特點、中醫(yī)證型分布情況,為急性下壁心肌梗死并發(fā)房室傳導(dǎo)阻滯中醫(yī)臨床辨證論治提供科學(xué)依據(jù)。方法:2011年1月至2017年3月有438例下壁AMI就診于遼寧中醫(yī)藥大學(xué)附屬醫(yī)院心內(nèi)二科,其中未并發(fā)AVB患者359例,按照中醫(yī)證型分為痰瘀互結(jié)組、氣滯血瘀組、氣陰兩虛組、心腎陽虛組四組。并發(fā)AVB患者79例,按照中醫(yī)證型分為痰瘀互結(jié)組、氣滯血瘀組、氣陰兩虛組、心腎陽虛組四組;按AVB類型分為Ⅰ度AVB,Ⅱ度AVB,Ⅲ度AVB三組,對病例資料進行回顧性分析。結(jié)果:1.359例下壁AMI未并發(fā)AVB患者中醫(yī)證型以實證居多,79例并發(fā)AVB患者以虛癥居多,P=0.0000.05有統(tǒng)計學(xué)意義。2.下壁AMI患者中醫(yī)證型為實證或虛癥的,并發(fā)AVB的發(fā)生時間上無差別,P=0.130.05無統(tǒng)計學(xué)意義。3.79例下壁AMI患者24h內(nèi)并發(fā)AVB 26例,多為Ⅲ度AVB;24h后并發(fā)AVB 53例,多為Ⅱ度AVB,P=0.0000.05有統(tǒng)計學(xué)意義。4.79例下壁AMI并發(fā)AVB患者死亡2例,出院77例,死亡率2.53%,中醫(yī)證型實癥與虛癥的死亡率無差別,采用Fisher精確檢驗,P=1.0000.05無統(tǒng)計學(xué)意義。結(jié)論:1.急性下壁心肌梗死患者中醫(yī)辨證分型屬虛癥者易并發(fā)房室傳導(dǎo)阻滯。2.急性下壁心肌梗死患者24小時內(nèi)易并發(fā)Ⅲ度房室傳導(dǎo)阻滯;24小時后易并發(fā)Ⅱ度房室傳導(dǎo)阻滯。3.急性下壁心肌梗死并發(fā)房室傳導(dǎo)阻滯患者,中醫(yī)證型實癥與虛癥的死亡率無差別。4.急性下壁心肌梗死未并發(fā)房室傳導(dǎo)阻滯患者中醫(yī)證型痰瘀互結(jié)證、氣滯血瘀證、氣陰兩虛證、心腎陽虛證所占比例依次減少;急性下壁心肌梗死并發(fā)房室傳導(dǎo)阻滯患者中醫(yī)證型心腎陽虛證、氣陰兩虛證、痰瘀互結(jié)證、氣滯血瘀證所占比例依次減少,有利于臨床采用中西醫(yī)結(jié)合預(yù)防和治療急性下壁心肌梗死并發(fā)房室傳導(dǎo)阻滯。盡早采用中西醫(yī)結(jié)合預(yù)防和治療急性下壁心肌梗死并發(fā)房室傳導(dǎo)阻滯,提高其治療效果。
[Abstract]:Objective: to investigate and analyze the characteristics and the distribution of TCM syndromes of acute Inferior Myocardial Infarctionm (AIMI) complicated with atrioventricular block (AVB) in acute inferior wall myocardial infarction (AMI), and to provide a scientific basis for clinical diagnosis and treatment of AV block in acute inferior wall myocardial infarction (AMI) complicated with atrioventricular block (AVB). Methods: from January 2011 to March 2017, 438 cases of lower wall AMI were admitted to the Department of Cardiac, affiliated Hospital of Liaoning University of traditional Chinese Medicine, of which 359 cases were not complicated with AVB. According to TCM syndrome type, they were divided into phlegm and blood stasis group, Qi stagnation and blood stasis group, qi and yin deficiency group. Four groups of heart and kidney yang deficiency group. 79 patients with AVB were divided into four groups according to TCM syndromes: phlegm and blood stasis group, qi stagnation and blood stasis group, qi and yin deficiency group, heart and kidney yang deficiency group, and according to the type of AVB, they were divided into three groups: 鈪，

本文編號：1956046