不穩(wěn)定型心絞痛中醫(yī)常見證型與其相關(guān)危險因素的關(guān)系研究
發(fā)布時間：2018-10-21 13:45
【摘要】：目的:通過對本次收集的病例進行辨證分型,得出不穩(wěn)定型心絞痛中醫(yī)證型分布規(guī)律,常見證型,分析中醫(yī)常見證型與性別、年齡、誘發(fā)因素、發(fā)病季節(jié)、高血壓、糖尿病、高脂血癥的關(guān)系。目的使中醫(yī)對不穩(wěn)定型心絞痛更加全面的了解,更加科學(xué)化、客觀化的指導(dǎo)其在臨床中的應(yīng)用。方法:收集我院2015年9月至2015年12月心內(nèi)科病房不穩(wěn)定型心絞痛患者150例,中醫(yī)分型標(biāo)準采用“新世紀(第二版)中醫(yī)內(nèi)科學(xué)胸痹之分型標(biāo)準”,西醫(yī)診斷標(biāo)準采用“第八版西醫(yī)內(nèi)科學(xué)診斷標(biāo)準”。性別不限,分別記錄其姓名、性別、年齡、發(fā)病季節(jié)、誘發(fā)因素及其臨床癥狀,根據(jù)臨床癥狀、舌、脈等辨證確定證型,入院后空腹檢查血脂、血糖等生化檢查。利用統(tǒng)計學(xué)軟件SPSS17.0進行統(tǒng)計分析,計數(shù)資料采用卡方檢驗或Fisher檢驗,計量資料采用方差分析,得出結(jié)果,進行分析。結(jié)果:1)通過對150例不穩(wěn)定型心絞痛患者進行辨證分型,得出心血瘀阻47例,痰濁閉阻41例,氣陰兩虛35例,氣滯心胸12例,心腎陰虛9例,心腎陽虛4例,寒凝心脈2例,總結(jié)出不穩(wěn)定型心絞痛中醫(yī)證型分布從大到小依次為:心血瘀阻痰濁閉阻氣陰兩虛氣滯心胸心腎陰虛心腎陽虛寒凝心脈;2)不穩(wěn)定型心絞痛中醫(yī)常見證型為心血瘀阻、痰濁閉阻、氣陰兩虛,并且三者在所有證型中所占比例為82%;3)分析心血瘀阻、痰濁閉阻、氣陰兩虛與性別之間的關(guān)系,結(jié)果表明此三型與性別之間無關(guān)(P0.05),但此三型中男性占69例,女性占54例,男性發(fā)病人數(shù)較女性人數(shù)多,原因可能與男性過度飲酒、吸煙等不良習(xí)慣有關(guān);4)分析心血瘀阻、痰濁閉阻、氣陰兩虛與年齡的關(guān)系,結(jié)果表明此三型與年齡之間具有明顯差異性(P0.01),此三型中41-50歲占18例,51-60歲占32例,61-70歲占34例,71-80歲占39例,可以認為隨著年齡的增加,不穩(wěn)定型心絞痛的發(fā)病率逐漸上升;5)分析心血瘀阻、痰濁閉阻、氣陰兩虛與誘發(fā)因素之間的關(guān)系,得出此三型與誘發(fā)因素之間具有差異性(P0.05),心血瘀阻證型中勞累和情緒激動共占63.8%,認為心血瘀阻多因勞累及情緒激動所誘發(fā),痰濁閉阻中飽食占41.5%,認為痰濁閉阻證型多因飽食所誘發(fā);6)分析心血瘀阻、痰濁閉阻、氣陰兩虛與發(fā)病季節(jié)的關(guān)系,得出此三型與發(fā)病季節(jié)無關(guān)(P0.05);7)分析心血瘀阻、痰濁閉阻、氣陰兩虛與高脂血癥的關(guān)系,得出此三型與高脂血癥之間具有差異性(P0.05);8)分析心血瘀阻、痰濁閉阻、氣陰兩虛與高血壓、糖尿病、吸煙之間的關(guān)系,得出此三型與高血壓、糖尿病、吸煙無關(guān)(P0.05)。結(jié)論:1)不穩(wěn)定型心絞痛中醫(yī)常見證型為心血瘀阻、痰濁閉阻、氣陰兩虛;2)不穩(wěn)定型心絞痛中醫(yī)常見證型與年齡、高脂血癥、誘發(fā)因素具有差異性;3)不穩(wěn)定型心絞痛中醫(yī)常見證型與性別、發(fā)病季節(jié)、高血壓、糖尿病、吸煙無關(guān)。
[Abstract]:Objective: to obtain the distribution rule of TCM syndrome type and common syndrome type of unstable angina pectoris, analyze the common syndromes and sex of TCM, age, inducing factors, onset season, hypertension, diabetes mellitus, and analyze the distribution of TCM syndromes, common syndromes and gender, age, inducing factors, onset season, hypertension, diabetes mellitus. The relationship between hyperlipidemia and hyperlipidemia. Objective to make Chinese medicine more comprehensive understanding of unstable angina pectoris, more scientific, objective guidance in clinical application. Methods: 150 patients with unstable angina pectoris were collected from September 2015 to December 2015 in our hospital. Western medicine diagnostic standard adopted the eighth edition of western medicine diagnostic criteria. Gender is not limited, their names, sex, age, onset season, inducing factors and their clinical symptoms, according to clinical symptoms, tongue, pulse and other syndrome differentiation, fasting examination of blood lipid, blood sugar and other biochemical examination. Statistical software SPSS17.0 is used for statistical analysis, chi-square test or Fisher test is used for counting data, and variance analysis is used for measurement data. The results are obtained and analyzed. Results: 1) according to the classification of 150 patients with unstable angina pectoris, there were 47 cases of heart blood stasis, 41 cases of phlegm turbid obstruction, 35 cases of deficiency of qi and yin, 12 cases of qi stagnation, 9 cases of heart and kidney yin deficiency, 4 cases of heart and kidney yang deficiency, 2 cases of cold coagulation heart vein. It is concluded that the distribution of TCM syndromes of unstable angina pectoris from big to small is as follows: heart blood stasis, phlegm stagnation, stagnation of qi and yin, stagnation of heart, kidney, yang deficiency, and cold clotting the heart pulse; 2) the common TCM syndromes of unstable angina pectoris are heart blood stasis, phlegm turbid blocking, The relationship between blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and sex was analyzed. The results showed that there was no correlation between the three types (P0.05), but 69 cases of these three types were male. 54 cases were female, the number of male patients was more than that of female, the reason may be related to male excessive drinking, smoking and other bad habits; 4) analysis of the relationship between heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and age. The results showed that there was a significant difference between the three types and age (P0.01). Among the three types, 18 cases were 41-50 years old, 32 cases were 51-60 years old, 34 cases were 61-70 years old, and 39 cases were 71-80 years old. The incidence of unstable angina pectoris increased gradually. 5) the relationship between heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and inducing factors were analyzed. The results showed that there was a difference between these three types and induced factors (P0.05). In the type of heart blood stasis syndrome, fatigue and emotional agitation accounted for 63.8%. It was considered that heart blood stasis was induced by overwork and emotional agitation. Satiety accounts for 41.5% of the total phlegm turbid obstruction. It is believed that the syndrome type of phlegm turbid blocking obstruction is mostly induced by satiety. 6) the relationship between heart blood stasis, phlegm and turbid obstruction, qi and yin deficiency and the onset season is analyzed. The results show that these three types are not related to the onset season (P0.05); 7) the analysis of heart blood stasis, phlegm turbid blocking obstruction, The relationship between the deficiency of qi and yin and hyperlipidemia, the difference between these three types and hyperlipidemia (P0.05); (8) the analysis of the relationship between blood stasis, phlegm stagnation, deficiency of qi and yin and hypertension, diabetes mellitus, smoking, and the relationship between these three types and hypertension, There was no correlation between smoking and diabetes (P0.05). Conclusion: 1) the common TCM syndromes of unstable angina pectoris are heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin, 2) common syndrome type and age of unstable angina pectoris, hyperlipidemia, hyperlipidemia. The common syndrome types of unstable angina pectoris were not related to sex, onset season, hypertension, diabetes, smoking.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
本文編號：2285256
[Abstract]:Objective: to obtain the distribution rule of TCM syndrome type and common syndrome type of unstable angina pectoris, analyze the common syndromes and sex of TCM, age, inducing factors, onset season, hypertension, diabetes mellitus, and analyze the distribution of TCM syndromes, common syndromes and gender, age, inducing factors, onset season, hypertension, diabetes mellitus. The relationship between hyperlipidemia and hyperlipidemia. Objective to make Chinese medicine more comprehensive understanding of unstable angina pectoris, more scientific, objective guidance in clinical application. Methods: 150 patients with unstable angina pectoris were collected from September 2015 to December 2015 in our hospital. Western medicine diagnostic standard adopted the eighth edition of western medicine diagnostic criteria. Gender is not limited, their names, sex, age, onset season, inducing factors and their clinical symptoms, according to clinical symptoms, tongue, pulse and other syndrome differentiation, fasting examination of blood lipid, blood sugar and other biochemical examination. Statistical software SPSS17.0 is used for statistical analysis, chi-square test or Fisher test is used for counting data, and variance analysis is used for measurement data. The results are obtained and analyzed. Results: 1) according to the classification of 150 patients with unstable angina pectoris, there were 47 cases of heart blood stasis, 41 cases of phlegm turbid obstruction, 35 cases of deficiency of qi and yin, 12 cases of qi stagnation, 9 cases of heart and kidney yin deficiency, 4 cases of heart and kidney yang deficiency, 2 cases of cold coagulation heart vein. It is concluded that the distribution of TCM syndromes of unstable angina pectoris from big to small is as follows: heart blood stasis, phlegm stagnation, stagnation of qi and yin, stagnation of heart, kidney, yang deficiency, and cold clotting the heart pulse; 2) the common TCM syndromes of unstable angina pectoris are heart blood stasis, phlegm turbid blocking, The relationship between blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and sex was analyzed. The results showed that there was no correlation between the three types (P0.05), but 69 cases of these three types were male. 54 cases were female, the number of male patients was more than that of female, the reason may be related to male excessive drinking, smoking and other bad habits; 4) analysis of the relationship between heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and age. The results showed that there was a significant difference between the three types and age (P0.01). Among the three types, 18 cases were 41-50 years old, 32 cases were 51-60 years old, 34 cases were 61-70 years old, and 39 cases were 71-80 years old. The incidence of unstable angina pectoris increased gradually. 5) the relationship between heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin and inducing factors were analyzed. The results showed that there was a difference between these three types and induced factors (P0.05). In the type of heart blood stasis syndrome, fatigue and emotional agitation accounted for 63.8%. It was considered that heart blood stasis was induced by overwork and emotional agitation. Satiety accounts for 41.5% of the total phlegm turbid obstruction. It is believed that the syndrome type of phlegm turbid blocking obstruction is mostly induced by satiety. 6) the relationship between heart blood stasis, phlegm and turbid obstruction, qi and yin deficiency and the onset season is analyzed. The results show that these three types are not related to the onset season (P0.05); 7) the analysis of heart blood stasis, phlegm turbid blocking obstruction, The relationship between the deficiency of qi and yin and hyperlipidemia, the difference between these three types and hyperlipidemia (P0.05); (8) the analysis of the relationship between blood stasis, phlegm stagnation, deficiency of qi and yin and hypertension, diabetes mellitus, smoking, and the relationship between these three types and hypertension, There was no correlation between smoking and diabetes (P0.05). Conclusion: 1) the common TCM syndromes of unstable angina pectoris are heart blood stasis, phlegm and turbid obstruction, deficiency of qi and yin, 2) common syndrome type and age of unstable angina pectoris, hyperlipidemia, hyperlipidemia. The common syndrome types of unstable angina pectoris were not related to sex, onset season, hypertension, diabetes, smoking.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
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