【摘要】：研究目的:研究非瓣膜性房顫患者的中醫(yī)證型分布特點與同型半胱氨酸(Hcy)的相關(guān)性。研究方法:本次研究根據(jù)制定的"非瓣膜病性房顫患者中醫(yī)證型量表"收集北京中醫(yī)藥大學(xué)東方醫(yī)院心內(nèi)科2016年3月1日至2017年3月31日的住院非瓣膜性房顫病人,收集信息包括患者的基本信息、中醫(yī)四診資料以及輔助檢查,按照納入以及排除標準,共入選了118例非瓣膜性房顫患者。對照組遵循年齡分層原則,按照入院先后順序連續(xù)選取2016年8月1日～2016年9月30日北京中醫(yī)藥大學(xué)東方醫(yī)院心內(nèi)科病房70例非房顫患者作為對照組研究對象。應(yīng)用SPSS21.0統(tǒng)計學(xué)軟件對數(shù)據(jù)進行分析,計數(shù)資料以例數(shù)(n)、百分數(shù)(%)表示,采用X2檢驗,計量資料以"X±S"表示,采用t檢驗或Z檢驗,以P0.05為差異有統(tǒng)計學(xué)意義。研究結(jié)果:1.非瓣膜性房顫危險因素:高血壓、腦血管病在房顫組與對照組間比較具有統(tǒng)計學(xué)意義(P0.05),未發(fā)現(xiàn)糖尿病、冠心病與房顫的相關(guān)性;2.非瓣膜性房顫患者中醫(yī)證型分布特點:對118例非瓣膜性房顫患者中醫(yī)證型分布特點研究發(fā)現(xiàn),中醫(yī)證型以氣虛血瘀證最多(59例,50%)氣陰兩虛證(24例,20.3%)痰瘀互阻證(14例,11.9%)陰虛火旺證(7例,5.9%)心血不足證(5例,4.2%)水飲凌心證(4例,3.4%)痰火擾心證(3例,2.5%)心陽不振證(2例,1.7%)。其中氣虛血瘀證與臨床研究認為是房顫患者常見中醫(yī)證型相符合。3.非瓣膜性房顫患者與左心房內(nèi)徑(LAD)的關(guān)系:房顫組和對照組患者間的LAD比較具有統(tǒng)計學(xué)意義(P0.05),說明在房顫患者中LAD普遍增大。4.非瓣膜性房顫患者與同型半胱氨酸(Hcy)的關(guān)系:118例非瓣膜性房顫患者血漿Hcy水平普遍升高,房顫組和對照組患者間的血漿Hcy水平比較具有統(tǒng)計學(xué)意義(P0.05),提示Hcy與非瓣膜性房顫的發(fā)病有一定的相關(guān)性。5.對85例Hcy升高(15 μmol/L)的房顫患者和與之相對應(yīng)的LAD進行相關(guān)性檢驗,提示Hcy增高與LAD之間沒有呈明顯的正相關(guān)性(P0.05)。對41例病程超過一年的房顫患者Hcy升高與LAD再次進行相關(guān)性檢驗,提示二者之間也沒有呈明顯的正相關(guān)性(P0.05)。研究結(jié)論:1.氣虛血瘀證型是非瓣膜性房顫患者的最常見中醫(yī)證型。2.非瓣膜性房顫患者中LAD普遍增大。3.非瓣膜性房顫患者血漿Hcy水平普遍升高,提示Hcy與非瓣膜性房顫發(fā)病有一定的相關(guān)性。
[Abstract]:Objective: to study the relationship between the distribution of TCM syndromes and homocysteine (Hcy) in patients with non-valvular atrial fibrillation. Methods: in this study, patients with non-valvular atrial fibrillation were collected from the Department of Cardiology of Oriental Hospital of Beijing University of traditional Chinese Medicine from March 1, 2016 to March 31, 2017, according to the scale of TCM Syndrome Type of non-valvular Atrial Fibrillation patients. According to the inclusion and exclusion criteria, 118 patients with non-valvular atrial fibrillation were enrolled in the data collection, including the basic information of the patients, the data of the four diagnostic methods of TCM and the auxiliary examination. 70 patients with non-atrial fibrillation were selected from August 1, 2016 to September 30, 2016 in Department of Cardiology, Oriental Hospital, Beijing University of traditional Chinese Medicine, in accordance with the principle of age stratification in the control group. SPSS21.0 statistical software was used to analyze the data. The counting data was expressed as (n), percentage (%), X2 test was used, the measurement data was expressed as "X + S", t-test or Z-test was used, and the data were measured by X-test and Z-test. The difference was statistically significant (P0.05). Research findings: 1. Non-valvular atrial fibrillation risk factors: hypertension, cerebral vascular disease in AF group and control group were statistically significant (P0.05), no diabetes mellitus, coronary heart disease and atrial fibrillation; 2. Distribution characteristics of TCM syndrome types in patients with non-valvular atrial fibrillation: according to 118 cases of non-valvular atrial fibrillation, it was found that the most of them were qi deficiency and blood stasis syndrome (59 cases, 50%), Qi-yin deficiency syndrome (24 cases), qi deficiency and blood stasis syndrome (50%) and Qi-yin deficiency syndrome (24 cases, P < 0.01). 20.3%) phlegm-stasis syndrome (14 cases, 11.9%) Yin deficiency and fire exuberance syndrome (7 cases, 5.9%) deficiency of heart and blood (5 cases, 4.2%) water drink Lingxin syndrome (4 cases, 3.4%) phlegm-fire disturbing heart syndrome (3 cases), 2. 5% (2 / 2, 1.7%) were diagnosed as heart-yang failure (2 cases, 1.7%). Among them, Qi deficiency and blood stasis syndrome is considered to be the common TCM syndrome type in patients with atrial fibrillation by clinical study. 3. The relationship between left atrial diameter (LAD) and non-valvular atrial fibrillation: there was significant difference in LAD between AF group and control group (P0.05), indicating that LAD generally increased in AF patients. 4. The relationship between homocysteine (Hcy) and non-valvular atrial fibrillation: the plasma Hcy level in patients with non-valvular atrial fibrillation was significantly higher than that in control group (P0.05), and the plasma Hcy level was significantly higher in patients with non-valvular atrial fibrillation than that in control group (P0.05). It is suggested that there is a certain correlation between Hcy and non-valvular atrial fibrillation. 5. 85 patients with atrial fibrillation with elevated Hcy (15 渭 mol/L) and the corresponding LAD were tested. The results showed that there was no significant positive correlation between the increase of Hcy and LAD (P0.05). There was no significant positive correlation between the increase of Hcy and LAD in 41 patients with AF more than one year old (P0.05). Research conclusions: 1. The most common TCM syndrome type in patients with non-valvular atrial fibrillation due to qi deficiency and blood stasis syndrome. 2. General increase of LAD in patients with non-valvular atrial fibrillation. 3. The level of plasma Hcy in patients with non-valvular atrial fibrillation was generally elevated, suggesting that Hcy was related to the pathogenesis of non-valvular atrial fibrillation.
【學(xué)位授予單位】：北京中醫(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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