【作者】 陈小英； 郑关毅； 谢碧香； 李楠； 詹传银； 夏委伟； 李金国； 孙旭东；

【Author】 CHEN Xiao-ying;ZHENG Guan-yi;XIE Bi-xiang;LI Nan;LI Jin-guo;SUN Xu-dong;Department of Traditional Chinese Medicine,Fujian Medical University Union Hospital;Department of Cardiovascular Disease,Fujian Medical University Union Hospital;Fujian Medical University Union Hospital;

【机构】 福建医科大学附属协和医院中医科； 福建医科大学协和医院； 福建医科大学附属协和医院心内科；

【摘要】 目的探讨颈动脉粥样硬化(Carotid Atherosclems,CAS)患者中医证型与冠状动脉病变的关系。方法 2009—2013我科住院的经颈动脉彩色多普勒超声证实为颈动脉粥样硬化者268例,对其进行中医辨证,分别为精髓亏虚证、痰瘀互结证及肝阳上亢证。观察各中医证型与冠状动脉病变(狭窄程度、累及支数)、病变支与中医证型间的关系。结果冠脉病变轻度狭窄以痰瘀互结为主(19/268),其次为精髓亏虚证(11/268);中度狭窄以痰瘀互结证为主(64/268),与肝阳上亢证、精髓亏虚证有统计学意义。(P(0.05))。重度狭窄以痰瘀血互结证为主(24/268),与其他两个证型比较有统计学意义。(P<0.05)。冠脉单支病变者以肝阳上亢证为主(27.27%),多支病变以以痰瘀互结证为主(32.33%),痰瘀互结证明显多于肝阳上亢证及精髓亏虚证(P<0.05)。三个证型均以狭窄"26%-50%"例数及狭窄支数为多。各中医证型与冠脉病变中左前降支(LAD)病变密切相关,单支病变中LAD最多(32.19%),并且冠脉病变中存在LAD病变最多(67.80%);单纯左主干(LAM)病变1例,但LM病变未见,多有合并其他支病变;左回旋支(LCX)与右冠(RC)病变在中医各证型分布中无统计学意义(P>0.05).随着病变加重,痰瘀互结证逐渐增加,而肝阳上亢证与精髓亏虚证有所减少(P<0.051.左冠病变主要证型是痰瘀互结证。与右冠相比有统计学意义(P<0.05)。结论颈动脉粥样硬化患者中医证型与冠脉病变有一定的相关性。更多还原

【Abstract】 Objective Study of carotid atherosclerosis(Carotid Atheroscleros,CAS) method of relationship between TCM syndrome type and coronary lesions in patients with 2009—2013 hospitalized in our department in the carotid color Doppler ultrasound confirmed 268 cases of carotid atherosclerosis,syndrome differentiation of traditional Chinese medicine on,respectively,the essence deficiency,phlegm and hyperactivity of liver yang.Observation of the TCM syndrome and coronary artery disease(the degree of stenosis was measured,the result relation,) lesions with TCM syndrome types of coronary artery lesions in mild stenosis with phlegm and blood stasis based(19/268),followed by the essence of deficiency syndrome(11/268);moderate stenosis with turbid phlegm and blood stasis is the main(64/268),and hyperactivity of liver Yang,deficiency of essence of statistical significance.(P <0.05).Severe stenosis with Phlegm Blood Stasis Syndrome(24/268),there is statistical significance compared with the other two syndromes.(P ’0.05).Single vessel coronary artery disease with hyperactivity of liver Yang Syndrome(27.27%),multivessel disease with phlegm and blood stasis syndrome mainly(32.33%),phlegm and blood stasis were significantly more than the hyperactivity of liver Yang and essence deficiency syndrome(P<0.05).Three syndromes are narrow "26%-50%" number and narrow count for.Left the TCM syndrome type of coronary artery lesion and anterior descending(LAD)lesions are closely related,single branch lesion in LAD(32.19%),and there are at most LAD lesions in coronary artery disease(67.80%);only the left main(LAM) 1 cases,but no LM lesions,with many other branches of left circumflex lesions;branch(LCX) and right coronary artery(RC) lesion had no statistical significance in different TCM syndrome type distribution(P>0.05).With the exacerbation of the lesion,phlegm and blood stasis syndrome increases gradually,while the hyperactivity of liver Yang and essence deficiency decreased(P<0.05).The left coronary artery main card type is phlegm and blood stasis.There was statistical significance compared with the right coronary artery(P<0.05) conclusion there is certain correlation between syndrome type of TCM in patients with carotid atherosclerosis and coronary artery disease.更多还原