【作者】 张玉辉；

【导师】 毛静远； 王强； 虞东玲；

【作者基本信息】 天津中医学院 ， 中医内科学， 2004， 硕士

【摘要】 目的：探索冠心病心绞痛气阴两虚及其兼痰瘀证型平板运动试验各指标的客观特征表现及其规律。方法：选择符合冠心病心绞痛诊断标准，中医辨证为气阴两虚(49例)及气阴两虚兼痰瘀(52例)证的患者共101例，所有入选病例均接受平板运动试验。记录①试验阴性或阳性结论；②总运动时间(Min)；③最大代谢当量(MaxMET)；④峰运动ST段平均下移(mv)；；⑤ST段下移0.1mv所需时间(Min)；⑥ST段下移0.1mv时代谢当量；⑦测量并计算运动前与运动后即刻QRS波时限变化(ms)。结果：与单纯气阴两虚组比较，兼痰瘀组平板运动试验阳性率较高(P＜0.05)，峰运动ST段平均下移幅度(P＜0.01)、运动后即刻与运动前QRS波时限差(P＜0.01)较大，总运动时间(P＜0.01)、最大代谢当量(P＜0.01)、ST段下移0.1mv所需时间(P＜0.01)、ST段下移0.1mv时代谢当量(P＜0.05)值均较低；运动诱发心绞痛的比率较大(P＜0.05)，能达到目标心率的患者所占比率较小(P＜0.05)。结论：冠心病心绞痛气阴两虚兼痰瘀证组较气阴两虚证组患者的运动耐量差，冠脉病变重，是较严重的中医证型阶段。更多还原

【Abstract】 Objective: to investigate the characters and laws of treadmill test (TET) indexes in patients with coronary heart disease (CHD) with angina pectoris (AP) and the syndrome differentiation of qi-yin deficiency or qi-yin deficiency plus phlegm and blood stasis in TCM simultaneously. Methods: 101 patients were divided into two groups: the qi- yin deficiency (QY group, 49 cases) and the qi-yin deficiency plus phlegm and blood stasis (QY plus group, 52 cases). All of patients accepted treadmill test and their results of treadmill test indexes were recorded and contrasted between two groups. The recorded contents included: ﹏egative or positive of TET; ﹖otal time of exercise; (3)max metabolic equivalent (Max MET); (4)the average of ST-segment depression at the exercise endpoint of test; ﹖he time of ST-segment depression 0.1 mv; ﹎etabolic equivalent at ST segment depression 0.1 mv; (7)QRS wave width before and after TET. Results: in QY plus group, the positive rates of TET were higher than those in QY group (PO.05); the average of ST-segment depressions at exercise endpoint of test (PO.01) and the differences of QRS waves width before and after TET (P<0.01) larger; the total time of exercise (PO.01), the max metabolic equivalent (P<0.01) and the metabolic equivalent at ST segment depression 0.1 mv (PO.05) lower; the required time of ST-segment depression 0.1 mv longer (PO.01); more patients were induced AP (PO.05) and less got to their target heart rate in the test. Conclusion: the exercise tolerances of patients in QY plus group were lower than those in QY group. It suggests that the syndrome differentiation of qi-yin deficiency plus phlegm and blood stasis were more severe period in TCM.更多还原