冠心病所致心力衰竭的中医证型分布及药证对应关系研究

【作者】 王乐；

【导师】 付亚龙；

【作者基本信息】 中国中医科学院 ， 中医内科学， 2008， 硕士

【摘要】 目的:总结临床住院冠心病所致心力衰竭患者中医证型分布,分析常见证型与一般临床指标的关系;总结对于冠心病所致心力衰竭疾病的治疗中的药证对应关系,并研究年龄、心功能、诊治医师等临床相关因素对冠心病心衰证型分布的影响及诊治特点。方法:通过对中国中医科学院广安门医院心内科2006年12月-2008年3月出院冠心病所致心力衰竭患者病例相关信息的采集,整理汇集成大量临床研究数据,然后按照标准进行筛选,使用SPSS13.0对数据进行统计分析,以及进行后期整理归纳,形成对我院冠心病所致心力衰竭患者证型分布、一般影响因素及诊疗规律的认识。结果:1.冠心病所致心力衰竭疾病的各中医证型在年龄、性别、左室舒张末期内径方面比较无显著差异;阳虚水泛证与其余证型相比在心功能、左室收缩功能方面有显著差异。2.临床治疗冠心病所致心力衰竭相同中医证候时的方药组成大致相同,但具体到各医师时又有各自不同的侧重点。结论:1.临床冠心病所致心力衰竭的回顾性研究表明,此类疾病为本虚标实之证,本虚为气虚、阳虚、阴虚,标实为血瘀、水饮、痰饮。病变过程为心气虚→病理产物蓄积(瘀血、痰浊、水饮)→心阴虚→病理产物进一步蓄积→心阳虚(气虚加重)。阳虚证是心力衰竭的终末阶段,与其余证型相比,在心功能、左室收缩功能方面有显著差异。2.通过对冠心病所致心力衰竭的药证对应性研究的结果表明,临床治疗各种证候的方药组成大致相同,但各医师又有各自不同的侧重点。更多还原

【Abstract】 Objective:to discuss the clinical TCM syndrome distribution of CHF,caused by coronary heart disease(CHD),and analyze the relationship between syndrome and general report of clinical examination.To discuss the relationship between drug and syndrome in healing people with CHF.Then we analyze the relative factors such as gender,age,etc.To sum up the regulations of CHF syndrome differentiation and therapeutic determineation.Methods:Collecting the inpatients’s corresponding information in the Guang An Men hospital from Dec,2006 to Mar 2008 then adapt the mass information to research data base.Process the clinical data by SPSS13.0.Through statistics analyzing,grasp the primary station of CHF(which caused by CHD)syndrome distribution,general influences regulations and characteristics of TCM diagnosing and treating.Result:1.When it comes to age,gender,left ventricular internal diameter at end-diastole(LVIDD),there are no deferences between CHF syndrome.But compare with other syndromes,yang-defiency and fluid-retention syndrome has poor heart function and left ventricular’s contractile function.2.The herb used to treat the CHF patients are accord with the TCM syndrome, but different doctor has different emphases.Conclusion:1.The retrospective study tells us that the reason of this disease is asthenia in origin and asthenia in superficiality.Asthenia in origin can be divided into qi-deficiency,yin- deficiency and yang- deficiency.Asthenia in superficiality can also be divided into phlegm block,fluid-retention and blood stasis.The process of the disease is:heart qi deficiency→pathological products block(phlegm block, fluid-retention and blood stasis,etc)→heart yin deficiency→the growing amount of pathological products→heart yang deficiency.Heart yang-defiency which is the last stage of CHF has poor heart function and left ventricle’s contractile function ompare with other syndromes.2.The research of the relationship between herb and syndrome tells us:The herb used to treat the CHF patients are accord with the TCM syndrome,but different doctor has different emphases.更多还原