【作者】 王艳红；

【导师】 陈秋雄；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2009， 硕士

【摘要】 研究目的:探讨本地区不稳定性心绞痛患者在介入治疗前后的中医证候分布规律,着重研究介入治疗对不稳定性心绞痛中医证候的影响,以期对临床诊治工作提供一定的借鉴和参考。研究方法:本研究应用临床流行病学研究方法,在广州地区开展不稳定性心绞痛患者的中医证候介入前后临床流行病学调查。研究对象来源主要为广东省中医院心脏中心的住院和门诊病人,在2007年10月～2008年12月日期范围内,按照诊断标准和纳入标准,筛选出合格的研究对象,观察受调查者介入治疗前及术后一周各自的中医临床证候学特征,根据已制定的“冠心病不稳定性心绞痛介入前后中医证型变化研究信息采集表”,采用临床病例直接观察法,完成资料的采集工作。核查完毕的病例报告表进行计算机数据录入,构建冠心病不稳定性心绞痛中医证候信息数据库,运用数据库统计分析软件SPSS 13.0对数据进行管理、处理和统计分析,提取证候要素相关信息,主要统计分析方法为括描述性统计分析。研究结果:本研究的67例冠心病不稳定性心绞痛病人,根据调查时点的不同,将其划分为介入治疗前和介入治疗后,分别对其进行临床证候信息采集分析,结果发现:1.介入治疗前冠心病不稳定性心绞痛中医证候中以血瘀证32例(47.76%)、气虚证26例(38.81%)、痰浊证22例(32.84%)最为常见。由多到少排列为:血瘀证＞气虚证＞痰浊证＞气滞证＞阴虚证＞寒凝证＞阳虚证＞水湿。2.介入术后一周冠心病不稳定性心绞痛中医证候中以血瘀证28例(41.79%)、气虚证24例(35.82%)、痰浊证19例(28.36%)最为常见。由多到少排列为:血瘀证＞气虚证＞痰浊证＞阴虚证＞阳虚证＞气滞证＞寒凝证=水湿。介入治疗前后比较,纳入研究病例患者心绞痛疼痛程度、发作次数及严重程度明显减轻,气短、神疲、倦怠乏力及眩晕等症状改善。术后一周与术前比较气滞及寒凝证减轻,术后一周与术前比较,阴虚证增加。研究结论:本研究通过对67例行介入治疗的冠心病不稳定性心绞痛患者进行介入术前后中医证型的变化对比,结果显示:介入治疗前后比较,患者心绞痛疼痛程度、发作次数及严重程度明显减轻,气短、神疲、倦怠乏力及眩晕等症状改善。术后一周与术前比较气滞及寒凝证减轻,术后一周与术前比较,阴虚证增加,而介入前后血瘀证无显著差异,表现亦以瘀血阻脉为主。说明冠心病患者介入治疗后可以较快的缓解患者标实的症状,机体各脏腑功能逐渐恢复,邪祛正安,但介入治疗方法未能明显改善冠心病患者血瘀证,术后阴虚证亦有所加重,表明介入治疗后继续治本的重要性和必要性。更多还原

【Abstract】 Objective:To explore the region of unstable angina patients before and after interventional therapy in the syndrome of traditional Chinese medicine distribution,focusing on PCI therapy for unstable angina effects of TCM Syndrome,with a view to provide a clinical diagnosis and treatment of the work of reference.Methods:In this study,clinical epidemiology research methods,in the Guangzhou region of unstable angina patients with coronary heart disease of TCM Syndrome Clinical epidemiological survey before and after PCI.The main source of research for the Guangdong Provincial TCM Hospital Heart Center,inpatient and outpatient,in October 2007～December 2008 date range, in accordance with the diagnostic criteria and inclusion criteria,selected eligible subjects,Observed by the investigators involved in the week before and after treatment of their clinical syndrome characteristics have been developed in accordance with the”PCI in unstable angina pectoris of coronary heart disease before and after changes in TCM research information collection form,“the use of direct observation of clinical cases law,the completion of data collection.Verification of the case report form completed computer data entry, constructing unstable angina pectoris of coronary heart disease syndromes of Chinese medicine information database,the use of database software SPSS 13.0 statistical analysis of the data management,processing and statistical analysis,extracts the relevant information elements syndrome,The main method of statistical analysis including descriptive statistical analysis. The results:In this study,67 cases of unstable angina patients with coronary heart disease,according to survey the different point in time will be divided into percutaneous coronary intervention before and after percutaneous coronary intervention after treatment,respectively,of their clinical syndrome information acquisition analysis,results were as follows:1.Before percutaneous coronary interventionIn coronary disease unstable angina pectoris Chinese medicine card period of five days by blood stasis card 32 example(47.76%),lacking in vital energy card 26 example(38.81%),phlegm muddy card 22 examples(32.84%)most common. From many to the few arrangements is:The blood stasis card > the lacking in vital energy card＞the phlegm muddy card＞the stagnation of flow of vital energy card＞the Yin deficient card＞congeals coldly the card＞the deficiency of yang card＞wet.2.After a week after percutaneous coronary interventionIn coronary disease unstable angina pectoris Chinese medicine card period of five days by blood stasis card 28 example(41.79%),lacking in vital energy card 24 example(35.82%),phlegm muddy card 19 examples(28.36%)most common. From many to the few arrangements is:The blood stasis card＞the lacking in vital energy card＞the phlegm muddy card＞the Yin deficient card＞the deficiency of yang card＞the stagnation of flow of vital energy card＞congeals coldly the card=wet.Percutaneous coronary intervention before and after treatment compared with patients included in the study of patients with angina pain,frequency and severity of the attack significantly reduced,shortness of breath,Mental fatigue,burnout symptoms such as fatigue and dizziness to improve.After one week compared with the preoperative Before the technique latter week and the technique,the comparison stagnation of flow of vital energy and congeals the card to reduce coldly,before the technique latter week and the technique compares,the Yin deficient card increases.Conclusion of the study:This study of 45 routine percutaneous coronary intervention in patients with unstable angina pectoris of coronary heart disease in patients with percutaneous coronary intervention before and after changes in TCM Syndrome contrast,results showed that:Percutaneous coronary intervention before and after treatment compared to patients with angina pain,frequency and severity of the attack significantly reduced,shortness of breath,Mental fatigue, burnout symptoms such as fatigue and dizziness to improve.After one week compared with the preoperative Before the technique latter week and the technique,the comparison stagnation of flow of vital energy and congeals the card to reduce coldly,before the technique latter week and the technique compares,the Yin deficient card increases,blood stasis before and after the intervention no significant differences in blood also impacted the performance of the main pulse.This shows that patients with coronary artery disease after percutaneous coronary intervention after treatment in patients with rapid relief of symptoms is marked,the body functions of the organs recovered Zhengan drive away evil,but percutaneous coronary intervention significantly improved treatment failure in patients with coronary heart disease Blood card, after card also increase the deficiency,indicating that percutaneous coronary intervention after the importance and necessity of a permanent cure.更多还原