摘要
目的研究冠心病冠状动脉支架术后早期证候表现及虚实演变。方法采用横断面调查方法对符合冠心病并成功进行冠状动脉支架术治疗的患者在术前,术后8 h,术后24 h以及48 h 4个时间点进行临床调查,并用冠心病心绞痛证候诊断量表进行证候及证候要素诊断,采用频数统计等方法对证候及其变化进行分析。结果(1)547例患者证候要素检出为:术前气虚474例、热蕴292例、血瘀264例、阴虚263例、阳虚251例、气滞186例、寒凝164例及痰浊157例;术后8 h气虚450例、阴虚291例、热蕴241例、血瘀194例、痰浊138例、阳虚112例、寒凝79例、气滞65例;术后24 h气虚434例、热蕴284例、阴虚258例、血瘀128例、痰浊113例、阳虚97例、气滞75例、寒凝70例;术后48 h气虚394例、热蕴294例、阴虚251例、血瘀115例、痰浊93例、阳虚93例、气滞75例、寒凝65例。(2)各证候要素术后变化为:术后8 h较术前气滞下降65%、阳虚下降55%、寒凝下降52%、血瘀下降27%、热蕴下降17%、痰浊下降12%、气虚下降5%,而阴虚上升11%;术后24小时较8小时血瘀下降34%、痰浊下降18%、气滞上升15%、阳虚下降13%、寒凝下降11%、气虚下降4%,热蕴上升18%、阴虚下降11%;术后48 h较24 h痰浊下降18%、血瘀下降10%、气虚下降9%、寒凝下降7%、阳虚下降4%、热蕴上升4%,阴虚下降3%,气滞未改变。(3)2013年与2017年两次调查的证候要素检出率不同,2017年组术前、术后8 h和术后24 h痰浊和热蕴,术前寒凝、气滞和阳虚均高于2013年组(P<0.05);术后3个时点血瘀和气滞,术后48 h寒凝和阳虚,术前、术后24 h和术后48 h阴虚以及4个时点气虚均低于2013年组(P<0.05)。结论冠状动脉支架植入术可以改变冠心病患者的证候表现,呈一定的规律性,实性证候要素检出减少,对虚性证候要素的改变呈多样性,为冠状动脉支架术后的中医辨证治疗提供了一定的临床证据。
Objective To study the early syndrome manifestations and the evolution of deficiency and excess after coronary stenting in coronary heart disease.Methods Cross-sectional survey method was used to conform to the coronary heart disease and patients with successful coronary stent therapy in the preoperative and postoperative 8 hours,48 hours after 24 hours,and four time points of clinical investigation,and coronary heart disease angina scale was used to diagnose syndromes,and syndrome elements.The method of frequency statistics was used to justify syndrome and analyze its changes.Results(1)The syndrome elements of 547 patients were detected as follows:before operation,there were 474 cases of qi deficiency,292 cases of heat accumulation,264 cases of blood stasis,263 cases of yin deficiency,251 cases of yang deficiency,186 cases of qi stagnation,164 cases of cold coagulation,and 157 cases of phlegm turbidity.At 8 hours after operation,there were 450 cases of qi deficiency,291 cases of yin deficiency,241 cases of heat accumulation,194 cases of blood stasis,138 cases of phlegm turbidity,112 cases of yang deficiency,79 cases of cold coagulation,and 65 cases of qi stagnation.24 hours after operation,there were 434 cases of qi deficiency,284 cases of heat accumulation,258 cases of yin deficiency,128 cases of blood stasis,113 cases of phlegm turbidity,97 cases of yang deficiency,75 cases of qi stagnation,and 70 cases of cold coagulation.48 hours after operation,there were 394 cases of qi deficiency,294 cases of heat accumulation,251 cases of yin deficiency,115 cases of blood stasis,93 cases of phlegm turbidity,93 cases of yang deficiency,75 cases of qi stagnation,and 65 cases of cold coagulation.(2)The postoperative changes of each syndrome element were as follows:8 hours after surgery compared with before surgery,qi stagnation decreased by 65%,yang deficiency decreased by 55%,cold coagulation decreased by 52%,blood stasis decreased by27%,heat accumulation decreased by 17%,phlegm turbidity decreased by 12%,qi deficiency dec
作者
张敏
宋烨闻
黄真奥
聂绍平
李军
芦瑞霞
衷敬柏
Zhang Min;Song Yewen;Huang Zhenao;Nie Shaoping;Li Jun;Lu Ruixia;Zhong Jingbai(L Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Beijing Dongcheng District Jianguomen Community Health Service Center,Beijing 100005,China;Emergency Critical Care Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Cardiology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2021年第12期4783-4790,共8页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家中医药管理局国家中医临床研究基地业务建设第二批科研专项(JDZX2015250):冠心病支架植入术后围手术期虚实演变与证治研究,负责人:衷敬柏。
关键词
冠状动脉支架术
演变规律
现况调查
证候要素
Coronary stenting
Evolvement rule
Inventory survey
Syndrome elements
