發(fā)布時(shí)間：2018-05-30 16:49

  本文選題：中醫(yī)證候 + 脈象�。� 參考：《長(zhǎng)春中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:通過冠狀動(dòng)脈造影下血管病變程度與證候及脈象的關(guān)系研究,提高脈診對(duì)冠心病的確診率,藉此豐富并指導(dǎo)冠心病中醫(yī)診療學(xué)。方法:選取100例因胸悶或胸悶痛為主癥于我院做冠狀動(dòng)脈造影檢查的住院患者為研究對(duì)象。于冠狀動(dòng)脈造影檢查前完成病史、中醫(yī)癥狀、脈象等要素的采集,進(jìn)行記錄,并做出中醫(yī)辨證分型。脈象及中醫(yī)證型的確立在行醫(yī)至少5年、副主任及以上醫(yī)師指導(dǎo)下完成。采用標(biāo)準(zhǔn)技術(shù)進(jìn)行冠狀動(dòng)脈造影檢查,記錄冠脈病變結(jié)果。使用SPSS 13.0統(tǒng)計(jì)學(xué)軟件進(jìn)行數(shù)據(jù)分析,統(tǒng)計(jì)中醫(yī)證候及脈象與冠脈造影下血管病變程度的關(guān)系。結(jié)果:各證候組間不同病變支數(shù)存在顯著差異(P0.05),氣陰兩虛挾痰瘀證病變血管支數(shù)多,多為多支血管病變;氣滯挾痰濕證組冠脈病變累及血管支數(shù)少,多為正常或單支病變。各證候組間冠脈血管不同狹窄程度存在統(tǒng)計(jì)學(xué)差異(P0.05),氣陰兩虛挾痰瘀證組冠脈狹窄程度重,多為重度狹窄,氣滯挾痰濕證組冠脈狹窄程度輕,多見于輕中度病變。各證候組間冠脈血管病變積分不同分段存在顯著差異(P0.05),氣陰兩虛挾痰瘀證組病變積分高,氣滯血瘀證組冠脈病變積分較低。各脈象組間不同血管病變支數(shù)存在統(tǒng)計(jì)學(xué)差異(P0.05),診脈屬弦細(xì)滑組病變累及血管支數(shù)多,多為多支血管病變。各脈象組間冠脈不同狹窄程度存在統(tǒng)計(jì)學(xué)差異(P0.05),弦細(xì)滑脈組冠脈狹窄程度重,澀脈組多為輕度狹窄。各脈象組間冠脈血管變病積分不同分段存在顯著差異(P0.05),弦細(xì)滑脈組病變積分高。結(jié)論:冠脈病變程度與中醫(yī)證候及脈象具有相關(guān)性,氣陰兩虛挾痰瘀證組及切脈屬弦細(xì)滑者提示冠脈病變程度較重,氣滯挾痰濕證組提示冠脈病變程度較輕,多見于早期病變,可以對(duì)冠心病的診斷及預(yù)后提供一定參考價(jià)值。
[Abstract]:Objective: to improve the diagnostic rate of coronary artery disease (CHD) through the study of the relationship between the degree of coronary artery disease and syndromes and pulse patterns under coronary angiography, so as to enrich and guide the diagnosis and treatment of coronary artery disease (CHD). Methods: 100 inpatients with chest tightness or chest tightness were selected for coronary angiography. The history, symptoms and pulse of coronary artery were collected and recorded before coronary angiography. Pulse and TCM syndromes are established for at least 5 years under the guidance of Deputy Director and above. Coronary angiography was performed with standard technique to record the results of coronary artery disease. SPSS 13.0 statistical software was used to analyze the relationship between TCM syndromes and pulse patterns and the degree of coronary artery lesion. Results: there were significant differences in the number of different pathological branches among different syndrome groups (P0.05A). The number of vessel branches in the syndrome of Qi and Yin deficiency with phlegm and stasis was more than that in the group of qi stagnation with phlegm dampness, and the number of coronary artery lesions with phlegm dampness was less in the group of qi stagnation with phlegm dampness, which was normal or single vessel disease. There were significant differences in different degree of coronary artery stenosis among different syndrome groups (P 0.05). The degree of coronary artery stenosis was severe in the group of Qi and Yin deficiency with phlegm and blood stasis, and the degree of coronary artery stenosis was mild in the group of Qi stagnation with dampness of phlegm, which was often seen in mild and moderate pathological changes. There were significant differences in the scores of coronary artery lesion between different syndromes groups (P 0.05). The pathological score of Qi and Yin deficiency combined with phlegm and stasis syndrome group was higher than that of Qi stagnation and Blood stasis syndrome group. The coronary artery lesion score of Qi stagnation and Blood stasis Syndrome group was lower than that of Qi stagnation and Blood stasis group. There were significant differences in the number of branches of different vascular lesions among different pulse groups (P0.05A). The number of branches involved in the diagnosis of vascular diseases was more than that of the control group, and most of them were multi-vessel diseases. There were significant differences in different degree of coronary stenosis among different pulse groups (P 0.05). The degree of coronary artery stenosis was severe in the chord fine smooth vein group and mild stenosis in the astringent vein group. There were significant differences among different segments of coronary artery angiopathy score among different pulse groups (P 0.05), and the lesion score of chord fine smooth vein group was higher. Conclusion: the degree of coronary artery lesion is correlated with syndrome and pulse of TCM. The patients with Qi and Yin deficiency combined with phlegm stasis syndrome and those with fine and slippery veins suggest that the severity of coronary artery lesion is serious, and the degree of coronary artery disease is lighter in Qi stagnation with phlegm dampness syndrome, and it is more common in early stage. It can provide some reference value for the diagnosis and prognosis of coronary heart disease.
【學(xué)位授予單位】：長(zhǎng)春中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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