冠心病慢性心力衰竭证候及证候要素分布特点的多中心横断面研究

目的通过多中心横断面研究,收集和分析14家临床协作单位经验辨证的结果,探索冠心病慢性心力衰竭常见证候和证候要素分布规律,为今后的证候规范研究提供依据.方法选取符合要求的冠心病慢性心力衰竭临床采集的经验辨证结果,对其命名进行规范后,借助EpiData3.1软件,运用SPSS16.0进行频率的统计分析.结果规范经验辨证后证候名称,共有39个证候类型,总频数924次.其中频率大于3%的证候有9个：气虚血瘀证、气阴两虚证、痰瘀互阻证、水饮内停证、痰浊证、心血瘀阻证、血瘀水停证、阳虚水泛证、心阳虚证,合计频率76.84%;其中气虚血瘀证（174例,18.83%）、气阴两虚证（154例,16.67%）远多于其他证候类型.肾精亏虚证、血虚证、脾胃亏虚证、肝郁脾虚证、寒热错杂证、心虚胆怯证、湿毒浸淫证、痰湿阻络证、肾阳虚证出现频次为1,故而为不常见证候.在规范后的证候命名基础上,提取病性类证候要素16个,总频数为1 740次;病位类证候要素9个,出现总频数为1 397次.其中频次排在前6位的病性类证候要素是：气虚、血瘀、阴虚、水停、痰、阳虚,它们的合计频率95.46%;其中证候要素气虚（497例,28.56%）、血瘀（448例,25.75%）远多于其他病性类证候要素类型.频次排在前4位的病位类证候要素是：心、肾、脾、肺,合计频率占89.26%;其中证候要素心（578例,41.37%）远多于其他病位类证候要素类型.结论冠心病慢性心衰的多中心横断面经验辨证结果,初步反映出冠心病慢性心衰最常见的证候及证候要素分布规律,为进一步确定冠心病慢性心衰的中医辨证分型标准了提供参考和依据.

The Analysis of Syndrome and the Elements of Syndrome of Coronary Heart Disease with Chronic Heart Failure in Multi-center Cross-sectional Study

Objective By Multi- center crosssectional study,to fully collect and analy 14 clinical experience in cooperative unit dialectical exploration of coronary heart disease with chronic heart failure Common Syndromes and syndrome elements distribution law for future evidence climate norms and to provide evidence. Methods Collection of coronary heart disease with chronic heart failure clinical experience to meet the requirements dialectical norms,and name through EpiData3.1 software, use SPSS16.0 statistical analy sis of the frequency. Results There were 39 syndromes of normative experience dialectical name,the total frequency of the number is 924. Frequency greater than 3% of them had 9 syndromes： Qi deficiency and blood stagnation syndrome, qi and yin deficiency syndrome, phlegm and blood stagnation syndrome, stop permit water to drink syndrome, phlegm syndrome, blood stagnation syndrome, blood stasis and water stop syndrome, yang deficiency and water stop syndrome, heart yang deficiency syndrome, accounting for 76.84% of their total frequency. Qi defkiency and blood stagnation syndrome （174 case, 18.83~）,qi and yin deficiency syndrome （154 case, 16.67%） far more than the other syndromes. Kidney essence vacuity, blood deficiency, spleen deficiency syndrome, liver stagnation and spleen deficiency syndrome, cold and heat mixed card, timid timid card, poisoning caused by exposure to the religion card,phlegm blocking the network card, deficiency syndrome frequency was 1, therefore designate seldom witness. Syndrome named after the specification based on the extraction of pathogenic class certificate syndrome factor total frequency was 1 740 times. Disease location class syndrome elements 9, the total frequency was 1 397 times. Designate elements of the frequency of the top six of the dis- ease class card were ： Deficiency of qi, blood stasis, deficiency, water retention, sputum, yang, accounted for 95.46 % of their total frequency. Which the syndrome elements qi deficiency （497 case,28.56%） syndrome elements stasis （448 case,25.75%） far more than other disease class syndrome feature type. Frequency of disease location were the top four syndromes elements： Heart, kidney, spleen, lung,aceounting for 89.26% of their total frequency; Syndrome factors of heart （578 case, 41.37%）,far more than other disease locations syndrome factor type. Conclusion Statistical analysis, multi - center cross - section of coroqary heart disease of chronic heart failure experience dialectical results can reflect the initial coronary heart diseave with chronic heart failure is the most common syndrome and syndrome elements distribution law,to further determine the coronary heart disease with chronic heart failure in TCM sub standard provide a reference and basis.