冠状动脉粥样硬化性心脏病中医证候特征的文献回顾分析

目的对冠状动脉粥样硬化性心脏病(冠心病)辨证分型的相关文献进行研究,以分析冠心病中医证候特征的变化规律。方法对1970～2009年中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、及万方医学数据库发表的冠心病中医证候相关文献进行全面检索,对其中冠心病心绞痛、无症状心肌缺血、心肌梗塞的中医证型、证候要素分布进行统计分析。结果冠心病临床上常见的证候类型为气虚血瘀、痰浊内阻、心血瘀阻、气滞血瘀、气阴两虚、痰瘀互结等证型。上述证型在冠心病心绞痛、无症状心肌缺血、心肌梗死及心力衰竭中的分布比例各有侧重,心绞痛、无症状心肌缺血以气虚血瘀、痰浊壅盛最为常见,心肌梗死以气阴两虚最为多见,而心力衰竭以阳气亏虚最为多见。在相关证候要素的分布中,心绞痛、无症状心肌缺血和心肌梗死排名前三位的证素为血瘀、气虚、痰浊。心力衰竭的证素排位为阳虚、气虚、血瘀、痰浊。结论发现"本虚标实"仍是心血管疾病的基本病机。冠心病本虚以气虚、阴虚为主,标实以血瘀、痰浊、气滞多见。

Retrospectively the literatures of coronary heart disease syndrom of traditional Chinese medicine

Objective To investigate the TCM syndrome Differentiation of coronary heart disease and analysis the changing regularity of TCM syndrome characteristics.Methods All the Chinese literature related to TCM syndromes of coronary heart disease were retrieved the distribution state and element of TCM syndrome of coronary heart disease Were analyzed statistically.Results syndrome of CHD such as deficiency of Qi and blood stasis,phlegm stasis,heart blood stagnation,Qi stagnation and blood stasis,deficiency of Qi and yin,Phlegm accumulating with blood stasis,were common,the propotion of which have its own focus,the element which related to CHD such as blood stasis,deficiency of Qi,phlegm stasis,deficiency of yin,Qi stagnation,deficiency of Qi.were more.In the Distribution of Related Syndrome elements of angina pectoris,silent myocardial ischemia and myocardial infarction,first three are heart blood stagnation,deficiency of Qi,phlegm stasis.In the Distribution of Related Syndrome elements of heart failure are deficiency of yang,deficiency of Qi,heart blood stagnation,phlegm stasis.Conclusion Root deficiency and branch excess are the basic pathogenesis.deficiency of Qi and yin could be the original cause of CHD,blood stagnancy,phlegm stasis and stagnation of Qi could be the superificial cause.