冠心病介入治疗前后中医证型变化的研究

目的 判别冠心病介入治疗前后中医证型变化的规律及探讨介入治疗对中医证型变化的影响.方法 对71例冠心病患者介入术前后进行中医证候分型,常见有气虚、阳虚、阴虚、气滞、血瘀、痰浊、寒凝、热证等证型.结果 冠状动脉介入治疗前以血瘀证53例（74.6%）、气虚证46例（64.8%）、痰浊证28例（39.4%）最为常见,气滞证12例（16.9%）,寒凝证12例（16.9%）;介入后1周亦以血瘀证47例（66.2%）、气虚证39例（54.9%）、痰浊证23例（32.4%）最为常见,气滞证2例（2.8%）,寒凝证1例（1.4%）;介入后1个月则以气虚证47例（85.4%）、血瘀证40例（72.7%）、痰浊证31例（56.4%）最为常见.冠状动脉介入治疗后,介入术后1个月与介入术后1周比较,气虚证及痰浊证加重;介入术后1周与介入术前比较,气滞证及寒凝证减轻.结论 介入治疗尽管在一定程度上改善了冠心病患者的标实症状,但仍不能从根本上改变冠心病的本虚标实的病机特点,提示我们应充分关注介入治疗后继续治本的重要性和必要性.

Study on Changes of TCM Syndrome in Patients with Coronary Heart Disease before and after Intervention Treatment

Objective To observe the changing laws of TCM syndrome type in patients with coronary heart disease (CHD) before and after intervention treatment (IT) and to explore the influence of IT on TCM syndrome type. Methods The TCM syndrome type of 71 patients with "Chest-Bi" was differentiated before and after percutaneous coronary intervention (PCI) treatment, of which the most common syndrome types were qi deficiency,yang deficiency, yin deficiency, qi stagnation, blood stasis, phlegm, cold coagulation, heat-syndrome, etc. Results Before PCI treatment, syndrome types of blood stasis (53 cases, 74.6%), qi deficiency (46 cases, 64.8%), and phlegm (28 cases,39.4%) were the commonest, while there were 12 cases of qi stagnation (16.9%) and 12 cases of cold coagulation (16.9%); One week after PCI treatment, the most commonly seen types were blood stasis (47 cases, 66.2%), qi deficiency (39 cases, 54.9%) and phlegm (23 cases, 32.4%), while qi stagnation (2 cases, 2.8%) and cold coagulation (1 case, 1.4%) were also found; One month after PCI, qi deficiency (47 cases,85.4%), blood stasis (40 cases,72.7%), phlegm (31 cases, 56.4%) were the most commonly seen types. Comparison of the syndrome types between before and after PCI showed that the syndromes of qi deficiency and phlegm were progressively aggravating, while syndromes of qi stagnation and cold coagulation were alleviated after PCI. Conclusion Although PCI treatment could relieve patients' symptoms of excess in superficiality, it can't radically change the pathogenetic nature of CHD, namely, the deficiency in origin and excess in superficiality, which indicates that one should pay full attention to the importance and necessity of CHD after PCI treatment.