40例冠心病合并2型糖尿病患者冠状动脉病变及中医证型分析

目的观察冠心病合并2型糖尿病（diabetes mellitus type 2-coronary heart disease,DM-CHD）患者冠状动脉病变及中医证型的特征。方法经冠状动脉造影诊断的冠心病患者80例，根据有无合并糖尿病分为2组，其中DM—CHD组40例，非合并糖尿病的冠心病（non diabetes mellitus type 2-coronary heart disease，NDM—CHD）组40例，观察两组患者冠状动脉病变情况（累及支数、狭窄程度及形态病变）及中医证型（虚证、实证及虚实夹杂证）的分布特征。结果DM-CHD组冠状动脉病变多见于3支病变或重度弥漫狭窄或严重钙化，与NDM—CHD患者的1支病变、轻重度狭窄和局限性狭窄比较，差异具有显著性（P〈0．01）。两组多见气虚、血瘀、痰浊、阴虚4证，DM—CHD组痰浊、阴虚、阳虚证发生率显著高于NDM—CHD组（P〈0．05），同时DM-CHD组多见复合证及虚实夹杂证，与NDM-CHD比较，差异具有显著性（P〈0．05）。结论DM—CHD患者冠脉病变程度较NDM—CHD患者严重，DM—CHD患者中医证型复杂，在气虚、血瘀基础上，多有阴虚、痰浊。

Analysis on Characteristics of Traditional Chinese Medicine Syndromes and Pathological Changes of Coronary Artery in Patients with Coronary Heart Disease Complicated with Type 2 Diabetes: A Report of 40 Cases

Objective To observe the characteristics of traditional Chinese medicine （TCM） syndromes and pathological changes of coronary artery in patients with diabetes mellitus complicated with coronary heart disease （DM-CHD）. Methods A total of 80 patients with coronary heart disease （CHD） diagnosed by coronary artery angiography, were divided into two groups complicated with or without type 2 diabetes, 40 patients with diabetes mellitus into DM CHD group and another 40 patients with non diabetes mellitus （NDM） into NDM-CHD group. Pathological changes of coronary artery （including involved branches, the severity of coronary stenosis and morphological lesions）, and distribution characteristics of TCM syn- dromes （including asthenia syndrome, sthenia syndrome, and asthenia complicated with sthenia syndrome） were observed and compared/ Results Pathological changes of coronary artery in DM-CHD group showed multiple lesions in three branches of coronary artery, or widespread stenosis or severe calcification; the in- cidence rates of one branch lesion, mild stenosis, severe stenosis, and local stenosis were significantly low- er than those in NDM-CHD group .The main four syndromes in both groups were qi deficiency, blood stasis, turbid-phlegm and yin deficiency in turn; the incidence rates of turbid-phlegm, yin deficiency and yang deficiency in DM-CHD group were higher than those in NDM-CHD group; and complex syndrome and asthenia complicated with sthenia syndrome were frequently found in DM-CHD group, incidence rates being significantly higher than those in NDM-CHD group. Conclusion The coronary lesions in patients with DM-CHD are severer than those in NDM-CHD patients; TCM syndromes are complex in DM-CHD patients, fre- quently showing yin deficiency and turbid-phlegm on the basis of qi deficiency and blood stasis.