糖尿病合并冠心病患者冠脉病变程度及中医证型特点分析

目的　探讨糖尿病 (NIDDM)合并冠心病 (CHD)、单纯 CHD患者冠状动脉 (CA)病变程度及中医证型变化 ,以指导 CHD中医临床治则调整 .方法　利用冠状动脉造影术和CHD中医辨证标准 ,观察两组 (各 45例 ) CHD患者 CA病变程度 (累及支数、狭窄度 )、中医证型 (虚证、实证、兼证 )之异同 ,初步分析其特点及相互关系 .结果　 NIDDM- CHD患者CA病变明显 (多支病变 ,重度狭窄占多数 ) ,与单纯 CHD患者CA病变 (单支病变 ,轻、中度狭窄为主 )比较有显著性差异 (P<0 .0 5 ) ;且阴虚、痰浊、痰浊血瘀为其主要中医证型 ,而单纯CHD表现为气虚血瘀、寒凝心脉为主 .结论　在中医益气活血基础上 ,NIDDM- CHD中医治则应注重养阴、祛痰 ;而单纯CHD则着用行气、温通

Clinical analysis on extent of CA lesions and characteristics of syndrome differentiation-typing in CHD complicated with NIDDM

AIM To guide adjusting therapeutic principle ofTCM on coronary heart disease(CHD). METHODS The extent of coronary artery(CA) lesions was measured by coronary arteriography and characteristics of syndrome differentiation tpying were observed by uniform standards in differentiation of symptoms and signs on CHD,in 90 CHD patients including 45 cases complicated with non insulin dependent diabetes mellitus(NIDDM)and 45 without. RESULTS The extent and multiplicity of CA lesins were significantly greater in CHD with NIDDM than those in without. The main syndrome of NIDDM CHD was Yin deficiency,Qi deficiency and turbidphlegm with blood stasis,while that of without NIDDM was Qi deficiency with blood stasis and cold accumulating cardiac non insulin dependent diabetes mellitus, vessels. CONCLUSION Based on supplement Qi for activating blood circulation, therapeutic principle in CHD with NIDDM lays stress on nourishing Yin and eliminating phlegm,warming yang and promoting the circulation of Qi in without NIDDM.