冠心病合并2型糖尿病病人中医证型与冠状动脉病变的关系探讨

目的探讨冠心病合并2型糖尿病病人中医证型与冠状动脉病变支数、狭窄程度及Gensini积分的关系。方法选取2012年1月—2016年12月在安徽中医药大学第一附属医院心内科行冠状动脉造影检查确诊为冠心病,同时经临床证实合并有2型糖尿病的病人共300例,分析冠状动脉病变程度(包括病变支数、狭窄程度分级、Gensini积分)与中医证型的关系。结果冠心病合并2型糖尿病病人同一冠状动脉狭窄程度的中医证型分布差异有统计学意义(P<0.05)。冠状动脉轻度狭窄病人以气阴两虚证(55.3%)为主;冠状动脉病变程度较重病人以气虚痰瘀证(中度狭窄占50.5%,重度狭窄占37.2%,完全闭塞占56.1%)及阳虚血瘀证(重度狭窄占35.9%)为主,且与气阴两虚证比较差异均有统计学意义(P<0.05)。冠状动脉单支病变病人以气阴两虚证为主,双支及多支病变病人以气虚痰瘀证为主,并且不同冠状动脉病变支数的气阴两虚证、气虚痰瘀证、阳虚血瘀证分布差异有统计学意义(P<0.01)。阳虚血瘀证的Gensini积分最高,与气阴两虚证、阳虚血瘀证比较差异均有统计学意义(P<0.05)。结论冠心病合并2型糖尿病病人的冠状动脉病变特点与中医证型之间具有一定的关联性。

Correlation between the TCM Syndromes and Coronary Artery Disease with Type 2 Diabetes Mellitus

Objective To explore the correlation between TCM syndromes of 300 patients with coronary heart disease combined with type 2 diabetes and the number of coronary lesion branches,stenosis degree,and Gensini score.Methods There hundred patients with coronary heart disease confirmed by coronary angiography and type 2 diabetes diagnosed clinically were selected,and the relationship between the degree of coronary artery disease(the number of coronary artery lesions,stenosis degree classification,Gensini score)and TCM syndromes was analyaed.Results The TCM syndromes of patients with coronary heart disease and type 2 diabetes showed a certain statistical difference in degrees of stenosis(P<0.05).Coronary artery stenosis was mainly caused by deficiency of qi and Yin(55.3%).The severity of coronary artery disease was mainly caused by qi deficiency and phlegm stasis syndrome(50.5%of moderate stenosis,37.2%of severe stenosis,56.1%of complete occlusion)and Yang deficiency and blood stasis syndrome(35.9%of severe stenosis),and both were statistically significant(P<0.05).The majority of single coronary artery lesions were caused by deficiency of qi and Yin,and the majority of bilateral and multiple lesions were caused by qi deficiency and phlegm stasis syndrome.Moreover,there were significant statistical differences in the distribution of three syndromes in the number of coronary artery lesions(P<0.01).The Gensini score of Yang deficiency and blood stasis syndrome was the highest,which had statistical significance compared with qi Yin deficiency syndrome and Yang deficiency blood stasis syndrome(P<0.05).Conclusion There is a certain correlation between the characteristics of coronary artery disease and TCM syndromes in patients with coronary heart disease and type 2 diabetes.