基于冠脉造影的冠心病冠脉病变与血瘀证的相关性研究

目的 探讨冠心病冠脉病变与血瘀证的相关性。方法 将多中心收集的500例经冠脉造影证实为冠心病患者进行中医辨证分型，观察冠脉病变支数及狭窄程度与血瘀证各亚型的关系。结果（1）冠心病血瘀证患者平均冠脉病变支数（2.28±0.82）支，冠心病非血瘀证平均冠脉病变支数（2.07±0.86）支，两者比较，差异有统计学意义（P＜0.05)。与冠心病非血瘀证患者比较，血瘀证患者的冠脉病变多表现为多支病变，重度狭窄（P＜0.05）；（2）冠心病血瘀证亚型中，阳虚血瘀证的平均冠脉病变支数为（2.58±0.65）支，明显多于其他血瘀证亚型（P＜0.05）；（3）与冠心病痰瘀互阻证比较，阳虚血瘀证患者的冠脉病变多表现为重度、中度狭窄（P＜005），而单支病变较少见（P＜0.05）。（4）采用对应相关分析发现阳虚血瘀证与冠脉重度狭窄关系密切（相关距离0.1899）。结论 冠心病患者冠脉病变的支数、狭窄程度与血瘀证存在一定的关系。

Research on Relationship between Coronary Lesion and Blood Stasis Syndrome Based on Coronary Angiography

Objective To explore the relationship between blood stasis （BS） syndrome and coronary lesion in patients with coronary heart disease （CHD）. Methods Syndrome types of 500 patients collected from multiple centers whose diagnosis of CHD confirmed by coronary angiography were differentiated. And the relationship be- tween BS syndrome, its subtypes, and coronary lesion （affected branches, degree of constriction） were analyzed. Results The affected branches of coronary artery in patients of BS syndrome was 2.28 ± 0.28, while that in the non-BS syndrome patients was 2.07 ± 0.86, showing significant difference between them （ P 〈 0.05） ; as compared to patients of non-BS syndrome, the coronary lesions in patients of BS syndrome were mostly multi-vascular, and of more severe degree （P 〈 0.05）. In patients of various BS syndrome subtypes, the average number of affected coronary branches in patients of yang-deficiency subtype was 2.58 ± 0.65, which was significantly more than the number in patients of other BS syndrome subtypes. The constriction degree of coronary lesions in patients of yang-defi- ciency BS syndrome subtype were mostly severe or moderate, and single branch lesion was rarely seen, as com- pared with those in patients of phlegm-stasis obstruction subtype, the difference was significant （P 〈 0.05）. The corresponding correlative analysis showed that close correlation was found between yang-deficiency subtype of BS syndrome and severe coronary constriction with the correlation distance of 0. 1899. Conclusion Relationship be- tween BS syndrome and coronary lesion （its number of branches and degree of constriction） truly exists to a certain extent.