冠心病药物洗脱支架植入患者介入前后中医证型变化的研究

目的探讨冠心病患者药物洗脱支架植入前后中医证型变化的规律及药物支架对中医证型的影响。方法对108例冠心病患者行药物洗脱支架植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、痰浊等证型。按术前、术后24h、术后1周、术后1个月4个时间段进行统计分析。结果标实证中除痰浊外，气滞证在介入术后24h、术后1周、术后1个月各阶段比较有统计学意义（P〈0．05），各阶段与术前比较有统计学意义（P〈0．01）；血瘀证除术后24h与术后1周比较无统计学意义（P〉0．05）外，余各组间比较有统计学意义（P〈0．01）；在本虚证中气虚、阳虚、阴虚各证各阶段比较无统计学意义（P〉0．05）。结论药物洗脱支架介入治疗明显改善冠心痛气滞证和血瘀证，充分证明了气滞血瘀是介入术后再狭窄的病机关键；但对本虚证的改变无统计学意义，故不能从根本上改变冠心痛的本虚标实的病机特点。

Study on TCM Syndrome Types of Coronary Heart Disease Before and After Drug - eluting Stent Implantation

Objective To observe TCM syndrome types in patients（pts） with coronary heart disease（CHD） before and after drug - eluting stent implantation,and to explore the influence of drug - eluting stent implantation on TCM syndrome types. Methods Based on the data of 108 CHD pts with drug- eluting stent implantation, TCM Syndrome types were analyzed before and after stent implantation. Principal TCM Syndrome was qi - deficiency syndrome, yang - deficiency syndrome, yin - deficiency syndrome, qi - stagnation syndrome, blood stasis syndrome, phlegm syndrome, etc. Results There was significantly difference in qi - stagnation syndrome in pre - operation,post - operation 24 hours,one week and one month（P〈0.05 or P〈0.01）. There was no difference in blood stasis syndrome between post - operation 24 hours and one week（P〉0.05）. There was difference in blood stasis syndrome between pre - operation and post - operation one month （P〈0.01）. There was no difference in qi - deficiency syndrome, yang deficiency syndrome, yin deficiency syndrome（P〉0.05）. Conclusion The drug - eluting stents could significantly relieve symptoms of qi - stagnation syndrome and blood stasis syndrome. The result suggested that qi - stagnation and blood stasis syndrome was the pathogenetic key after stenting restenosis. It could not be radically changed in the pathogenetic nature of CHD.