冠心病介入术前后的中医证型研究

目的：探讨冠心病患者在冠状动脉支架植入术前后中医证型的特点及演变规律。方法：对89例冠心病患者介入术前后进行中医证候分型,常见有血瘀证、气虚证、热证、痰浊证、气滞证、阳虚证、阴虚证、寒凝证等证型。结果：冠状动脉介入治疗前以血瘀证54例（60.7%）,气虚证50例（56.2%）,热证32例（40%）,痰浊证20例（22.5%）最为常见,气滞证13例（14.6%）,阳虚证8例（9%）,阴虚证6例（6.7%）,寒凝证3例（3.4%）。介入术后3天中医辨证中以血瘀证40例（44.9%）,气虚证33例（37.1）最为常见,热证17例（19.1%）,痰浊证15例（16.9%）,气滞证13例（14.6%）,阳虚证9例（10.1%）,阴虚证6例（6.7%）,寒凝证0例。结论：介入术后胸闷、胸痛及汗出临床症状较介入前均有显著改善（P〈0.01）;而乏力、眩晕、气短等症状在介入术前后变化不明显（P﹥0.05）。结论：①＂热证＂已成为冠心病的临床常见证型;②虽然介入手术治疗能够显著改善冠心病患者的临床症状,但并不能从根本上改变冠心病的＂本虚标实＂的病机特点。

Chinese Medicine Syndrome Type Research of Coronary Artery Disease Before and After Percutaneous Coronary Intervention

Objective：to discuss the evolution rule and TCM syndrome feature of before and afte coronary stent implantation.Methods：89 cases before and afte percutaneous coronary intervention were divide into different types of syndrome,there were blood-stasis syndrome,Qi deficiency,heat syndrome,phlegm syndrome,syndrome of stagnation of QI.,yang asthenia,yin asthenia,Cold congealing and so on.Result：Before coronary stent implantation 54 cases blood-stasis syndrome（60.7% ）,50 cases Qi deficiency（56.2% ）,32 cases heat syndrome（40% ）,20 cases phlegm syndrome（22.5% ）,13 cases syndrome of stagnation of QI（14.6% ）,8 cases yang asthenia（9% ）,6 cases yin asthenia（6.7% ）,3 cases Cold congealing（3.4% ）,After coronary stent implantation 40 cases bloodstasis syndrome（44.9% ）,33 cases Qi deficiency（37.1% ）,17 cases heat syndrome（19.1% ）,15 cases phlegm syndrome（16.9%）,13 cases syndrome of stagnation of QI（14.6%）,9 cases yang asthenia（10.1%）,6 cases yin asthenia（6.7%）,0 cases Cold congealing.Conlusions：The chest distress and pain and perspiration etc symptom of the disease before treated was imporved abivously（P〈0.01）;But debilitation and short breath and DZ were not improved abviously（P〉0.05）.Conlusions：①Heat syndrome is common type of syndrome of CAD;②Interventional therapy can improve CAD,but can＇t change the Benxubiaoshi pathogenesis feature of CAD.