不同辨证分型急性心肌梗死日分布的中医病理节律研究

目的探索不同中医证型急性心肌梗死（AMI）日发病的时间节律。方法对155例AMI患者进行问誊调查，并辨证分型，从中医时间医学的角度探究不同中医证型AMI的日发病节律。结果155例AMI患者中各中医证型的例数由多到少依次为：气虚血瘀证〉心血瘀阻证〉气阴两虚证〉心肾阴虚证〉气滞血瘀证〉痰阻心脉证〉阳气虚衰证〉阴寒凝滞证。心血瘀阻证、气虚血瘀证、心肾阴虚证AMI日发病高峰分别在下晡、平旦、日中；气阴两虚证AMI日发病高峰在日中、下晡。结论2006年12月-2007年4月不同证型AMI发病高峰的五脏主时时段不尽相同，具有明显的中医病理节律。

Study on Pathological Rhythm of Traditional Chinese Medicine about Circadian Distribution of AMI Patients with Different Syndrome Types

Objective To explore the onset circadian rhythm for different patterns of acute myocardial infaretion（AMI）patients with syndrome differentiation. Methods A questionnaire investigation was performed on 155 patients with AMI. After the differentiation of symptoms and signs for classification of syndrome for the AMI patients,we observed the circadian rhythm when AMI happens according to the theory of chronomedicine in traditional Chinese medicine （TCM）. Results The incidence rate of TCM syndrome types were in order： Qi-deficiency and blood stasis syndrome, heart blood stasis syndrome,deficiency syndrome of both Qi and Yin, deficiency syndrome of heart and kidney Yin, Qi- stagnation and blood stasis syndrome, syndrome of stagnation of phlegm in the heart vessel,Yang- Qi deficient syndrome, cold coagulation syndrome. In patients with Qi- deficiency and blood stasis syndrome, heart blood stasis syndrome,deficiency syndrome of heart and kidney Yin,AMI mostly appeared in Xiabu,Pingdan or Rizhong. In patients with deficiency syndrome of both Qi and Yin,AMI mostly happened in Rizhong or Xiabu. Conclusion Patients with different TCM syndrome types for have their own onset peak - time of AMI when five viscera master. There was a manifest regulation of TCM pathological circadian rhythm of the incidence in patients with AMI.