糖尿病冠心病本虚标实证型分布特征及与病程年龄关系初探

目的:探讨糖尿病冠心病本虚标实证型分布特征及其与病程、年龄的关系。方法:选择91例经冠脉造影确诊的糖尿病冠心病患者,进行中医辨证分型,统计分析其病程、年龄等资料。结果:本虚证集中分布为气阴两虚、气虚、阳气两虚、阳虚4证,其糖尿病平均病程按气阴两虚、气虚、阳气两虚、阳虚的排序递增,平均年龄按气虚、阳气两虚、阳虚的排序递增,阳虚组较其余3组差异显著(P≤0.05)。标实证集中分布为寒凝、痰浊、血瘀、气滞血瘀、寒凝血瘀、痰浊血瘀6证,各证患者平均年龄、平均糖尿病病程无统计学差异(P>0.05)。结论:糖尿病冠心病患者本虚以气虚、阳虚为主,且随年龄增长和病程延长,由气虚向阳虚发展;标实以痰浊、血瘀为主,且贯穿疾病始末。提示临床治疗应益气温阳以扶正,活瘀化痰以祛邪。

Distribution Characters of Diabetic Coronary Diseases of Type of Deficiency in Origin and Excess in Superficiality and It Relationship with the Course of Disease and Age

Objective: To probe the relationship between syndrome distribution character and course of diseases and age in diabetic coronary heart disease.Methods: 91 patients with diabetic coronary heart disease,it was diagnosed by coronal artery angiography,were observed at random.We divided them into different groups with method of syndrome differentiation and observed its data including course of diseases and age.All patients were divided into 2 types: type of deficiency in origin and type of excess in superficiality.Results: As to the group of type of deficiency in origin,it included 4 types.As to its distribution character in course of diseases,it increased in degrees with deficiency of qi and yin,deficiency of qi,deficiency of both qi and yang,and deficiency of yang.As to its distribution character in age,it increased in degrees with deficiency of qi,deficiency of both qi and yang,and deficiency of yang.The group of yang deficiency had significant difference from other groups(P<0.05).As to the group of type of excess in superficiality,it included 6 types;they were purplish clots,phlegm,and blood stasis,blood stasis due to stagnation of qi,blood stasis due to purplish clots,phlegm and blood stasis.As to its distribution character in both course of diseases and age,there were no statistic difference in all groups(P>0.05).Conclusion: For patients with diabetic coronary heart disease,its main type of deficiency in origin was deficiency of qi and deficiency of yang.With the extending of course and age,type of deficiency qi had a trend developing into type of deficiency of yang.As to type of excess in superficiality,its main type was type of phlegm and type of blood stasis.This hinted us to pay more attention to invigorating qi,warming yang,activating blood circulation to dissipate blood stasis and reducing phlegm during the treatment of patients with diabetic coronary heart disease.