胸痹心痛中医证型与16层螺旋CT冠状动脉成像的相关性研究

目的：探讨胸痹的证型和16层螺旋CT冠状动脉成像之间的关系。方法：对167例胸痹心痛患者进行中医辨证分型并行16层螺旋CT冠脉造影检查,观察不同证型的冠脉狭窄范围及程度。结果：胸痹实证患者表现为重度狭窄为主,虚证患者表现为轻度狭窄,实证与虚证之间比较,差异有统计学意义（P〈0.05）。实证中阴寒凝滞证表现为轻度狭窄。心血瘀阻证、痰浊壅塞证3支病变、2支病变的比例均显著高于其他证型（P〈0.05）。结论：胸痹中医证型与16层螺旋CT冠状动脉成像间具有一定相关性。胸痹实证较虚证重,痰浊壅塞证与心血瘀阻证无论在狭窄程度还是在病变分布上都明显高于其他证型,是胸痹心痛的危险证型。

Correlation Study between TCM Patterns of Chest Discomfort and Coronary Arteriongraphy of 16 Slices Spiral CT

Objective： To explore the relation between patterns of chest discomfort and coronary angiography of 16 slices spiral CT. Methods： All 167 patients were grouped according to syndrome differentiation and patterns,and examined by 16 slices spiral CT, the degrees and the ranges of coronary stenosis in different patterns were observed. Results： The patients of excess pattern manifested severe stenosis mainly, the ones of deficiency pattern light stenosis, the difference had statistical meaning in the comparison between excess pattern and deficiency pattern（P〈0.05）.The patients of Yin-cold stagnation pattern demonstrated light stenosis. The patients of heart-blood obstruction pattern and phlegm-turbidity congestion pattern were with higher ratio of triple vessel disease in both groups than other patterns significantly（P〈0.05）. Conclusion： Patterns of chest discomfort are related to coronary angiography of 16 slices spiral CT to a certain degree. The patients of excess pattern are severer than the ones of deficiency pattern.