冠心病心绞痛气阴两虚及兼痰瘀证平板运动试验结果对照分析

目的 探讨冠心痛心绞痛气阴两虚及兼痰瘀证型患者平板运动试验各指标的客观特征表现及其规律，为临床冠心病的防治提供一定参考。方法 选择符合冠心痛心绞痛诊断标准，中医辨证为气阴两虚证(49例)及气阴两虚兼痰瘀证(52例)的患者共101例，所有入选病例均接受平板运动试验记录(1)试验阴性或阳性结论；(2)总运动时间(min)；(3)最大代谢当量(Max MET)；(4)峰运动ST段平均下移(mV)；(5)ST段下移0．1mV所需时间(min)；(6)ST段下移0．1mV时代谢当量；(7)测量并计算运动前与运动后即刻QRS波时限(ms)变化。结果 与单纯气阴两虚证组比较，气阴两虚兼痰瘀证组平板运动试验阳性率较高，峰运动ST段平均下移幅度，运动后即刻与运动前QRS波时限差较大，总运动时间、最大代谢当量、ST段下移0．1mV所需时间、ST段下移0．1mV时代谢当量值均较低；运动诱发心绞痛的比率较大，能达到目标心率的患者所占比率较小，两组比较，差异均有显著性(P<0．05，P<0．01)。结论 冠心病心绞痛气阴两虚兼痰瘀证组较气阴两虚证组患者的运动耐量差，冠脉病变程度重，是较严重的中医证型阶段。

Comparative Analysis on Results of Treadmill Test in Patients of Coronary Heart Disease Caused Angina Pectoris with Qi-Yin Deficiency Syndrome with or without Accompanied Phlegm and Blood Stasis Syndrome

ObjectiveTo explore the objective special features and role of various indexes of treadmill exercise test (TET) in patients of coronary heart disease (CHD) caused angina pectoris with Qi-Yin deficiency syndrome (QYD) with or without accompanied phlegm and blood stasis syndrome (PBS), to provide references for preventing and treating CHD in clinical practice. MethodsOne hundred and one patients, whose diagnosis measured to the diagnostic standard and the inclusion criteria of angina pectoris and CHD, were classified according to their TCM syndrome type to two groups, the QYD without PBS group (49 cases) and the QYD with PBS group (52 cases). TET was conducted on all the patients. The relative parameters were measured and compared. ResultsAs compared with the QYD without PBS group, in the QYD with PBS group, (1) the TET positive rate was higher; (2) total exercise time was lesser; (3) the maximal metabolic equivalent (Max MET) was lower; (4) the average depression of ST segment at the exercise endpoint of test (mV) was higher; (5) the time of ST segment depressed for 0.1mV (min) was longer; (6) the metabolic equivalent during ST-segment depressed by 0.1mV was shorter;and (7) the change of QRS wave time-limit before and immediately after TET was more evident. Moreover, in the testing time more patients revealed angina episode after exercise, and less patients had their heart rate reached the requirement in the QYD with PBS group than those in the QYD without PBS group. Comparison between the two groups in all the above-mentioned indices showed significant difference respectively (P<0.01 or P<0.05). ConclusionPatients with CHD caused angina pectoris of QYD with PBS are worse in the tolerance for exercise and severer in pathological change of coronary artery than those in those without PBS, they belong to the severe phase of TCM syndrome.