摘要
目的探讨急性冠脉综合征(ACS)患者血运重建围术期中医证型变化和短期预后的关系。方法 205例ACS患者冠脉血运重建术前根据中医辨证分型分为心血瘀阻证组(140例)、气阴两虚证组(42例)、心肾阴虚证组(13例)、痰阻心脉证组(10例)4组。于术后第1天、第3天再次进行中医辨证分型,观察患者证型变化;分析不同证型患者住院期间与随访6个月预后的差异。结果 205例患者的冠状动脉造影结果显示3支病变90例(43.9%),C型病变124例(60.5%)。痰阻心脉证组复杂病变比例明显高于其他3组。血运重建术后心血瘀阻证减少,痰阻心脉证明显增加。随访6个月时痰阻心脉证组MACE发生率高于其他3组(分别为30.0%、5.0%、4.8%、0%)。结论 ACS围术期主要中医证型为心血瘀阻证。血运重建术在一定程度上可改善血瘀证,痰阻心脉证患者预后相对较差。
Objective To explore the relationship of TCM syndromes change and short-term prognosis for perioperative period of revasculaxization in acute coronary syndrome （ACS）. Methods Two hundred and five cases of ACS were divided into four groups before coronary revascularization, according to syndrome differentiation of TCM, which were a heart-blood stasis syndrome group （140 cases）, a deficiency of both qi and yin syndrome group（42 cases）, a yin deficiency of heart-kidney syndrome group（13 cases） and a phlegm blocking heart vessel syndrome group （10 cases）. At the 1st and the 3rd day of postoperation, syndrome differentiation of TCM was applied again to observe the change of syndrome patterns, and analyze differences in prognosis of patients with different syndromes between hospitalized period and 6-month follow-up visit. Results Of 205 cases, there were 90 eases（43.9%） with triple vessel disease and 124 cases（60.5%） with type C lesion by coronary arteriograpby. The rate of complex lesions in the phlegm blocking heart vessel syndrome group was apparently higher than the other three groups. After the revascularization, cases of heart-blood stasis syndrome were decreased while phlegm blocking heart vessel syndrome were apparently increased. In the 6-month follow-up visit, the incidence of MACE in the phlegm blocking heart vessel syndrome group was higher than that in the other three groups （respectively 30.0%, 5.0%, 4.8% and 0%）. Conclusion The heart-blood stasis syndrome is considered as the major TCM syndrome for perioperative period of ACS, which could be improved with revaseularization. The patients with syndrome of phlegm blocking heart vessel has a relatively poor prognosis.
出处
《北京中医药》
2013年第1期28-30,43,共4页
Beijing Journal of Traditional Chinese Medicine
基金
北京市中医药科技发展基金(JJ2009-21
JJ2010-14)
关键词
急性冠脉综合征
血运重建
中医证型
预后
acute coronary syndrome
revascularization
TCM syndrome
prognosis
