1124例急性心肌梗死住院患者中医证候特征及病死率相关性探究.docVIP

1124例急性心肌梗死住院患者中医证候特征及病死率相关性探究摘 要:目的:调查北京地区中医医院急性心肌梗死(AMI)住院患者中医证候特征及其与病死率的关系。方法:采用临床调查表的方式对2002年1月1日-2005年12月31日北京地区14家中医医院AMI住院患者进行调查,ACCESS建立数据库, SPSS统计软件进行中医证型规律及其与病死率关系等分析。结果:1124例AMI患者中男女患病比例为1.75∶1,患者平均年龄(66.7±12.3)岁。证素分布虚证以气虚所占比例最多(58.1%),实证以血瘀所占比例最多(85.1%)。临床证型分布中共出现74个证型,证型中所占比例在5%以上的为:气虚血瘀证、痰瘀互阻证、气虚兼痰瘀互阻证、气阴两虚兼痰瘀互阻证;分类证型分布中虚证占5.2%,实证占30.9%,虚实夹杂占63.9%。住院期间AMI总病死率14.0%。证素中血虚证、阳虚证、阴虚证的患者死亡风险较高,而以血虚证为最。气虚血瘀证,血瘀痰阻证,气虚兼痰瘀互阻证,气阴两虚兼痰瘀互阻证4个临床证型与死亡风险无明显相关性。分类证型中虚证与死亡具有相关性,是死亡的危险因素。结论:从基本证素分析,以气虚、血瘀所占比例最高;临床实际证型过多;分类证型显示虚实夹杂证为主。证素及分类证型研究结果均提示虚证与死亡有相关性,其中以血虚证为最。提示虚证是AMI死亡的危险因素,治疗上应注重标本兼顾。临床实际证型与病死率无明显相关性,可能与中医证候诊断标准化不足有关。 关键词:急性心肌梗死;中医证候;病死率? 中图分类号:R542.2 文献标识码:B 文章编号:1673-7717(2010)04-0771-04 Study of the Characteristics of TCM Syndrome on Patients with Acute Myocardial Infarction and Its Relationship with Mortality of Chinese Medicine Hospitals in Beijing Area LIU Hong?xu, WANG Ling, SHANG Ju?ju (Beijing Chinese Medicine Hospital of Capital Medical University, Beijing 100010, China)? 收稿日期:2009-11-30 基金项目:首都医学发展科研基金北京医学卫生科技联合攻关项目(2003-I-4) 作者简介:刘红旭(1963-),男,北京人,主任医师,学士,研究方向:中医药防治心血管病。 Abstract:?Objective:? To Survey the patients of acute myocardial infarction (AMI) with the characteristics of TCM syndromes and its relationship with mortality in Beijing area.?Methods:?Using the clinical questionnaire to investigate AMI patients on January 1, 2002 -2005 in December 31 in Beijing 14 of hospitals for Chinese medicine. Using ACCESS to establish a database and SPSS statistical software for TCM syndrome and its relationship with mortality analysis.?Results:?The ratio of sick men and women in 1124 cases of AMI patients were 1.75∶1, the average age of patients were 66.7±12?3 years old. By Su-certification,clinical type of syndrome and classificated type of syndrome to study the distribution of Syndromes, Qi deficiency in the proportion of Deficiency in Su-certification is accounted for a maximum (58.1%), the proportion of positive to a maximum of B