冠心病血清胆红素、血脂、冠状动脉造影与中医证型的相关性分析-中医诊断学专业论文.docxVIP

成都中医药大学硕士学位论文 成都中医药大学硕士学位论文 PAGE PAGE 1 中文摘要 目的：通过对冠心病血清胆红素、血脂、冠状动脉造影与中医证型的相关性研究， 试图找出一些特异的客观指标，以引入中医对冠心病的辨证，使其辨证更加客观 化，并为中医论治及预后提供可靠的依据。 方法：将收集的 150 例冠心病病例参照《中药新药临床研究指导原则》（2002 年 试行版）有关冠心病中医证候标准分为 6 证型；同时收集其血清胆红素、血脂和 60 例行冠脉造影患者冠脉造影结果，对冠心病中医证型分布情况及其与血清胆红 素、血脂、冠脉造影结果的相关性进行统计分析。 结果： 1、冠心病的六个中医证型构成比从大到小依次排列为心血瘀阻证＞痰阻 心脉证＞气虚血瘀证＞气阴两虚证＞心肾阴虚证＞气滞血瘀证。2、本课题研究发 现冠心病心血瘀阻组的血清胆红素明显低于其它组，痰阻心脉组次之，与虚症组 比较有显著差异。3、痰阻心脉组甘油三酯、总胆固醇、低密度脂蛋白浓度较其它 组高，经统计学处理，具有显著差异。4、痰阻心脉、心血瘀阻及气滞血瘀组冠脉 以多支病变为主，而气虚血瘀、气阴两虚、心肾阴虚组以单支病变为主。实证组 以重度狭窄及闭塞性病变为主，而虚证组以中轻度狭窄为主。 结论：1、冠心病中医证型分布及变化有一定的规律性。2、冠心病各实证组血清 胆红素明显低于虚证组，故血清胆红素可作为冠心病中医虚证和实证辨证的一个 参考指标。3、血脂，尤其是甘油三酯、总胆固醇、高密度脂蛋白和低密度脂蛋白 可为冠心病临床辨证论治提供一参考依据。4、冠脉病变支数及狭窄程度可作为冠 心病中医虚证和实证辨证的一个参考依据。 关键词：冠心病 中医证型 血清胆红素 血脂 冠脉造影 Abstract Objective : Through relative researches of TCM type of coronary heart disease and serum bilirubin ,blood fat, coronary arteriongraphy, trying to find some specific objective indexes and leading them to the TCM differentiation of CHD. These indexes which make differentiation more objective and provide a reliable basis for treatment and prognosis. Methods : Totally 150 patients of CHD are divided into six groups according to the standardization of syndrome of the guide book of new TCM pharmacological clinical research (2002 version).Dividing the patients by differential standard and collecting their serum bilirubin ,blood fat and 60 patients’ coronary arteriongraphy results (those who have accept coronary arteriongraphy ).to analyze the distribution regularity or TCM patterns of CHD and its relationship to the levels of these tests results. Results : 1. Arrange six TCM syndrome patterns of CHD according to their constitute ratio in order : stagnation of heart-blood syndrome＞stagnation of phlegm of heart meridian syndrome ＞deficiency of vital energy and stagnation of blood syndrome＞ deficiency of both vital energy and yin syndrome ＞deficiency of both heart-Yin and kidney-Yin syndrome＞stagnation of both vital energy and blood syndrome. 2. The resear