21例自发性及变异性心绞痛的中医证侯特点分析

作者	单位
何熹延	江苏省中医药研究所内科 (南京210037)
丁惠玲	江苏省中医药研究所内科 (南京210037)
娄彬	江苏省中医药研究所内科 (南京210037)

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中文摘要:

通过对21例自发性、变异性心绞痛与147例劳力性心绞痛的对比分析,结果认为前者有三个中医证候特点:寒凝标实证型较多(42.86%:3.40%),阳虚本证较多(33.33%:6.12%),气虚本证较少(33.33%:72.11%);自发与变异两型心绞痛间证型无明显差异;寒凝型心绞痛的本证以阳虚与阴虚为多。文中对以上发生机理进行讨论,同时,还提出寒凝型心绞痛的辨证标准补充修改意见及该证型在临床上的重要意义。

英文摘要:

An analysis of TCM syndromes is reported in 21 cases with both spontaneous and variant angina as compared with 147 cases with effort angina. The results showed that 3 characteristic features were present, which were as follows: the Biao-Shi(标实) syndrome of cold condensation was more than that of the control group in ratio of 42.86% to 3.40%; the Ben-Xu(本虚) syndrome of Yang (阳) deficiency was more and that of Qi(气) deficiency less than those in the control group, and they were in ratio of 33.33% to 6.12% and 33.33% to 72.11% respectively. An absolute reduction of blood supply resulted from coronary spontaneous spasm in both spontaneous and variant angina causes severe chest pain during attacks as a cold condensation type. Hyperfunction of parasympathetic nerves often occurring in coronary heart disease with Yang deficiency is liable to vasoconstriction of the large coronary arteries leading to episodes of both spontaneous and variant angina. The presence of less Qi deficiency type may be related to the less impairment of cardiac function resulted from the short course in these cases and only relatively mild state of an illness, even no marked lesion in coronary arteries in a part of patients with both spontaneous and variant angina. No significant difference in TCM syndromes occurred between spontaneous and variant angina. Both Yang and Yin(阴) deficiency, as the Ben-Xu syndromes, were more present in angina of cold condensation type. At the same time, the authors suggested the criteria of some modification and addition for diagnosis of cold condensation type in angina-serious chest pain accompanied by pale face, cold limbs and cold sweat during attacks and araised its significance.

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