女性冠心病中医证候学及冠脉病变特点研究

作者	单位
何庆勇	中国中医科学院西苑医院
王阶	中国中医科学院广安门医院
张允岭	北京中医药大学东方医院
汤艳莉	北京中医药大学东方医院

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中文摘要:

目的探讨女性冠心病的临床特点、冠脉病变特点及中医证候学特征。方法对297例经冠脉造影证实的女性冠心病患者的临床资料进行分析,并与772例男性冠心病患者临床资料作比较。结果女性冠心病发病年龄晚,多合并糖尿病及血脂紊乱,冠脉病变程度较严重,以多支、双支病变为主,常累及前降支、右冠状动脉及回旋支。常见证候要素及组合有气虚、血瘀、阴虚、气虚血瘀、气阴两虚、痰浊、阳虚等,常见舌脉有舌暗红、舌紫暗,舌淡红、舌体胖大,舌苔少津,舌苔黄、舌苔厚腻、舌无苔少苔,舌下络脉青紫、舌下络脉曲张,脉细弱或细数。结论女性冠心病有独特的临床特点、冠脉病变特点及中医证候学特征,预防女性冠心病重在预防和控制糖尿病及血脂紊乱,中医治疗应以益气、活血、养阴为主法,辅以化痰,通阳之法。

英文摘要:

Objective To study the clinical feature,coronary artery lesion specialty and Chinese medicine syndrome characteristics of coronary heart disease(CHD)in females.Methods The clinical materials of 297 female patients with CHD,whose diagnosis had been confirmed by coronary angiography,were analyzed and compared with those of 772 male patients.Results CHD in females was characterized by later occurrence,frequently complicated with diabetes mellitus and blood lipid disorder,and rather serious coronary lesion,mainly the multi-or double-branch lesion,involving the anterior descend branch,right coronary artery and convolution branch;with the often encountered syndrome factors and their combinations of qi deficiency,blood stasis,yin deficiency,blood stasis due to qi deficiency,deficiency of both qi and yin,turbid phlegm,yang-deficiency,etc.;the figures of tongue and pulse were generally dark-red or dark-purple or pale-red colored corpulent tongue proper,with waterless yellow or less coating,even without coating,cyanosed varicose sublingual veins,thin-weak or thin-rapid pulse.Conclusion Female CHD has its special clinical feature,coronary specialty and Chinese medicine syndrome characteristics.Proper treatment methods for it are supplementing qi,activating blood,nourishing yin in dominance,with dissolving phlegm and accessing yang as accessory.

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