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新疆不同民族慢性心力衰竭患者凝血因素与中医证型的关系研究
作者:汤献文等 
单位:新疆乌鲁木齐市中医院
关键词:慢性心力衰竭  血栓前状态:中医证候  不同民族 临床流行病学 
分类号:
出版年·卷·期(页码):2012·40·第五期(517-520)
摘要:

目的 通过临床流行病学调查研究不同民族慢性心力衰竭(chronic heart failure,CHF) 患者凝血功能、血脂、同型半胱氨酸等实验室指标与中医证型的相关性。方法:对400例CHF患者进行病例调查,采集心力衰竭患者凝血功能,血脂,同型半胱氨酸等实验室指标与各证型进行频数统计分析,删除各指标中构成比<10.0%的变量。分析其临床流行病学特点,反映心衰患者凝血状态和血脂及同型半胱氨酸各指标与中医证型的相关性。结果:(1)CHF患者存在血栓前状态(凝血功能检测改变均>73.44% ),并出现D-二聚体、同型半胱氨酸、凝血功能各指标在中医各证型中均有不同程度的变化,特别以痰瘀互结证为多见;(2)CHF患者中出现频数最多的中医证型是痰瘀互结证和气虚血瘀证(均>80.5%);少数民族CHF患者中证型分布最多的是痰瘀互结证 (56.75%),其次为气虚血瘀证(23.75%)。(3)血脂变化最为明显的CHF患者中医证型中以痰瘀互结为多见,气虚血瘀证次之。(4)CHF患者随着心功能的分级,从Ⅱ-Ⅳ级加重,D-二聚体变化明显。Ⅱ级占(18.00%)Ⅲ级占(22.75%)Ⅳ级占(59.25%)。结论:CHF患者存在血栓前状态;CHF患者血栓前状态中医证候的分布规律以气虚血瘀,痰瘀互结为多见;少数民族中以痰瘀互结证型最为多见;D-二聚体与心衰所有中医证型相关,其中痰瘀互结变化最明显;在痰瘀互证型中分布最多;随着心功能分级加重,二聚体变化明显。血脂、同型半胱氨酸、凝血功能在中医各证型中均有不同程度的变化,特别以痰瘀互结证为多见。

Abstract: objective through the clinical epidemiological study different national chronic heart failure (chronic heart failure, CHF) patients blood clotting, blood fat and homocysteine, laboratory index and the correlation of TCM syndrome type. Methods: 400 cases of CHF patients for cases survey, collection heart failure patients with blood clotting, blood fat, homocysteine, with each card type laboratory parameters for frequency statistics analysis, delete the index than < 10.0% in a variable. Analysis the clinical epidemiology characteristics, reflect the heart failure patients blood coagulation state and blood lipid and homocysteine each index and the correlation of TCM syndrome type. Results: (1) the CHF patients before the presence of thrombi state (blood clotting detect the change are > 73.44%), and the emergence of the d-dimer, homocysteine, coagulant function of each index in Chinese medicine every syndrome in type are different degree of change, especially with phlegm and blood stasis syndrome which is being seen each other "; (2) CHF patients appear frequency of most TCM syndrome type is mutual and phlegm and blood stasis syndrome and qi and blood stasis syndrome (both > 80.5%); Minority CHF patients type has the most phlegm and blood stasis distribution is mutual "card (56.75%), followed by the debility blood stasis syndrome (23.75%). (3) blood fat change the most obvious of the CHF patients in TCM syndrome type with phlegm and blood stasis knot each see more, debility blood stasis syndrome take second place. (4) CHF patients with cardiac function classification, from Ⅱ-Ⅳ level is aggravating, the d-dimer changes remarkably. Ⅱ level (18.00%) of Ⅲ level (22.75%) of Ⅳ level of (59.25%). Conclusions: patients with state there before thrombosis CHF; CHF patients before thrombosis state distribution rule of traditional Chinese medical syndrome with qi and blood stasis, phlegm and blood stasis married each other more see; Minority to each other and phleg

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