摘要
冠状动脉粥样硬化性心脏病(简称冠心病)是常见的心血管疾病之一,呈现出动脉粥样硬化和心肌缺血两大病理特点。冠心病患者临床上常见胸闷、胸痛、心悸、气短等症状,归属于中医学“胸痹”“心痛”等疾病范畴。中医医师通过“望、闻、问、切”四诊收集病情资料,综合辨证,随证遣方而治之。辨对证才能用对药,因此辨证的准确性是中医治疗能否充分发挥疗效的关键所在。但中医搜集四诊信息进行辨证、辨病的过程受医师自身临床经验丰富程度的影响,辨证结果有被医师个人主观倾向干扰的可能,证型诊断缺乏一定的客观依据,可能出现误诊或辨证不够精确的问题。本研究通过检索近10余年多个数据库中有关中医证型与现代医学检验、检查手段等相关性的研究文献,总结冠心病常见的中医证型为心血瘀阻、痰阻心脉、痰瘀互结、气虚血瘀、气阴两虚血瘀、气滞血瘀等,发现不同中医证候或证型的诊断与血脂水平、炎症因子水平、凝血功能等现代医学临床检验指标、心电图特征、冠状动脉病变情况等心血管疾病常规检查手段结果,以及年龄、性别、体质等一般资料之间存在的关联,为冠心病中医证型的诊断提供了客观参考,从而推动中医辨证的标准化和客观化,以助力中医药疗效的充分发挥。
Coronary atherosclerotic heart disease(CHD)is one of the common cardiovascular diseases,showing two pathological characteristics:atherosclerosis and myocardial ischemia.The common clinical symptoms of CHD patients are chest distress,chest pain,palpitations,and shortness of breath,which belong to the disease category of“chest numbness”and“heartache”in Chinese medicine.TCM doctors classify the syndrome by the four traditional methods of diagnoses:observation,listening,interrogation and pulse-taking,and then treat them with the syndrome.Therefore,the accuracy of syndrome differentiation is the key to give full play to the curative effect of TCM treatment.However,the process of TCM collecting the four diagnosis information for syndrome differentiation and disease differentiation is affected by the doctor’s own clinical experience,and the result of syndrome differentiation may be interfered by the doctor’s personal subjective tendency,and the diagnosis of syndrome types lacks certain objective basis,which may lead to misdiagnosis or inaccurate syndrome differentiation.By searching the research literature on the correlation between TCM syndrome types and modern medical examination methods in multiple databases in the past 10 years,this paper summarized the common TCM syndrome types of coronary heart disease as follows,including blood stasis,heart collaterals obstruction due to phlegm accumulation,phlegm-blood stasis,Qi(气)deffciency and blood stasis,Qi and Yin(阴)deffciency and blood stasis,Qi stagnation and blood stasis,etc.It is found that the diagnosis of different TCM syndromes is correlated with modern medical clinical test indicators such as blood lipid level,inffammatory factor level,coagulation function,electrocardiogram characteristics,coronary artery disease and other routine examination results of cardiovascular diseases,as well as general information such as age,gender and constitution,which provide an objective reference for the diagnosis of TCM syndrome types of coronary heart disease.To promote the standardization and objectiffcation of traditional Chinese medicine syndrome differentiation,and help to give full play of the curative effect of traditional Chinese medicine.
出处
《中医临床研究》
2025年第4期143-148,共6页
Clinical Journal Of Chinese Medicine
基金
江苏卫生健康发展研究中心课题(JSHD2021022)
南京市名中医工作室项目(2023-NJSMZYGZS-CSP)。
