WANG Jie, CHU Fu-yong, LI Jun, YAO Kui-wu, ZHONG Jing-bai, ZHOU Ke-hua, HE Qing-yong, SUN Xiao-wei
Guang 'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing (100053), China.
Chin J Integr Med. 2008 Dec;14(4):274-80. doi: 10.1007/s11655-008-0274-2. Epub 2008 Dec 12.
Recently, a new traditional Chinese medicine differentiation theory "Syndrome Element (SE)" has been raised. In this study, the main syndrome element types and their correlations with the results of coronary angiography (CAG) in patients with coronary heart disease (CHD) were investigated.
Epidemiology cross-sectional study method was employed and 324 patients with CHD were enrolled, and their syndrome element types as well as the CAG results were analyzed. The correlations among syndrome element types, Gensini score, and the number of abnormal branches were also analyzed based on the distribution characteristics of syndrome element and coronary angiography results in the 324 cases.
According to their occurrence frequency in 324 CHD patients, the top eight major heart syndrome elements were Xin () blood stasis (85.8%), Xin qi deficiency (79.6%), Xin heat blockage (41.1%), Xin phlegm with turbid fluid (38.0%), Xin qi stagnation (24.7%), Xin yang deficiency (18.9%), Xin yin deficiency (17.5%) and Xin cold coagulation (4.4%), respectively, which suggested that Xin blood stasis and Xin qi deficiency were the two most common syndrome elements. Also, as coronary artery Gensini score increased, the changing trend of the syndrome element was "Xin yang deficiency with blood stasis" to "Xin phlegm obstruction with heat blockage" to "Xin yin deficiency with blood stasis" to "Xin qi deficiency with blood stasis" to "Xin cold coagulation with phlegm and turbid fluid, "Xin cold coagulation with blood stasis" to "Xin deficiency of qi, yin and yang". As the number of abnormal branches increased, the syndrome element changing trend was "simultaneous occurrence of cold and heat syndrome" to "Xin qi and yang deficiency with blood stasis" to "Xin retention of phlegm with turbid fluid" to "Xin cold coagulation in the heart meridian", "Xin deficiency of both qi and yin". The result of this study shows that Xin qi deficiency and Xin blood stasis were the major syndrome elements in patients with CHD.
As the severity and extent of coronary artery lesion increased, there were some apparent correlations among syndrome elements, Gensini score and number of abnormal coronary artery branches.
近年来，提出了一种新的中医辨证理论“证素”。本研究探讨冠心病（CHD）患者的主要证素类型及其与冠状动脉造影（CAG）结果的相关性。
采用流行病学横断面研究方法，纳入324例冠心病患者，分析其证素类型及CAG结果。并根据324例患者证素分布特点及冠状动脉造影结果，分析证素类型、Gensini评分及异常分支数之间的相关性。
按证素在324例冠心病患者中的出现频率，心脏主要证素前八位依次为心血瘀阻（85.8%）、心气亏虚（79.6%）、心热壅盛（41.1%）、心痰浊（38.0%）、气滞心脉（24.7%）、心阳虚（18.9%）、心阴虚（17.5%）、心阳暴脱（4.4%），提示心血瘀阻、心气亏虚为最常见的两个证素。冠状动脉Gensini评分升高时，证素变化趋势为“心阳虚血瘀证”→“痰热互结证”→“心阴虚血瘀证”→“心气亏虚血瘀证”→“痰瘀互结证”→“寒凝血瘀证”→“气阴两虚证”。异常分支数增多时，证素变化趋势为“寒热错杂证”→“心气虚阳虚血瘀证”→“痰浊内阻证”→“寒凝心脉证”→“气阴两虚证”。本研究结果显示，心气亏虚、心血瘀阻是冠心病患者的主要证素。
随着冠状动脉病变严重程度及范围增加，证素、Gensini评分及冠状动脉异常分支数之间存在明显相关性。
