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基于德尔菲法的冠心病不同临床类型中医证候特征专家调查

[Expert survey for Chinese medicine syndrome characteristics of different clinical types of coronary artery disease based on the Delphi method].

作者信息

Bi Ying-fei, Mao Jing-yuan, Wang Xian-liang, Li Bin, Hou Ya-zhu, Zhao Zhi-qiang, Ge Yong-bin, Zhao Gui-feng

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2014 Oct;34(10):1192-6.

Abstract

OBJECTIVE

To carry out expert survey for traditional Chinese medicine (TCM) syndrome characteristics of different clinical types of coronary artery disease (CAD).

METHODS

By using Delphi method, we carried out two rounds of nationwide expert surveys for modern TCM characteristics of syndrome elements and syndrome types of CAD.

RESULTS

Based on expert consensus, qi deficiency, blood stasis, phlegm turbidity, qi deficiency blood stasis, and intermingled phlegm and blood stasis are common TCM syndromes for different clinical types of CAD. Of them, qi stagnation, blood stasis, phlegm turbidity, heat accumulation, cold coagulation, yang deficiency, deficiency of both qi and yang were more often seen in patients with unstable angina than in those with stable angina. Qi deficiency, yin deficiency, and deficiency of both qi and yin were less seen. We could see more excess syndrome and less deficiency syndrome (such as qi deficiency, yin deficiency, etc.) in acute ST-segment elevation myocardial infarction (STEMI) than acute non-ST-segment elevation myocardial infarction (NSTEMI). Qi deficiency, blood stasis, water retention, yang deficiency, phlegm turbidity, yin deficiency, Xin-qi deficiency, and qi deficiency blood stasis induced water retention are the most common TCM syndrome types of CAD heart failure (HF). Blood deficiency, yin deficiency, heat accumulation, deficiency of both Xin and Pi, deficiency of both qi and blood, deficiency of both qi and yin, yin deficiency and fire hyperactivity were more often seen in CAD arrhythmias.

CONCLUSIONS

TCM syndrome distributions of different clinical types of CAD have common laws and individual characteristics. Results based on the expert consensus supplied evidence and support for clinical diagnosis and treatment of CAD.

摘要

目的

对不同临床类型冠心病的中医证候特点进行专家调查。

方法

采用德尔菲法,对冠心病证候要素及证型的现代中医特征进行两轮全国范围的专家调查。

结果

经专家共识,气虚、血瘀、痰浊、气虚血瘀、痰瘀互结是不同临床类型冠心病的常见中医证候。其中,气滞、血瘀、痰浊、热蕴、寒凝、阳虚、气阳两虚在不稳定型心绞痛患者中比稳定型心绞痛患者更常见。气虚、阴虚、气阴两虚较少见。急性ST段抬高型心肌梗死(STEMI)比急性非ST段抬高型心肌梗死(NSTEMI)实证更多、虚证(如气虚、阴虚等)更少。气虚、血瘀、水饮、阳虚、痰浊、阴虚、心气亏虚、气虚血瘀水停是冠心病心力衰竭(HF)最常见的中医证型。血虚、阴虚、热蕴、心脾两虚、气血两虚、气阴两虚、阴虚火旺在冠心病心律失常中更常见。

结论

不同临床类型冠心病的中医证候分布有共同规律和个体特点。基于专家共识的结果为冠心病的临床诊疗提供了证据和支持。

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