高血压病合并冠心病患者不同中医证型与心电图关系分析
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R541.3;R540.4+1

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Analysis of Relationship Between Different Chinese Medicine Syndrome Types and Electrocardiogram in Patients with Hypertension Complicated with Coronary Heart Disease
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    摘要:

    目的:分析高血压病合并冠心病患者不同中医证型与心电图的关系。方法:首先对2018 年6 月—2019 年6 月纳入高血压病合并冠心病的患者进行中医辨证分型,直到满足6 个组且每组不少于20 例为止停止分型,再参考抽签法获得每组20 例,并以12 导联心电图机完成相关检测,比对各相关指标以及不同中医证型之间存在的关系。结果:120 例高血压病合并冠心病临床患者中, 心肌缺血41.67% (50/120)、心律失常28.33% (34/120)、左室高电压19.17% (23/120)、左室肥大10.83% (13/120)。其中心肌缺血主要涉及瘀血闭阻型、寒凝心脉型、心气亏虚型、痰浊内阻型,依次占据65.00%、50.00%、50.00%、45.00%。心律失常的每个证型占据20.00%~35.00%。左室高电压以心肾阳虚型(30.00%)、心肾阴虚型(35.00%) 为主。左室肥大以痰浊内阻型(20.00%)、心肾阳虚型(15.00%)、心肾阴虚型(15.00%)为主。Q-T 间期延长阳性者34.17%(41/120),S-T 段下移阳性者42.50%(51/120),Q-T 间期延长阳性者以瘀血闭阻型为主,S-T 段下移也以瘀血闭阻型为主。QRS 波群离散度对比,从高至低分别是瘀血闭阻型>痰浊内阻型>心肾阳虚型>寒凝心脉型>心气亏虚型>心肾阴虚型(P<0.05)。结论:在以心肌缺血为主的高血压病合并冠心病临床患者中,不同的中医证型、心电图之间相互关联。主要证型为瘀血闭阻型,而心电图则是表现为Q-T 间期延长或是S-T 段下移乃至QRS 波群离散度增强。

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    Abstract: Objective: To analyze the relationship between different Chinese medicine syndrome types and electrocardiogram in patients with hypertension complicated with coronary heart disease. Methods:First of all,the patients with hypertension and coronary heart disease from June 2018 to June 2019 were classified according to TCM syndrome differentiation until they met the requirements of 6 groups with no less than 20 cases in each group,each group had 20 cases. Relevant examination was conducted through 12-lead electrocardiograph.Relevant indexes and relationship between different Chinese medicine syndrome types were compared. Results: Among 120 cases of clinical patients with hypertension complicated with coronary heart disease,myocardial ischemia,arrhythmia,left ventricular high voltage,and left ventricular hypertrophy accounted for 41.67% (50/120), 28.33% (34/120), 19.17% (23/120), and 10.83% (13/120) respectively. Myocardial ischemia was mainly related to obstruction of static blood type(65.00%), cold congealing in the heart vessel type(50.00%) , the heart qi deficiency type(50.00%) , and internal obstruction of phlegm turbidity type(45.00%). The proportion of each syndrome type of arrhythmia ranged from 20.00% to 35.00% .Left ventricular high voltage was mainly related to heart- kidney yang deficiency type(30.00%) and heart- kidney yin deficiency type(35.00%). Left ventricular hypertrophy was mainly related to internal obstruction of phlegm turbidity type(20.00% ), heart- kidney yang deficiency type(15.00%) , and heart-kidney yin deficiency type(15.00%).Obstruction of static blood type was the most common in positive patients with prolonged Q- T interval accounting for 34.17% (41/120) and positive patients with S- T segment depression accounting for 42.50%(51/120). The QRS complex dispersion of different Chinese medicine syndrome types from high to low was as follows:obstruction of static blood type,internal obstruction of phlegm turbidity type,heart-kidney yang deficiency type,cold congealing in the heart vessel type,heart qi deficiency type,and heart-kidney yin deficiency type(P< 0.05). Conclusion: There is an internal relationship between different Chinese medicine syndrome types and electrocardiogram in clinical patients with hypertension dominated by myocardial ischemia complicated with coronary heart disease.The main syndrome type is obstruction of static blood type.The manifestations of electrocardiogram include prolonged Q-T interval,S-T segment depression,and even increased QRS complex dispersion.

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舒孝萧,吕文明.高血压病合并冠心病患者不同中医证型与心电图关系分析[J].新中医,2021,53(11):77-79

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  • 在线发布日期: 2021-06-10
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