岭南地区冠心病中医证型及证素分布的地域性特征研究(1)
[摘要] 目的 探讨岭南地区冠心病证型及证素分布规律。 方法 采集2013年1月～2015年12月就诊于南方医科大学珠江医院的岭南地区冠心病患者的信息，根据证型及证素判别标准，采用统计学方法挖掘证型及证素分布规律。 结果 岭南地区冠心病患者心血瘀阻证、痰阻心脉证比例分别为31.13%、17.13%，占主导地位，阴寒凝滞证及心肾阴虚证较少，证素分析结果同样支撑了此结果。 结论 本研究揭示了岭南地区冠心病患者证型及证素分布特征，有利于构建本地区冠心病中医临床路径和标准化治疗方案，可提升临床治疗的针对性和有效性。
[关键词] 岭南地区；冠心病；证型；证素；分布特征
[中图分类号] R541.5 [文献标识码] A [文章编号] 1673-7210(2016)10(a)-0073-04
Study on regional characteristics of TCM syndrome types and syndrome elements distribution of coronary heart disease in south of the Five Ridges
ZHU Lixia
Department of Traditional Chinese Medicine， Zhujiang Hospital， South Medical University， Guangdong Province， Guangzhou 510282， China
[Abstract] Objective To incestigate the TCM syndrome elements of coronary heart disease (CHD) and syndrome types distribution characteristics in south of the Five Ridges. Methods The informations of CHD patients from the south of the Five Ridges treated in Zhujiang Hospital， South Medical University from January 2013 to December 2015 were collected， according to the identification standard of TCM syndrome types and syndrome elements， the syndrome types and syndrome elements distribution were carried out by statistical analysis. Results The proportion of blood stasis syndrome and phlegm heart vessel syndrome was 31.13% and 17.13% respectively， which occupied the dominant position in CHD patients of the south of the Five Ridges. Yin cold stagnation syndrome and heart and kidney yin deficiency were extremely rare. Syndrome elements analysis results also supported the results. Conclusion This study reveals the distribution characteristics of syndrome types and syndrome elements in CHD patients in south of the Five Ridges， which is conducive to the construction of the local area clinical path and standardized treatment programme， and it also can improve the pertinence and effectiveness of clinical treatment.
[Key words] South of the Five Ridges； Coronary heart disease； Syndrome types； Syndrome elements； Distribution characteristics
冠心病属中医“胸痹”“心痛”范畴[1]，中医认为寒邪内侵、饮食不当、情志失调以及年老体虚等因素可引发冠心病[2]。临床上较为常见、典型、证名规范的证，可称为证型[3-4]，西医辨病、中医辨证的病证结合治疗冠心病取得了满意疗效。随着时代变迁，冠心病证型分布也有一定变化[5]。王永炎院士提出的“证候要素与应证组合理论”为中医辨证规范化标准化提供了很好的思路与方法[6-7]。
证素是构成证名的基本要素，具有八大基本特征[8]，通过对证候的辨识而确定的病位和病性，建立了基本理论体系[9-13]。辨证过程就是根据证候(病理信息)→辨别证素(确定病变本质)→组合成证名(辨证诊断)的思维认识过程[14-15]。证素间的联系组合构成了完整的证名。通过把复杂证候分解为简单的证候要素，进而通过证候要素之间的组合、证候要素与其他传统辨证方法的组合，建立多维多阶的辨证方法新体系[16]。陈洪晶等[17]综述了证素分析法进行冠心病研究概况。
目前岭南地区冠心病证型多为文献个案的回顾性和整理性研究，研究对象的取舍及证型判断标准不一，少有临床大规模的统计分析报道。南方医科大学珠江医院(以下简称“我院”)在国内较早进行冠心病介入治疗，对于冠心病的治疗水平居国内前列。本文以我院门诊和住院的冠心病患者为研究对象，通过大样本的临床调查揭示岭南地区冠心病证型及证素的分布特征，以期为临床借鉴，提升治疗的针对性和有效性。, 百拇医药(朱黎霞)
[关键词] 岭南地区；冠心病；证型；证素；分布特征
[中图分类号] R541.5 [文献标识码] A [文章编号] 1673-7210(2016)10(a)-0073-04
Study on regional characteristics of TCM syndrome types and syndrome elements distribution of coronary heart disease in south of the Five Ridges
ZHU Lixia
Department of Traditional Chinese Medicine， Zhujiang Hospital， South Medical University， Guangdong Province， Guangzhou 510282， China
[Abstract] Objective To incestigate the TCM syndrome elements of coronary heart disease (CHD) and syndrome types distribution characteristics in south of the Five Ridges. Methods The informations of CHD patients from the south of the Five Ridges treated in Zhujiang Hospital， South Medical University from January 2013 to December 2015 were collected， according to the identification standard of TCM syndrome types and syndrome elements， the syndrome types and syndrome elements distribution were carried out by statistical analysis. Results The proportion of blood stasis syndrome and phlegm heart vessel syndrome was 31.13% and 17.13% respectively， which occupied the dominant position in CHD patients of the south of the Five Ridges. Yin cold stagnation syndrome and heart and kidney yin deficiency were extremely rare. Syndrome elements analysis results also supported the results. Conclusion This study reveals the distribution characteristics of syndrome types and syndrome elements in CHD patients in south of the Five Ridges， which is conducive to the construction of the local area clinical path and standardized treatment programme， and it also can improve the pertinence and effectiveness of clinical treatment.
[Key words] South of the Five Ridges； Coronary heart disease； Syndrome types； Syndrome elements； Distribution characteristics
冠心病属中医“胸痹”“心痛”范畴[1]，中医认为寒邪内侵、饮食不当、情志失调以及年老体虚等因素可引发冠心病[2]。临床上较为常见、典型、证名规范的证，可称为证型[3-4]，西医辨病、中医辨证的病证结合治疗冠心病取得了满意疗效。随着时代变迁，冠心病证型分布也有一定变化[5]。王永炎院士提出的“证候要素与应证组合理论”为中医辨证规范化标准化提供了很好的思路与方法[6-7]。
证素是构成证名的基本要素，具有八大基本特征[8]，通过对证候的辨识而确定的病位和病性，建立了基本理论体系[9-13]。辨证过程就是根据证候(病理信息)→辨别证素(确定病变本质)→组合成证名(辨证诊断)的思维认识过程[14-15]。证素间的联系组合构成了完整的证名。通过把复杂证候分解为简单的证候要素，进而通过证候要素之间的组合、证候要素与其他传统辨证方法的组合，建立多维多阶的辨证方法新体系[16]。陈洪晶等[17]综述了证素分析法进行冠心病研究概况。
目前岭南地区冠心病证型多为文献个案的回顾性和整理性研究，研究对象的取舍及证型判断标准不一，少有临床大规模的统计分析报道。南方医科大学珠江医院(以下简称“我院”)在国内较早进行冠心病介入治疗，对于冠心病的治疗水平居国内前列。本文以我院门诊和住院的冠心病患者为研究对象，通过大样本的临床调查揭示岭南地区冠心病证型及证素的分布特征，以期为临床借鉴，提升治疗的针对性和有效性。, 百拇医药(朱黎霞)