CAJ | 학술논문

目的研究糖尿病急性心肌梗死与非糖尿病急性心肌梗死中医证候特点.方法采用统一调查表,收集北京地区6家三级甲等中医医院急性心肌梗死有效病例1 158例,其中糖尿病组361例,非糖尿病组797例,建立ACCESS数据库,采用SPSS 15.0统计软件对糖尿病组与非糖尿病组急性心肌梗死患者的中医证候特点进行对比分析.结果糖尿病组易见阴虚有热症状,阳虚与阴虚比例明显高于非糖尿病组;两组虚证均以气虚为主,实证均以血瘀为主,且以虚实夹杂证最为多见,糖尿病组比例更高;糖尿病组有56种证型,非糖尿病组有74种证型,虚证以气阴两虚证多见,实证以血瘀痰阻证多见.虚实夹杂证糖尿病组40种,非糖尿病组56种,2组构成比排在前4位的证候类型均为:气虚血瘀痰阻证、气虚血瘀证、气阴两虚血瘀痰阻证、气虚阴虚血瘀证,而糖尿病组气阴两虚血瘀痰阻证的比例明显高于非糖尿病组.结论糖尿病合并急性心肌梗死中医证候类型表现复杂多样,治法应注意攻补兼施、寒温并用以求阴平阳秘.
목적 연구당뇨병급성심기경사여비당뇨병급성심기경사중의증후특점.방법 채용통일조사표,수집북경지구6가삼급갑등중의의원급성심기경사유효병례1 158례,기중당뇨병조361례,비당뇨병조797례,건립ACCESS수거고,채용SPSS 15.0통계연건대당뇨병조여비당뇨병조급성심기경사환자적중의증후특점진행대비분석.결과 당뇨병조역견음허유열증상,양허여음허비례명현고우비당뇨병조;량조허증균이기허위주,실증균이혈어위주,차이허실협잡증최위다견,당뇨병조비례경고;당뇨병조유56충증형,비당뇨병조유74충증형,허증이기음량허증다견,실증이혈어담조증다견.허실협잡증당뇨병조40충,비당뇨병조56충,2조구성비배재전4위적증후류형균위:기허혈어담조증、기허혈어증、기음량허혈어담조증、기허음허혈어증,이당뇨병조기음량허혈어담조증적비례명현고우비당뇨병조.결론 당뇨병합병급성심기경사중의증후류형표현복잡다양,치법응주의공보겸시、한온병용이구음평양비.
Objective To study the TCM syndrome characteristics of acute diabetic myocardial infarction and non-diabetic myocardial infarction.Methods The questionnaires were used to collect the data from 1 158 cases of acute diabetic myocardial infarction in 6 TCM hospitals of grade III-A in Beijing. All cases were divided into diabetes group (n=361) and non-diabetes group (n=797). An ACCESS database was established and the TCM syndrome characteristics were compared and analysed in two groups.Results In the diabetes group yin deficiency with fever was common, and the proportion of yang deficiency to yin deficiency was higher significantly than that in the non-diabetes group. In two groups the deficiency syndromes were mainly qi deficiency, and excess syndromes were mainly blood stasis, among which the syndromes of deficiency complicated with excessiveness were the most common, especially in the diabetes group. There were 56 syndrome types in the diabetes group and 74 in the non-diabetes group, among which the deficiency syndrome was mainly dual deficiency of qi and yin syndrome, and the excess syndrome was mainly syndrome of blood-stasis and phlegm obstructing collateral. There were 40 syndromes of deficiency complicated with excessiveness in the diabetes group and 56 in the non-diabetes group, among which the first 4 syndromes included the syndrome of qi-deficiency blood-stasis phlegm-obstruction, syndrome of qi-deficiency blood-stasis, syndrome of dual qi-yin-deficiency blood-stasis phlegm-obstruction, and syndrome of dual qi-yin-deficiency blood-stasis. The proportion of the syndrome of dual qi-yin-deficiency blood-stasis phlegm-obstruction was higher significantly in the diabetes group than that in the non-diabetes group.Conclusion TCM syndromes of acute diabetic myocardial infarction show complicated characteristics, which should be treated with the therapy of elimination and reinforcement, and Chinese herbal remedies of cold and warm in nature used in combination for steadying yang and calming yin.