稳定期冠心病患者中医证候演变规律的研究

摘要

目的：探讨稳定期冠心病患者发生急性心血管事件的中医证候演变规律及其与随访发生急性心血管事件的关系。方法纳入稳定期冠心病患者303例，详细记录入选时、半年、1年的中医证候情况及2年随访时事件发生情况。应用频数分布法，观察两组患者整体的证候分布。应用多因子降维(MDR)数据挖掘方法探讨中医证候的演变规律。结果频数法显示3个时间点(两个时间段)的演变趋势：两组的气滞、寒痰(第2时段)均呈现降低趋势，痰热证在事件组呈现逐渐增加。阴虚、气虚的变化趋势基本相同，而阳虚的变化两组则呈现相反的方向。应用 MDR来研究证候之间的转化，结果提示，第2个时点的阳虚转化为第3个时点的痰热、第2个时点的气虚转化为第3个时点的痰热与发生心血管事件呈正相关。结论证候演变中以气虚-痰热、阳虚-痰热的转化易引发心血管事件。%Objective To investigate the evolution of traditional Chinese medicine (TCM)syndromes in stable coronary heart dis-ease (CHD)patients with acute cardiac event (ACE).Methods Three hundreds and three patients with stable CHD were enrolled, the syndromes of patients should be records in half a year and one year.The events were recorded in 2 year follow up.The frequen-cy distribution method was used to analyze the characteristic of syndromes distribution.Then,multifacfor dimensionality reduction (MDR)data mining methodology was used to analyze the syndrome change of stable CHD patients with ACE.Results Based on the frequency distribution map,qi stagnation syndrome and phlegm cold (secondary phrase)showed the descending trends,the phlegm heat syndrome showed gradually increasing trend in ACE group.The yin deficiency syndrome and qi deficiency syndrome showed the same trends,while yang deficiency performs opposite direction of changing.The results showed that the trends of yang deficiency syn-drome to phlegm heat syndrome and qi deficiency syndrome to phlegm heat syndrome were closely related,and the correlation was positive.Conclusion the trends of qi deficiency syndrome to phlegm heat syndrome and yang deficiency syndrome to phlegm heat syndrome could trigger ACE more easily.