关键词:

胸痹, 心脏双源CT, 中医辨证分型, 冠状动脉狭窄程度

Abstract:

Objective　To explore the correlation between the degree of coronary artery stenosis in the dual source CT examination results of thoracic obstruction patients in the real world and the different types of traditional Chinese medicine (TCM) syndrome differentiation. Methods　This study collected general information, examination information, and diagnostic information of 431 patients with thoracic obstruction who underwent cardiac dual-source CT examination at Traditional Chinese Medicine Department, The First Affiliated Hospital of PLA Air Force Military Medical University from July 1, 2011 to December 31, 2021. Circulation software was used to analyze the stenosis site of coronary artery and the degree of intraluminal stenosis. The percentage of each stenosis lesion was recorded and measured. The age and gender of the patients and the distribution of TCM syndrome types were analyzed, and the relationship between thoracic obstruction syndrome types and the degree of coronary artery stenosis was explored. χ² test was used for statistical analysis. Results　A total of 431 patients were included, including 215 males and 216 females. The age range was concentrated between 22 and 81 years old, with an average of 57.28 years old. There were 45 cases <45 years old, 219 cases 45-60 years old, and 167 cases >60 years old. There were 89 cases (20.6%) of heart and blood stasis obstruction, 88 cases (20.4%) of phlegm turbidity obstruction, 65 cases (15.1%) of qi and yin deficiency, 57 cases (13.2%) of heart and kidney yang deficiency, 54 cases (12.5%) of qi stagnation and cardioplegia, 41 cases (9.5%) of heart and kidney yin deficiency, and 37 cases (8.6%) of cold coagulation heart meridian. There were 35 cases (8.1%) of grade 0 coronary artery stenosis, 94 cases (21.8%) of grade 1 stenosis, 111 cases (25.8%) of grade 2 stenosis, 101 cases (23.4%) of grade 3 stenosis, and 90 cases (20.9%) of grade 4 stenosis. Blood stasis obstruction and phlegm turbidity obstruction were more common in grade 3 and grade 4 stenosis of various empirical syndrome types, and were positively correlated with the degree of stenosis. There was no significant difference in the degree of stenosis of the cold coagulation heart meridian, while the qi stagnation heart chest syndrome was more common in grade 1-3 stenosis. The types of deficiency syndromes, including qi yin deficiency, heart kidney yin deficiency, and heart kidney yang deficiency, were mostly distributed in grade 1-2 coronary artery stenosis. The incidence rates of each syndrome type in different degrees of stenosis were statistically different (χ²=111.370, P<0.001). Conclusion　There is a clear correlation between various TCM syndromes and the degree of coronary artery stenosis in patients with thoracic obstruction.

Key words:

Thoracic obstruction, Cardiac dual source CT, Traditional Chinese medicine syndrome type, Degree of coronary artery stenosis