摘要
目的观察心房颤动(简称房颤)患者射频消融术前后中医证候要素的演变规律。方法选择2021年1月—2023年1月于北京中医药大学东方医院心血管科住院接受射频消融术治疗的房颤患者90例,分别于术前、术后1周及术后1个月收集相关资料,分析证候要素。结果证候要素分布:射频消融术前依次为气虚、阴虚、血瘀、痰浊、血虚、气滞、阳虚、火热,术后1周依次为气虚、阴虚、血瘀、痰浊、血虚、气滞、火热、阳虚,术后1个月依次为气虚、阴虚、血瘀、阳虚、血虚、气滞、痰浊、火热。证候要素演变:术后1周血瘀证、火热证显著增多,术后1个月血瘀证、痰浊证、火热证较术后1周显著减少,痰浊证较术前显著减少。证候要素组合:术前及术后1个月以两证组合为主,其次为单证、三证组合;术后1周以两证组合为主,其次为三证组合、单证。聚类分析结果:术前及术后1个月中医证候要素组合均聚为阳虚-痰浊-气虚、气滞-血瘀、阴虚-火热-血虚三类,术后1周聚为血瘀-痰浊-阳虚-气虚、气滞、阴虚-火热-血虚三类。结论房颤患者射频消融术前后具有明显的中医证候要素演变规律;气虚、阴虚贯穿始终,术后1周时血瘀、火热加重,术后1个月时痰浊明显改善;血瘀的病机变化最显著,术后1周瘀血易合并阳气亏虚、痰浊内生,术前及术后1个月气滞血瘀是其主要病机。
Objective To observe the evolution pattern of traditional Chinese medicine syndrome after radiofrequency ablation in patients with atrial fibrillation.Methods Ninety patients with atrial fibrillation who were hospitalized in the Department of Cardiology,Dongfang Hospital,Beijing University of Chinese Medicine from January 2021 to January 2023 were treated with radiofrequency ablation.Relevant data were collected preoperatively,1 week postoperatively and 1 month postoperatively,and the TCM syndrome were analyzed.Results Distribution of TCM syndrome:Qi deficiency,Yin deficiency,blood stasis,phlegm,blood deficiency,Qi stagnation,Yang deficiency,and fire heat in order before RF ablation,Qi deficiency,Yin deficiency,blood stasis,phlegm,blood deficiency,Qi stagnation,fire heat,and Yang deficiency in order one week after surgery,and Qi deficiency,Yin deficiency,blood stasis,Yang deficiency,blood deficiency,Qi stagnation,phlegm,and fire heat in order one month after surgery.Evolution of TCM syndrome:blood stasis and fire-heat increased significantly one week after surgery,and blood stasis,phlegm and fire-heat decreased significantly at one month after surgery compared with one week after surgery,and phlegm decreased significantly compared with the preoperative period.Combination of TCM syndrome:preoperative and one month postoperative were dominated by two TCM syndrome combinations,followed by single TCM syndrome and three TCM syndrome combinations;one week postoperative were dominated by two TCM syndrome combinations,followed by three TCM syndrome combinations and single TCM syndrome.Cluster analysis results:Yang deficiency-phlegm-qi deficiency,qi stagnation-blood stasis,and yin deficiency-fire heat-blood deficiency in the preoperative period and one month postoperatively,and blood stasisphlegm-yang deficiency-qi deficiency,qi stagnation,and yin deficiency-fire heat-blood deficiency one week postoperatively.Conclusion Atrial fibrillation patients before and after radiofrequency ablation had a clear pattern of evolution of TCM syndrome;qi deficiency and yin deficiency were present throughout the whole period,blood stasis and fire-heat worsened at 1 week after surgery,and phlegm was improved markedly at 1 month after surgery;the pathogenesis of blood stasis was the most typical,and stasis of blood was easy to be combined with deficiency of yang qi and phlegm in the 1-week period after surgery,while stagnation of qi and blood stasis was the main pathogenesis of the disease in the preoperative period and the 1-month period after surgery.
作者
刘伟
李星星
林泉
范宗静
崔杰
胡继强
吴旸
LIU Wei;LI Xingxing;LIN Quan;FAN Zongjing;CUI Jie;HU Jiqiang;WU Yang(The Second School of Clinical Medicine,Beijing University of Chinese Medicine,Beijing 100078,China;Department of Cardiology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)
出处
《北京中医药》
2024年第3期256-260,共5页
Beijing Journal of Traditional Chinese Medicine
基金
国家自然科学基金资助项目(81573900)
中央高校基本科研业务费专项资金项目(2022-JYB-XJSJJ-073)。
关键词
射频消融
心房颤动
证候要素
atrial fibrillation
radiofrequency ablation
traditional Chinese medicine syndrome
作者简介
刘伟,男,29岁,博士研究生。研究方向:中西医结合防治心血管疾病;通信作者:吴旸,E-mail:drwuyang@163.com。
