| Objective:Coronary heart disease (CHD) is the dangerous disease Which harms the human health. Nowadays, in our country the incidence of CHD increases quickly. The motherland medicine converges coronary disease "the chest rheumatism to be grieved" the category, thinks its main pathogenesis for the heart arteries rheumatism anti. At present in the world recognizes diagnosis coronary disease "golden standard" for coronary artery radiography, but it to the technology, the equipment and the expense request is high, the patient generally accepts with difficulty. Along with the supersonic technical development, the use supersonic phantom quantitative measurement technology observation carotid artery pathological change advancement forecast the coronary artery pathological change already day by day received takes. This article through colored Doppler supersonic comparison coronary disease patient and in normal coronary artery carotid artery film thickness (imtima-media thickness IMT), arteria carotis communis anterior inside diameter, gruel type mottling shape and with coronary disease Chinese medicine card Hou Fenxing relations,discussion neck atherosclerosis and coronary disease Chinese medicine card relations and clinical significance, in order to the doctor practicing western medicine unifies the angle provides the scientific basis for the clinical coronary disease diagnosis and preventing and controlling.MethodChooses in March, 2005-2006 year in October period inWuhan the cooperation of Chinese and Western medicine hospital heart internal medicine department in hospital 60 example patient is the object of study, in which male 38 examples, the feminine 22 examples, average age (56.82±7.61) year old. After in hospital surveys by the specialist the trying height, the body weight, the blood pressure, inquired and records patient's family history, the smoking history, the cardiovascular disease medical history in detail and so on, and after in hospital next day early morning empty stomach gathering venous blood specimen, the unification delivers the test center to carry on the blood biochemistry the chemical examination analysis, including the blood fats analysis, the blood sugar determination, the hepatorenal function, the electrolyte and the cardiac muscle enzyme spectrum inspection. The complete patient accepts the coronary artery radiography inspection, divides into the normal crown arteries group, coronary disease single pathological change group and coronary disease many pathological change group according to the radiography result, in which coronary disease group's patients according to the Chinese medicine symptom, the tongue coating and the pulse condition carries on the Chinese medicine dialectical minute. All patients around radiography a week expert carotid artery blood vessel colored Doppler supersonic inspection. Carries on the comparison to each group of coronary disease dangerous factor, simultaneouslyompares in the carotid artery blood vessel behind which during each group obtains film thickness IMT value, the arteria carotis communis anterior inside diameter, the mottling occurrence situation, the mottling Crouse integral, the mottling quality of material shape and with coronary disease Chinese medicine card relations. Statistics processing: The measurement material by the mean value addition and subtraction standard deviation(X±S)expression, uses the single factor variance analysis to three group of mean value differences to carry on the significance examination, the group the mottling picks out rate the comparison uses the card side examination. The complete material uses the SPSS13.0 statistical analysis software to carry on statistical processing, by P＜0.05 thought the difference has the significance statistics significance.Results1 normal coronary artery group, coronary artery single pathological change group, many pathological change group patient common material comparison: Three group of patients in the sex, the age compare the P＞0.05 difference not to have statistics significance, has the commeasurability. Compares with the normal coronary artery group, the coronary artery single pathological change group and many pathological change group's smoking history, hypertension medical history, saccharorrhea medical history, the body weight index, the blood cholesterol level, the empty stomach blood sugar value have the obvious markup, the P＜0.05 difference have statistics significance.2Compares with the normal coronary artery group, the coronary artery single pathological change group and many pathological change group institute obtains the IMT value, the arteria carotis communis anterior inside diameter and the mottling Crouse integral obvious markup, the P＜0.01 difference has the remarkable statistics significance. Moreover the IMT value, the arteria carotis communis anterior inside diameter and the mottling Crouse integral has the accumulation tendency along with the coronary artery pathological change count increase, compares with the normal coronary artery group, the coronary artery single pathological change group and many pathological change group's mottling formation rate also obviously elevates, the difference has the remarkable statistics significance, P＜0.01; The single pathological change group compares the P＜0.05 difference with many pathological change group also to have the remarkable statistics significance.3 Diagnosis for in coronary disease patient blood stasis card and lacking in vital energy card for most main card period of five days, next for phlegm muddy card and deficiency of yang card. In which single pathological change patient take the blood stasis and the phlegm muddy as the main card period of five days, in many pathological change patient by lacking in vital energy blood stasis primarily card.4 In the carotid artery mottling shape the flat spot formation rate is highest, in which correspondence Chinese medicine card for the painstaking care stasis anti- card, next the formation rate high is the soft spot, if corresponds Chinese medicine card for lacking in vital energy blood stasis card.Conclusions1 Neck atherosclerosis and in front of coronary artery pathological change has strong and the remarkable relevance, moreover the two have the similar dangerous factor.2 In the carotid artery film thickness increase is one kind of reflection early time atherosclerosis target, is reflected the coronal atherosclerosis serious degree not creates the target. The colored Doppler supersonic inspection can not create, accurate, direct-viewing dynamic surveys in the carotid artery film thickness and the mottling situation understood neck atherosclerosis the degree, can for appraise in a big way, the middle atherosclerosis comprehensively provides a window, to the clinical diagnosis, the treatment as well as prevention coronary disease has the important practical value.3 Neck atherosclerosis and between coronary disease Chinese medicine card has certain relevance, has provided the clinical basis for coronary disease cooperation of Chinese and Western medicine research. |
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