基于比较流行病学的冠心病心血瘀阻证危险因素地域性差异研究

目的探讨不同地域冠心病证候表现和“冠心病心血瘀阻证”危险因素的差异。方法1500例冠心病患者分别来自长沙、太原和新乡3个不同地域，在质量控制的前提下，进行中医证候的判定，并对不同地域“冠心病心血瘀阻证”的危险因素进行描述和对比研究。结果冠心病总体临床证型分布显示心血瘀阻〉痰阻心脉〉心阴亏虚〉气滞心脉〉心气亏虚〉寒滞心脉〉心阳亏虚，3个不同地域心血瘀阻证的分布相近：心血瘀阻证危险因素的地域差异性主要体现在载脂蛋白E基因多态性上。结论“冠心病心血瘀阻证”为冠心病最常见的证型，其危险因素分布均表现出一定的地域特征，这种差异可能与各地域地理环境气候特征及其影响下的患者人群体质和生活习惯相关。

Study Based on Regional Differences of Risk Factors of Coronary Heart Disease with Heart and BloodStasis Syndrome in Epidemiology

Objective： To explore symptoms of CHD with heart and blood stasis syndrome in different regions and regional differences of risk factors. Methods： 1500 patients with coronary heart disease （CHD） were chosen from three areas, Changsha, Xinxiang and Taiyuan. In the premise of quality control,to the TCM syndromes were determined and regional risk factors of CHD with blood stasis syndrome were described and compared. Results： The distribution of overall clinical syndromes of coronary heart disease was as follows： Heart and Blood Stasis 〉 Phlegm Blocking Heart Vein 〉 Heart and Yin Deficiency 〉Qi Stagnation of Heart 〉Heart and Qi deficiency〉 Cold Stagnation of Heart〉 Heart and Yang Deficiency. The distribution of CHD with blood stasis syndrome in three re- gions was not significantly different. The regional differences of the risk factors of blood stasis syndrome were mainly embodied in polymorphism of Apo lipoprotein E gene. Conclusion： Heart and blood stasis syndrome is the most common syndrome of coronary heart disease. The distribution of risk factors has some regional characteris- tics. The difference may relate to geographical environment and climatic characteristics, and climatic influence of patient population constitution and living habit.