【目的】探讨冠状动脉粥样硬化性心脏病（简称冠心病）患者CT 影像学表现与中医证候诊断标准的相关性。【方法】选取 2024 年3 月至2025 年2 月期间在河南省中医院心内科住院并接受冠状动脉CT 血管造影（CTA）检查的120 例冠心病患者作为研 究对象。通过联影UCT968 多层螺旋CT 机进行影像学检查，结合《冠心病中医辨证标准》进行中医辨证分型，分析中医证 型与性别、斑块类型（钙化斑块和非钙化斑块）、病变支数及冠脉狭窄程度的相关性。【结果】（1）中医证型分布方面：120 例 冠心病患者中，以心肾阳虚证患者的占比最高（41 例，34.17%），其他从高到低依次为心血瘀阻证（23 例，19.17%）、痰瘀 互结证（21 例，17.50%）、气阴两虚证（19 例，15.83%）、气滞血瘀证（16 例，13.33%）。（2）中医证型与性别、斑块类型、病变 支数及冠状动脉狭窄程度的关系方面：不同中医证型的性别、斑块类型、病变支数及冠状动脉狭窄程度均存在显著的统计 学差异（P＜0.05 或P＜0.01），其中，气阴两虚证在女性中比例较高，痰瘀互结证在钙化斑块患者中比例较高；病变支数分 布方面，心肾阳虚证和气阴两虚证以单支病变为主，心血瘀阻证多见双支和三支病变；冠脉狭窄程度方面，心肾阳虚证患 者多表现为冠状动脉轻度狭窄，而痰瘀互结证患者则多见冠状动脉重度狭窄。【结论】冠心病患者中医证型与CT 影像学表现 存在显著相关性，可为中西医结合诊疗冠心病提供新的视角。中医证型与斑块类型、病变支数及狭窄程度的关系为个性化 治疗方案的制定提供了理论依据，有助于提高冠心病的早期筛查与干预效果。

Objective To investigate the correlation between coronary computed tomography（CT）imaging findings and traditional Chinese medicine（TCM）syndrome diagnostic criteria in patients with coronary atherosclerotic heart disease（CHD）. Methods A total of 120 patients with CHD who were hospitalized in the Department of Cardiology， Henan Provincial Hospital of Traditional Chinese Medicine，and underwent coronary CT angiography（CTA） between March 2024 and February 2025 were enrolled as study subjects. Imaging examination was performed using a United Imaging UCT 968 multi-slice spiral CT scanner. TCM syndrome differentiation was conducted according to the“Standards for TCM Syndrome Differentiation of Coronary Heart Disease”. The correlations of TCM syndrome types with gender，plaque type（calcified and non-calcified plaques），number of affected vessels，and the degree of coronary artery stenosis were analyzed. Results（1）Distribution of TCM syndrome types：Among the 120 patients，heart-kidney yang deficiency syndrome accounted for the highest proportion（41 cases，34.17%）， followed in descending order by heart-blood stasis syndrome（23 cases，19.17%）， phlegm interweaved with stasis syndrome（21 cases，17.50%），qi-yin deficiency syndrome（19 cases，15.83%），and qi stagnation and blood stasis syndrome（16 cases，13.33%）.（2）Relationship of TCM syndrome types with gender，plaque type， number of affected vessels，and coronary artery stenosis severity：Statistically significant differences were observed in gender distribution，plaque type，number of affected vessels，and the degree of coronary artery stenosis among different TCM syndrome types（P＜0.05 or P＜0.01）. Specifically，qi-yin deficiency syndrome showed a higher proportion in female patients，while phlegm interweaved with stasis syndrome had a higher proportion in patients with calcified plaques. Regarding the distribution of affected vessels，heart-kidney yang deficiency syndrome and qi-yin deficiency syndrome were predominantly characterized by single-vessel disease， whereas heart-blood stasis syndrome was more frequently associated with double- and triple-vessel disease. In terms of coronary artery stenosis severity，patients with heart-kidney yang deficiency syndrome predominantly presented with mild stenosis，while those with phlegm interweaved with stasis syndrome more commonly exhibited severe stenosis. Conclusion A significant correlation exists between TCM syndrome types and CT imaging features， offering a novel perspective for the integrated traditional Chinese and western medicine diagnosis and treatment of CHD. The relationship of TCM syndrome types with plaque type，number of affected vessels，and stenosis severity provides a theoretical basis for formulating personalized treatment strategies，thereby contributing to enhanced the effectiveness of early screening and intervention for CHD.

R259.414

河南省中医药科学研究专项课题（编号：2019JDZX005）