Syndrome Factors And Quality Of Life, Based On The Seattle Angina Scale Angina Pectoris Card

Coronary heart disease(CHD) is a severe disease that harms human's health. Recently,with the development of iatrotechnique,the fatality of patients with CHD had greatly decreased,and more and more patients survived with the disease.At the same time,how to improve their quality of life(QOL) became a focused problem.The traditional Chinese medicine(TCM) has a unique character and advantage that pays attention to the entirety and combination of disease and syndrome.The theory of syndrome factors,could solve the difficult problem of classifying and judging syndromes.Therefore,this theory could be used to investigate the syndrome factors and their combination regularities of angina,based on which the correlation of syndrome and QOL could be analyzed.We hope this study can provide evidence for the future construction of assessment system of TCM efficacy evaluation by analyzing the inner association of syndrome and QOL,as well as their compatibility and complementation.PartⅠObjectStudy the characters of distribution and combination of syndrome factors of angina,and settle basement for the investigation of correlation with QOL.Methods233 patients with angina confirmed by coronary angiography were investigated for their symptoms and syndrome factors by the method of cross sectional questionnaire.ResultsBlood stasis was the main syndrome factors accounted for 79.4%,and next was qi deficiency accounted for 50.6%.The other factors in order were turbid phlegm(36.9%),yin deficiency(19.3%),qi stagnation(10.7%),yang deficiency(6.9%),intrinsic heat(9.0%) and cold coagulation(1.7%) Confounding syndrome of asthenia and sthenia accounted for 55.79%,pure sthenia was 36.91%,and pure asthenia was 7.3%.The combing style of syndrome factors of angina had some certain characters:①the most closely related two factors:qi stagnation and blood stasis,blood stasis and qi deficiency,turbid phlegm and blood stasisi,cold coagulation and yang deficiency, intrinsic heat and turbid phlegm,qi deficiency and.blood stasis,yang deficiency and qi deficiency,as well as yin deficiency and qi deficiency;②the most closely related three factors:turbid phlegm and blood stasis+qi deficiency,qi deficiency and blood stasis+yin deficiency;③the main pattern of syndrome:turbid phlegm and blood stasis(27.5%),qi deficiency and blood stasis(29.2%),qi and yin deficiency+others (13.3%),yang deficiency+others(6.9%),other(23.2%).ConclusionThe syndrome factors of angina,which could compose syndrome by certain regularities,were limited,and had relations with each other.The regularity of Syndrome factors of angina was centered by qi deficiency and blood stasis, sub-centered by yin deficiency and turbid phlegm,and surrounded by qi stagnation, yang deficiency and intrinsic heat.PartⅡObjectEvaluate the QOL of patients with angina,and analyze their correlation with syndrome factors and other correlated agents.MethodsThe QOL of 233 patients with angina were investigated by SAQ.One way anova and q test was used for comparing between different syndrome groups,and analysis of Spearman rank correlation and multiple stepwise regression were applied for comparing among multiple factors.ResultsThe QOL of the 233 patients with angina were low with the integral score 77.96±8.43,but the five scales were differently damaged.The angina stability scale was the lowest,while physical limitation scale was relatively better.Qi stagnation and intrinsic heat group had a better disease perception scale compared with that of the cold coagulation group(P＜0.01);yang deficiency group hada lower angina stability scale compared with that of qi stagnation group (P＜0.01).Compared with that of qi deficiency blood stasis group,yang deficiency+other group had a better angina frequency and treatment satisfaction (P＜0.05),and also a better treatment satisfaction compared with turbid phlegm and blood stasis group(P＜0.05).The integral scores of yang deficiency+other group and qi and yin deficiency+other group were obviously higher than that of turbid phlegm and blood stasis group(P＜0.01).In addition the disease perception scale of confounding syndrome of asthenia and sthenia group and pure sthenia group were lower than that of pure asthenia group(P＜0.05).QOL of patients from different hospitals also had significant difference,such as the QOL of patients from Anzhen hospital was better than Henan affiliated hospital and Guanganmen hospital(P＜0.01).QOL of patients with slight illness were higher than that with severe illness, especially in the scale of physical limitation and angina stability(P＜0.01).Age,coronary integral,qi stagnation,blood stasis,turbid phlegm,intrinsic heat,yang deficiency and yin deficiency were found had either positive or negative influences on QOL by Spearman scale correlation analysis.Turbid phlegm had a negative influence on QOL,while qi stagnation,intrinsic heat and yin deficiency had a positive influence,mainly affected the angina stability and integral score. Intrinsic heat played a positive role for angina frequency and treatment satisfaction.The results obtained by multiple stepwise regression,analysis were similar with the above results.In addition,we also found that advanced age always had a negative role for QOL,and female had a better treatment satisfaction and better disease perception.ConclusionSyndrome factors could properly explain the QOL of patients,and different syndromes had a certain correlation with QOL,which supported the rationality of TCM theory.In addition,it provided reference and direction for establishing unique treatment strategy for different types of patients.For example,we should pay more attention in controlling the angina frequency for patients with classical syndromes(blood stasis,qi deficiency and turbid phlegm);While for patients with turbid phlegm,more efforts should be put on improving their physical limitation, reducing the treatment course,and improving the treatment satisfaction; moreover,healthy education should be provided for male patients,which could help them understand more knowledge of the disease and improve their coping capacity,resulting in good QOL.