Coronary Heart Disease (chd) Obstruction Of Syndrome Types And Some Influence Factors

Objective:Through the larger sample size of cases of coronary heart disease,to analysis TCM syndrome of coronary heart disease and basic conditions. Focus on discussing the unstable state of intracoronary stent implantation,the state of new time collateral circulation before stenting,the discussion of TCM syndrome and some influencing factors. The paper is intended to guide modern clinical diagnosis,treatment and prevention, to analysis and to raise awareness about the new progress on diagnosis and treatment of coronary heart disease and chest pain from the point of view of combining traditional Chinese and Western medicine.Methods:To Collect cases from Beijing dongzhimen hospital. The case numbers is113022-133619. By establishing a database and using SPSS17.0to analysis, the data is the count data,using the chi-square test.Results:(1)Collateral circulation:coronary angiography’s reports have86cases,mentioning collateral circulation’s situation is71cases(82.6%);not mentioning collateral circulation’s situation is15cases(17.4%); collateral circulation which established is13cases(18.3%); collateral circulation which not established is58cases (81.7%). Collateral circulation which not established was more common in multi-vessel pathological changes. Three vascular pathological changes in8cases(61.5%); Two vascular pathological changes in4cases (30.8%). There are significant differences between suffering diabetes group and collateral circulation which established(P<0.05). There are significant differences between suffering high blood pressure group and collateral circulation which established(P<0.001). There is no significant difference between collateral circulation which established and the length of history of coronary heart disease(P>0.05). Collateral circulation to establish whether or not has statistically significant in qi deficiency syndrome (P<0.05). Collateral circulation to establish whether or not has statistically significant in phlegm retention syndrome and blood stasis syndrome(P<0.001). Collateral circulation to establish whether or not has no statistically significant in deficiency syndrome and excess syndrome(P>0.05).(2) Time of onset of chest pain and the corresponding western medical diagnosis: Patients are more concentrates in January to April. The time of onset is in the winter and early spring. The western medical diagnosis is the most common is coronary heart disease of185cases(92.5%). Secondly,in turn to have cardiac neurotic sign is4cases(2.0%),have high blood pressure is3cases(1.5%), have rheumatic heart disease is2cases (1.0%) and have hypertrophic cardiomyopathy is2cases(1.0%).(3)Syndrome type of coronary heart disease:Descending order of the number of cases,the syndrome type is blood stasis syndrome of195cases(90.7%), phlegm retention syndrome of158cases(73.5%), qi deficiency syndrome of133cases (61.9%), yin Deficiency syndrome of56cases(26.0%),qi stagnation syndrome of22cases(10.2%),yang deficiency syndrome of15cases(7.0%). In summary,descending order of the number of cases,total syndrome type is qi deficiency syndrome accompanied with phlegm and blood stasis of55cases (25.6%), phlegm-blood stasis syndrome of43cases (20.0%), qi-yin deficiency syndrome accompanied with phlegm and blood stasis of26cases(12.1%),qi deficiency and blood stasis syndrome of23cases (10.7%). In the syndrome type of deficiency and excess,the most commom is deficiency-excess miscellaneous syndrome of147cases(68.4%);the more common is excess syndrome of64cases(29.8%). Thirdly,deficiency syndrome has4cases (1.8%).(4)Syndrome type changes in some factors:①Gender:male patients in phlegm retention syndrome are more commom than female patients (P<0.05). Female patients in qi stagnation syndrome are more than male patients (P<0.05).②Age:Blood stasis syndrome is most common in70-79age group.③Number of diseased vessels: having a clear relationship about syndrome type. Qi deficiency syndrome is more common in the three vascular pathological changes(P<0.05). Deficiency-excess miscellaneous syndrome is more common in the three vascular pathological changes (P<0.05). A combination of three syndrome type is more common in the three vascular pathological changes(P<0.05).④The history of tobacco and alcohol:Non-Smoking is more common in yang deficieny syndrome,yin deficiency syndrome.(P<0.05). Drinking is more common in blood stasis syndrome(P<0.05).⑤Complications:Yang deficieny syndrome and blood stasis syndrome are more common in coronary heart disease accompanied by dyslipidemia history (P<0.05). Yin deficieny syndrome is more common in coronary heart disease accompanied by history of diabetes and abnormal blood glucose (P<0.05).⑥The remaining factors:The following factors have no significant relationship with syndrome type of coronary heart disease which including coronary angiography, the family history of coronary heart disease.(P>0.05).Conclusion:(1)The establishment of collateral circulation or not have affected by diabetes and hypertension. The establishment of collateral circulation can make the number of patients with qi deficieny syndrome,phlegm retention syndrome and blood stasis syndrome of TCM syndrome types reduce. The establishment of collateral circulation can make to alleviate the symptoms.(2)After stenting in the state of instability there are a series of reasons. Including:①More basic diseases, longer history;②Poor living habits usually,longer history of alcohol and tobacco;③The treatment effect is not ideal usually;④Using western drugs mainly,using Chinese medicine rarely,especially using the chinese herbs of promoting blood circulation and removing blood stasis;⑤The results of coronary angiography all showed no establishment of collateral circulation.(3)The pain of chest occurs in the winter and early spring and corresponds to a variety of western diagnostic.(4)The common syndrome types of coronary heart disease are blood stasis syndrome, phlegm retention syndrome, qi deficiency syndrome and yin deficiency syndrome. The specific syndrome types are most common in qi deficiency syndrome accompanied with phlegm and blood stasis and deficiency-excess miscellaneous syndrome(5)The following factors have influence on syndrome type including gender,age, collateral circulation,number of diseased vessels, the history of tobacco and alcohol, complications accompanied by dyslipidemia history,history of diabetes and abnormal blood glucose. Other factors have no significant relationship with syndrome types.