Tcm Syndrome Characteristics Of Hospitalized Patients With Coronary Heart Disease, Diabetes Mellitus And Prognosis Research Related To The Physical And Chemical Indicators

Objective:The results of our research about the standard of characteristics syndrome element、 CRP and serum lipid of the patients suffered Coronary Heart Disease(CHD) complicated by Type2Diabetes Mellitus(T2DM),along with the occurrence of the cardiovascular events within one year,shows there influence with the prognosis, which has clinical reference significance in improving the dialectical analysis.Methods:We did a cross-sectional study and one year follow-up of3537CHD patients,1137of them was complicated with T2DM. The TCM dialectical analysis was made according to the "CAIM(Chinese Association of the Integration of Traditional and Western Medication)". We used the SPSS17.0statistic analysis software. X2test and t-test was used to do the univariate analysis and logistical test was used to do the multiplicity. The data analysis was about the characteristically dialectical analysis of the patients with or without T2DM, and the influence of the prognosis.The major adverse cardiac events were also analyzed.We made all the patients into several subgroups as follows:①CHD complicated by T2DM and blood sugar higher than or equal to6.1mmol/L and CHD definitive no T2DM and blood sugar less than6.1mmol/L.②CHD complicated by T2DM and blood lipid higher or less than normal level.③CHD complicated by T2DM and Hs-CRP higher or less than normal level,and did some comparison to analysis the relationship between cardiovascular events and physicochemical indexes.Results:1.General information:The age of3537CHD patients is from24-94years old.The average age is24-94(64.88±11.98).2314(65.4%) of them are male and1223(34.6%)are female.469patients has a major adverse cardiac events in one year and the incidence rate is13.3%.1137(32.1%) patients,aged25-93,are accompanied with T2DM.The average age of them is66.33±11.20.Of those patients,674(59.4%) are male and462(40.6%) are female and190of them have a major adverse cardiac events in one year,with the incidence rate of16.7%.2.The distribution characteristic of TCM dialectical analysis of CHD:blood stasis>qi deficiency>phlegm turbid>yin deficiency> qi stagnation; the occurrence frequency of the first three elements are higher, more than40%.The distribution characteristic of TCM dialectical analysis of CHD accompanied with T2DM:blood stasis>qi deficiency>phlegm turbid>yin deficiency> yang deficiency;the occurrence frequency of the first three elements are higher, more than40%. Compared with CHD, yang deficiency syndrome was higher. The result is almost similar with that of the CHD patients, apart from that the occurrence frequence of yang deficiency is higher.3.With the CHD complicated with/without T2DM as the dependent variable, with the syndrome factors as the arguments to do the binary logistic regression analysis,and moderate the age and sex, the result shows:qi deficiency(p=0.046;OR=1.193), yin deficiency (P=0.000; OR=1.462)、yang deficiency(P=O.003; OR=1.723)、heat syndrome (P=0.023; OR=1.634) has statistical differences, which means compared with the CHD patients without T2DM, the related syndrome factors of CHD patients with T2DM are qi deficiency、yin deficiency、yang deficiency and heat syndrome. To further reduce the simple size, with the FBG level of6.1mmol/L as the delaminating criterion, the patients was divided into two groups:CHD patients complicated with T2DM with poorly-controlled blood sugar and the CHD patients without T2DM with well-controlled blood sugar. The syndrome factors of both groups are brought into the binary logistic regression analysis, the age and sex are both being moderated simultaneously, the results shows yin deficiency(P=0.000,0R=1.287)、phlegm turbid(P=0.013,0R=1.583)、yang deficiency(P=0.033,0R=1.634) have the statistical differences, which means the main related syndrome factors of CHD patients accompanied with T2DM with poorly-controlled blood sugar are phlegm turbid、yin deficiency and yang deficiency, compared with the CHD patients without T2DM with well-controlled blood sugar.4.The syndrome elements of CHD accompanied with/without T2DM and the prognosis:The patients who have the cardiovascular event was divided into four groups:the CHD patients complicated with/without T2DM、 the CHD patients complicated T2DM whose FPG was higher than6.1mmol/L and the CHD patients without T2DM. We have done a comparison between the former2and the latter2groups and the both of the results show that phlegm turbid is the most related factor.5.The serum lipid of CHD patients and the prognosis:The patients are divided into4groups:①TC higher than or equal to1.7mmol/L and TC less than1.7mmol/L.②LDLC higher than or equal to3.37mmol/L and LDLC less than3.37mmol/L.③HDLC less than or equal to1.7mmol/L and HDLC higher than1.04mmol/L.④TG higher than or equal to5.18mmol/L and TG less than5.18mmol/L. The results show no statistical differences.6.The hs-CRP of CHD patients accompanied with T2DM and the prognosis:In all the cases that selected,570patients has accurate hs-CRP index and61(10.7%) of them had cardiovascular events within one year. Rank sum test shows that those who suffered cardiovascular events have higher hs-CRP level.Conclusion:1.The main related factors of CHD patients and CHD patients accompanied with T2DM are blood stasis, qi deficiency and phlegm.2.Compared with the CHD patients without T2DM,the main related factors of CHD patients accompanied with T2DM are qi deficiency、yin deficiency、yang deficiency and heat syndrome.3.Compared with the CHD patients without T2DM, the cardiovascular events related syndrome factors of the patients accompanied with T2DM is phlegm.4.CHD patients accompanied with T2DM who suffered cardiovascular event have high HS-CRP level, which means the HS-CRP level may increase the risk of the incidence of cardiovascular event of the CHD patients accompanied with T2DM.