The Relationship Between TCM Syndrome Types Of Unstable Angina Pectoris And Coronary Lesions And Heart Rate Variability

Purpose:Objective to analyze the relationship between TCM syndrome types of unstable angina pectoris(UA)and the severity of coronary artery disease and heart rate variability(HRV)of the three,to provide the reference for the severity of coronary artery lesions in patients with UA to predict and autonomic nerve function damage judgment.Material and method:All the patients were admitted to the Department of Cardiology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from March2015 to December 2016,and were diagnosed with UA by CAG.Of the 168 patients enrolled in this study,According to TCM dialectical divided into syndrome of qi stagnation and blood stasis group(43 cases),syndrome of blood stasis due to qi deficiencygroup(57 cases),syndrome of intermin-gled phlegm and blood stasis group(68 cases);according to the number of diseased coronary artery was divided into single vessel group(53 cases),double vessel lesion group(60 cases),multi vessel disease group(55 cases)according to the degree;coronary artery stenosis divided into mild stenosis group(27 cases),moderate stenosis group(79 cases),severe stenosis group(62 cases).The results of coronary angiography were normal and 24 hours dynamic electrocardiogram in the control group(54 cases).The HRV time domain index of all subjects was recorded with 12 lead Holter(model BI9800)within 72 hours of admission,standard deviation of all normal intervals(SDNN)、standard deviation of the average values of NN intervals(SDANN)、mean value of the standard deviations of all NN intervals(SDNN INDEX)、the square root of the mean of sum of the squares of differences between adjacent R-R intervals(RMSSD)、the percentage of adjacent NN intervals differing by more than 50ms(PNN50)、the adjacent NN intervals differing by more than 50ms(NN50)、HRV triangle index,record 24 hours.Results: 1.The single,double and multi vessel lesions were divided into three grades,rank sum test,syndrome of qi stagnation and blood stasis group,syndrome of blood stasis due to qi deficiency group,syndrome of intermin-gled phlegm and blood stasis group of lesion grade distribution had significant difference(p<0.05),the number of coronary artery lesions with syndrome of qi stagnation and blood stasis group>syndrome of blood stasis due to qi deficiency group>syndrome of intermin-gled phlegm and blood stasis group trend.2.Mild,moderate and severe according to the severity of coronary artery disease lesions were divided into three levels,the rank sum test showed no significant differences between the syndrome of qi stagnation and blood stasis group,syndrome of blood stasis due to qi deficiency group,syndrome of intermin-gled phlegm and blood stasis group(P>0.05);but the severity of lesions with syndrome of qi stagnation and blood stasis group>syndrome of blood stasis due to qi deficiency group>syndrome of intermin-gled phlegm and blood stasis group trend.3.Compared with control group,SDNN,SDANN,SDNN INDEX in syndrome of qi stagnation and blood stasis group,syndrome of blood stasis due to qi deficiency group and syndrome of intermin-gled phlegm and blood stasis group were significantly lower(P<0.05);and compared with syndrome of qi stagnation and blood stasis group and syndrome of blood stasis due to qi deficiency group,SDNN in syndrome of intermin-gled phlegm and blood stasis group was lower(P<0.05);and compared with control group,RMSSD in syndrome of qi stagnation and blood stasis group and syndrome of intermin-gled phlegm and blood stasis group were lower(P<0.05);and compared with control group,HRV triangle index in syndrome of blood stasis due to qi deficiency group and syndrome of intermin-gled phlegm and blood stasis group was lower(P<0.05);compared with syndrome of qi stagnation and blood stasis group,HRV triangle index in syndrome of intermin-gled phlegm and blood stasis group was lower(P<0.05).4.Compared with control group,SDNN,SDANN,SDNN INDEX in single vessel disease group,double vessel disease group and multivessel disease group were significantly lower(P<0.05);and compared with single vessel disease group anddouble vessel disease group,SDNN,SDANN in multivessel disease group were significantly lower(P<0.05);compared with control group,RMSSD,PNN50,HRV triangle index in double vessel disease group and multivessel disease group were lower(P<0.05);compared with single vessel disease group,HRV triangle index in double vessel disease group and multivessel disease group were significantly lower(P<0.05).5.Compared with control group,SDNN in mild stenosis group,moderate stenosis group and severe stenosis group was significantly lower(P<0.05);and compared with mild stenosis group and moderate stenosis group,SDNN in severe stenosis group was lower(P<0.05);SDANN between the four groups was control group>mild stenosis group>moderate stenosis group>severe stenosis group(P<0.05);compared with control group and mild stenosis group,SDNN INDEX in moderate stenosis group and severe stenosis group was lower(P<0.05);compared with control group,HRV triangle index in moderate stenosis group and severe stenosis group was lower(P<0.05).Conclusion: 1.UA of TCM syndrome types is associated with the severity of coronary artery disease,qi stagnation and blood stasis,Qi deficiency and blood stasis and phlegm and blood stasis in the three group,phlegm and blood stasis syndrome of most lesions,followed by qi deficiency and blood stasis,qi stagnation and blood stasis syndrome lesions lightest.2.UA patients with HRV decreased,there is impaired autonomic function;correlation exists between HRV and traditional Chinese medicine syndrome,phlegm and blood stasis group HRV was significantly lower than that of qi deficiency and blood stasis group and qi stagnation and blood stasis group;HRV decreased with the severity of coronary artery disease.