Study On The Evolution Of TCM Syndrome Type After PCI And The Correlation Of The Quality Of Life And The Syndrome

Coronary atherosclerotic heart disease(CHD)is a major global public health problem,it is often referred simply to coronary heart disease and is expected to become the leading cause of global disease by 2020.The shortened life expectancy,declining quality of life and medical expenses which is caused by Coronary heart disease have placed a considerable burden on society.According to the 2017 Chinese cardiovascular disease report,the mortality rate of coronary heart disease is higher in China,with110.67/10 million in the city and 110.91/10 in the rural area,and the number of acute myocardial infarction(AMI)deaths has increased year by year.The treatment of coronary heart disease mainly includes the treatment of drugs,percutaneous coronary intervention(PCI)and surgery,and the effect of PCI is remarkable,it is widely used in clinical practice.The TCM syndromes of patients with coronary heart disease after PCI will tend to evolve.The previous studies are scattered and not systematic enough to further improve the relevant research.Objective:To investigate the evolution of TCM syndrome type after PCI and study the correlation between the relevant laboratory indicators and syndrome type at the same time,and further use Seattle angina pectoris to analyze the distribution of TCM syndrome type of patients after PCI and the quality of life,The relationship is expected to effectively guide effectively phased dialectical treatment in relevant patients based on the relationship between coronary heart disease syndromes and related laboratory indicators,the dynamic changes in coronary heart disease after PCI,and the relationship between postoperative syndrome distribution and quality of life.Method:The clinical questionnaire was used to collect the information of the enrolled patients.The baseline data,main symptoms,TCM syndromes,laboratory indicators,and the Seattle Angina Scale(SAQ)were collected.Baseline data and laboratory parameters were collected within 1 week before surgery.Blood samples were collected when the patient was hospitalized.The Seattle Angina Pectoris(SAQ)was recorded at 6 months after surgery.The rest of the data were recorded 1 week before surgery,Two weeks later,one month after surgery,and six months after surgery.Results:1.A total of 98 patients were enrolled in the study,49.0% had a history of smoking,34.7% had a history of drinking,60.2% had hypertension,26.5% had diabetes,20.4% had a family history of coronary heart disease,6.1% patients prefer sweet taste,38.8% of patients prefer salty taste,14.3% of patients are addicted to spicy food,16.3% of patients are greasy.2.The first week before PCI,qi deficiency and blood stasis syndrome were the most,followed by sputum syndrome and heart blood stasis syndrome.The deficiency of heart-qi deficiency syndrome was the least.After one month,qi deficiency and blood stasis syndrome was the most,and Hanning heart syndrome was the least.Six months after the operation,Qi deficiency and blood stasis syndrome were the most,followed by heart-qi deficiency syndrome and heart-blood stasis syndrome,and Hanning heart syndrome was the least.There was no significant change in blood stasis syndrome,qi stagnation and blood stasis syndrome,and Cold coagulating heart pulse syndrome between preoperative and postoperative(P>0.05).the Syndrome of phlegm and blood stasis was significantly reduced(P<0.05)within the first 2 weeks of surgery compared with preoperative,and was significantly reduced at 6 months postoperatively compared with 2 weeks postoperatively(P<0.05).Heart-qi deficiency syndrome was significantly increased at 6 months after operation(P<0.01).Heart-yang Deficiency Syndrome significantly increased 1 month after operation compared with 1 week before operation(P<0.05).The deficiency of Qi and Yin deficiency was significantly increased in the first month after operation compared with the first week after operation(P<0.05).Qi Deficiency Blood Stasis Syndrome significantly decreased after 6 months compared with 2 weeks after operation(P<0.05).3.In the first week before PCI,blood stasis was the most and Yang deficiency was the least.After 2 weeks,the blood stasis syndrome was the most,and the cold stagnation syndrome was the least.One month after surgery,blood stasis was still the most,and cold stagnation was the least.Six months after operation,Qi deficiency syndrome and blood stasis syndrome were the most,and cold stagnation syndrome was the least.Blood stasis syndrome decreased 1 month after surgery compared with 1 week before surgery(P<0.05),and was significantly decreased at 6 months after operation compared with 2 weeks after surgery(P<0.01).There was a statistically significant difference in the history of turbidity syndrome within 2 weeks after surgery(P<0.05).Qi stagnation did not change significantly at all stages(P>0.05).Cold coagulation syndrome was significantly reduced within 2 weeks and 6 months after operation compared with 1 week before surgery(P<0.05).Qi Deficiency Syndrome significantly increased within 2 weeks after operation compared with 1 week before operation(P<0.05),and it significantly increased at 1 month after operation compared with 1 week before operation(P<0.01).There was a significant increase in Yang deficiency syndrome at 6 months after surgery(P<0.01).4.Compared with PCI within 1 week before PCI,symptoms such as difficulty in falling asleep and symptoms of tetanic heart fever increased significantly within 2 weeks after operation,and symptoms of chest tightness decreased significantly(P<0.05)compared with 2 weeks after operation.In comparison,symptoms such as chest pain and difficulty in falling asleep were significantly reduced(P<0.05),sweating activity,urine clearing,and loose stools were significantly increased(P<0.05).Chest pain and difficulty falling asleep at 6 months after operation were significantly reduced.Reduction(P<0.01),active sweating and loose stools and other symptoms were significantly increased(P<0.01).5.Compared with 1 week before operation,the ratio of red tongue and thin yellow coating increased significantly(P<0.05)within 2 weeks after surgery,and the degree of tongue darkness,sublingual vein engorgement,and greasy yellow coating were reduced(P<0.05),pale tongue,thin tongue,and pale tongue tongue increased at 1 month after surgery(P<0.05)compared with 2 weeks postoperatively,while point gills,red tongue,and greasy moss were decreased(P<0.05).At 6 months after operation,except for pale tongue,dark purple tongue,thin tongue,and greasy tongue,which were similar to postoperative one month,the yellow tongue of the tongue was significantly reduced(P<0.05).Six months after operation and one month after operation,tongue images such as lean tongue and thin yellow tongue were significantly increased(P<0.05),while those with dark tongue,little moss or no tongue tongue were significantly reduced(P<0.05).).6.Compared with PCI within 1 week before PCI,deep pulse,taut pulse,slippery pulse and thready pulse,unsmooth pulse were all significantly reduced(P<0.05),and the rapid pulse increased(P<0.05)within 2 weeks after PCI.Compared with within 2 weeks after operation,the weak pulse increased significantly(P<0.05),the smooth pulse decreased significantly(P<0.05),and rapid pulse and smooth pulse decreased significantly after 6 months postoperatively(P<0.05).The weak pulse was significantly increased,and the difference was statistically significant(P<0.05).7.There was no significant difference in the indexes of blood lipids and coagulation time between the solid,deficiency and false and solid inclusion syndrome before PCI(P>0.05).8.There was no relationship between TCM syndrome type and the degree of physical activity limitation(PL)and disease awareness(DS)at 6 months after PCI(P>0.05).The stable state of angina(AS)was negatively correlated with age and yang deficiency and water pantograph(P<0.05),and the angina pectoris(AF)was negatively correlated with Syndrome of phlegm and blood stasis(P=0.001).The satisfaction of treatment(TS))It was also negatively correlated with Syndrome of phlegm and blood stasis(P=0.029).9.There was no relationship between TCM syndrome type and the degree of physical activity limitation(PL)and stable state of angina(AS)at 6 months after PCI(P>0.05).Angina pectoris(AF)was negatively correlated with turbidity syndrome(P<0.01),and satisfaction with treatment(TS)was also negatively correlated with turbidity syndrome(P=0.002),disease awareness(DS)and coronary heart disease family were also negatively correlated with turbidity syndrome(P<0.05).Conclusion:1.Patients with coronary heart disease requiring PCI operation often have multiple risk factors,which may affect the occurrence and development of the disease.2.There are dynamic changes of syndromes in each period after PCI.The syndrome of intermingled deficiency and excess is accompanied by various periods,and the proportion is the largest,but there is a trend of gradual decrease.The excess syndrome is more in the early stage after PCI,and gradually increases with the extension of the course of the disease.The deficiency syndrome occur less frequently in the early stage after PCI,and tend to increase gradually as the duration of the disease increases.3.Before PCI,the majority syndrome of coronary heart disease is excess syndrome and the syndrome of intermingled deficiency and excess,which contain Qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome and heart-blood stasis syndrome.in the early stage after PCI,the majority syndrome of coronary heart disease is also excess syndrome and the syndrome of intermingled deficiency and excess,which contain Qi deficiency and blood stasis syndrome,phlegm and stasis syndrome and the syndrome of deficiency of Qi and Yin.in the metaphase after PCI,the majority syndrome of coronary heart disease is deficiency syndrome and the syndrome of intermingled deficiency and excess,which contain Qi deficiency and blood stasis syndrome,the syndrome of deficiency of Qi and Yin and heart-blood stasis syndrome,in the later period after PCI,the majority syndrome is deficiency syndrome and the syndrome of intermingled deficiency and excess,which include Qi deficiency and blood stasis syndrome and heart Qi deficiency syndrome.4.The main treatment of coronary heart disease patients before PCI is mainly tonifying Qi and activating blood and eliminating phlegm,in the early stage after PCI,it should be tonifying Qi,activating blood,eliminating phlegm and nourishing yin,in the middle stage after PCI,the main treatment should be tonifying qi and activating blood and nourishing Qi and Yin,in the later stage after PCI,the main treatment should be tonifying Qi and activating blood.5.There was no significant difference in blood lipid and blood coagulation time between deficiency syndrome,solid syndrome and false and solid inclusion syndrome before PCI,indicating that these indexes were not correlated with these syndromes.6.Age and Yang deficiency and water flooding were negatively correlated with the stable state of angina(AS),and the syndrome of phlegm and blood stasis was negatively correlated with angina pectoris(AF)and treatment satisfaction(TS),respectively.And at the level of syndrome element,turbid syndrome can affect the quality of life of patients,including the onset of angina,satisfaction with treatment,and disease awareness.