| Objective: Based on clinical research and the method of syndrome element differentiation,this study explores the distribution of syndrome elements in obese patients with Coronary Heart Disease(CHD)and the relationship between physicochemical indexes and syndrome element,in an attempt to provide the basis for the early intervention of traditional Chinese medicine and syndrome differentiation of obese patients with CHD.Methods: With the "four diagnosis information collection table",the four diagnosis information of patients with coronary heart disease was collected.Meanwhile the study adopts the method of syndrome element differentiation.In the meantime,the study records the gender,age,height,weight,waist circumference,diet,smoking and drinking hobbies,blood pressure,and the patients’ hypersensitivity CRP,blood lipid,blood glucose,blood homocysteine,and uric acid levels was measured.At the same time,the patients were grouped into coronary heart disease obesity group,coronary heart disease non-obesity group according to the patient’s body mass index,then do some statistical processing for the analysis of the distribution of TCM syndrome element in the groups and the comparison of differences in syndrome element and related factors between groups.Results:1.Characteristics of syndrome elements in patients with coronary heart disease:The sequence of frequency of syndrome elements of disease sites are as follows: heart > liver >lung > spleen > kidney;the sequence of frequency of excess syndrome elements are as follows: phlegm > dampness > blood stasis > heat > qi stagnation > yang hyperactivity;the sequence of frequency of deficiency syndrome elements are as follows: Yin deficiency > Qi deficiency > Yang deficiency > blood deficiency.2.Clustering characteristics of syndrome element are as follows:Kidney,Yang hyperactivity are classified as one category;Liver,Yin deficiency,heat are classified as one category;Lung,qi stagnation,blood stasis,heart are classified as one category;Spleen,phlegm,dampness and other syndrome elements are classified as one category.3.Characteristics of syndrome elements in obese patients with coronary heart disease:the main disease sites are heart and spleen,followed by liver,lung,gall,kidney,stomach;the main excess syndrome elements are as follows: phlegm,dampness,heat,blood stasis,qi stagnation,Yang hyperactivity;while qi deficiency,blood deficiency,yin deficiency,yang deficiency are the main deficiency syndromes.4.The disease sites of non-obese patients with coronary heart disease are mainly in heart,followed by lung,liver,gallbladder,kidney,spleen and stomach;the main excess syndrome elements are as follows: phlegm,dampness,blood stasis,heat,qi stagnation and yang hyperactivity;the main deficiency syndrome elements are as follows: yin deficiency,Qi deficiency,Yang deficiency and blood deficiency.Compared with the non-obese group of coronary heart disease,the frequency of spleen syndrome element and the score of syndrome elements are higher in obese patients with coronary heart disease;In addition,the frequency of phlegm,dampness,qi stagnation,qi deficiency,and yang deficiency syndrome element and the score of syndrome elements are higher in obese patients with coronary heart disease than those in non-obese patients with coronary heart disease.5.The relationship between syndrome element and gender: Among obese patients with coronary heart disease,the scores of kidney and yin deficiency syndrome element in women are higher than those in men,and the difference is statistically significant(P <0.05).The scores of heart,spleen,phlegm,dampness,and yang deficiency syndrome element in male coronary heart disease obesity group are higher than those in coronary heart disease non-obese group,and the difference is statistically significant(P <0.05).The scores of heart,gallbladder,phlegm,dampness,and heat syndrome element in female coronary heart disease obesity group are higher than those in coronary heart disease non-obese group,and the difference is statistically significant(P <0.05).6.The relationship between syndrome element and age: The scores of heart,phlegm and yang deficiency syndrome element in the obese elderly group with coronary heart disease are higher than those in the middle-aged group,and the difference is statistically significant(P <0.05).In the middle-aged people(41-65 years old),the scores of heart,phlegm,dampness,yang deficiency,and qi deficiency syndrome element in coronary heart disease obesity group are higher than those in coronary heart disease non-obese group,and the difference is statistically significant(P <0.05).In the elderly(> 65 years),the scores of heart,phlegm and dampness syndrome element in coronary heart disease obesity group are higher than those in coronary heart disease non-obese group,and the difference is statistically significant(P<0.05).The score of yin deficiency syndrome element in non-obese group of coronary heart disease is higher than that of obesity group of coronary heart disease,and the difference is statistically significant(P <0.05).7.The relationship between syndrome element and physicochemical indexes: Among obese patients with coronary heart disease,high-density lipoprotein is negatively correlated with Qi stagnation;fasting blood glucose is positively correlated with Qi stagnation and dampness.In patients with coronary heart disease,BMI is negatively correlated with yin deficiency.Conclusion:1.Patients with CHD are mainly in the heart,and liver,lung,spleen,kidney related.The excess syndrome elements of CHD patients are mainly phlegm,dampness,blood stasis,heat and qi stagnation.2.The TCM pathological basis of obese patients with coronary heart disease is mainly phlegm,dampness and mixed qi stagnation,qi deficiency and yang deficiency,and the disease site is mainly at the heart and spleen.3.Female obese patients with coronary heart disease are mainly manifested by bile-heat phlegm disturbance,and their kidney and yin deficiency are more severe than men.4.As obese patients with coronary heart disease increase in age,the degree of heart,phlegm,dampness,and yang deficiency worsens;with obesity in patients with coronary heart disease,the degree of yin deficiency increases with age.5.Fasting blood glucose can be used as an objective index to measure the degree of qi stagnation and dampness in obese patients with coronary heart disease.HDL can reflect the degree of qi stagnation in obese patients with coronary heart disease. |
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