Analysis Of The Characteristics Of TCM Syndrome Elements In Different Lesions Of Coronary Heart Disease And Its Correlation With Blood Lipid

Objective:To explore the characteristics of TCM syndrome elements in Coronary Heart Disease patients with different lesions and the correlation between TCM syndrome elements and blood lipids,provide potential basis for objectification of TCM syndrome elements of CHD and determination of high-risk groups of CHD from the perspective of TCM syndrome elements,and provide personalized treatment plans for CHD patients.Methods:A total of 271 patients with coronary artery stenosis who were hospitalized in the Department of Cardiovascular Medicine of Wuhan First Hospital from August 2020 to December 2021 underwent coronary angiography were collected.Combined with the clinical symptoms,signs and related examination results,the patients were divided into three groups according to the degree of coronary artery lesions shown by coronary angiography:moderate stenosis group,severe stenosis group and occlusion group.1.Classification and quantification of TCM syndrome elements according to the combination of TCM four diagnoses and TCM syndrome elements scale of Coronary Heart Disease;2.According to the data collection schedule,collected patients’general information,the result of coronary angiography,blood lipid;3.The distribution law of TCM syndrome elements and the difference of the score of each syndrome element were compared among all groups,the difference of Gensini score of each TCM syndrome element was analyzed,and the correlation between the score of each TCM syndrome element and Gensini score and the level of each blood lipid was discussed.Results:1.Baseline data:A total of 271 subjects meeting the criteria were included in this study,including 98（36.16%）in moderate stenosis group,92（33.95%）in severe stenosis group,and 81（29.89%）in occlusion group.There were 175 male patients（64.58%）and 96female patients（35.42%）.114 cases（42.07%）had smoking history;Average age:64.08±10.08 years;BMI was 23.55±2.24kg/m~2.206 cases（76.01%）were complicated with hypertension.108cases（39.85%）with type 2 diabetes mellitus;101 cases（37.27%）with hyperuricemia;42 cases（15.50%）had a family history of CHD.There were no significant differences in gender、age、BMI、history of Hypertension、history of Hyperuricemia and family Cardiovascular disease.but significant differences in smoking history and past history of type 2 diabetes among the three groups（P<0.05）.2.The analysis results of TCM syndrome elements showed that the distribution of blood stasis syndrome,phlegm turbidness syndrome,cold coagulation syndrome,Qi deficiency syndrome and Yang deficiency syndrome had significant differences among the three groups（P<0.05）.The TCM syndrome elements score of blood stasis syndrome,phlegm turbidity syndrome,cold coagulation syndrome,Qi deficiency syndrome and Yang deficiency syndrome had statistical significance among the three groups（P<0.05）.3.There was significant difference in Gensini score among TCM syndrome elements（P=0.000<0.05）,the minimum value is 2 points,and the maximum value is 210 points,and M（P25,P75）was 38（15,77）points.The TCM syndrome elements score of blood stasis syndrome,phlegm turbidness syndrome,cold coagulation syndrome and Qi deficiency syndrome was positively correlated with Gensini score（P<0.05）.4.There was no significant difference in Triglyceride（TG）level among 3 groups（P=0.102）,while there were significant differences in Low Density Lipoprotein Cholesterol（LDL-C）,Total Cholesterol（TC）,High Density Lipoprotein Cholesterol（HDL-C）,Apolipoprotein A1（Apo A1）and Apolipoprotein B（Apo B）levels among 3groups（P<0.05）.The score of Qi stagnation syndrome,blood stasis syndrome and phlegm turbidity syndrome was positively correlated with TC level（P<0.05）,the score of Qi stagnation syndrome and blood stasis syndrome was positively correlated with TG level（P<0.05）,the score of blood stasis syndrome and phlegm turbidity syndrome was positively correlated with LDL-C level（P<0.05）,and the score of blood stasis syndrome and phlegm turbidity syndrome was negatively correlated with HDL-C level（P<0.05）.The score of cold coagulation syndrome was negatively correlated with Apo A1 level（P<0.05）,while the score of Qi stagnation syndrome and phlegm turbidity syndrome was positively correlated with Apo B level（P<0.05）.Conclusion:1.In this study,the proportion of CHD TCM syndrome elements was blood stasis>phlegm turbidity>Qi deficiency>Qi stagnation>cold coagulation>Yin deficiency>Yang deficiency>heat accumulation.2.CHD may have some correlation with the degree of coronary lesion stenosis.When coronary artery stenosis was moderate,TCM syndrome elements were mostly Qi deficiency syndrome.When the degree of stenosis was severe or even occlusion,TCM syndrome differentiation mostly showed sputum turbidity syndrome and blood stasis syndrome.3.The TCM syndromes of CHD may have a certain correlation with Gensini score of coronary artery,and the scores of blood stasis,phlegm turbidity,cold coagulation and Qi deficiency syndrome were positively correlated with Gensini score.4.There was a certain correlation between TCM syndrome elements of CHD and blood lipid level,Worsening of Qi stagnation is associated with elevated TC,TG and Apo B.When blood stasis was obvious TC,TG and LDL-C increased.The gradual aggravation of phlegm turbidity syndrome suggested the increase of TC,LDL-C and Apo B,and the decrease of HDL-C.Cold coagulation syndrome can be manifested as decreased Apo A1.