Correlation Between Carotid Atherosclerosis And Phlegm-blood Stasis Syndrome Elements Of Chest Pain In TCM

Objective:To analyze the distribution of TCM syndromes in 282 patients with chest distress and heartache in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,analyze the correlation between carotid atherosclerosis indexes and coronary artery stenosis,and analyze the correlation between chest distress and heartache phlegm-blood stasis syndrome elements and carotid atherosclerosis,in order to explore the correlation between TCM syndromes and modern medical examination indexes,and provide clinical basis for further improving the TCM diagnosis and treatment standard system.Methods:The subjects were patients with chest distress and heartache hospitalized in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from July 2021to June 2022.The clinical data of patients with chest distress and heartache,such as general information,TCM syndrome elements,medical history information,carotid Doppler ultrasonography and coronary CT angiography(coronary CTA),were collected.The case information record form was filled in and a database was established using Excel.Stata17.0was used for statistical analysis.Results:Of the 89 patients with chest distress and heartache who had the results of coronary CTA,42 had moderate stenosis and 47 had no moderate stenosis.There was no statistically significant difference in the history of chest distress and heartache,combined hypertension,and diabetes between the coronary artery stenosis group and the non-coronary artery stenosis group(P>0.05),and there was a statistically significant difference in gender and age combined with dyslipidemia(P<0.05);Spearman correlation analysis and logistic regression analysis showed that carotid Crouse score,semi-quantitative score,and grade score were significantly positively correlated with coronary artery stenosis(P<0.01);regression analysis of the three scores with the adjusted model showed that carotid Crouse score was significantly correlated with coronary artery stenosis(P<0.05);in the trend test,compared with the lowest score group,the trend of coronary artery stenosis in the high score group was significant(P<0.01),and the trend ranking between groups:Crouse score>grade score>semi-quantitative score;in the stratified analysis,the stability ranking of the three carotid artery scores associated with coronary artery stenosis:Crouse score>grade score>semi-quantitative score.Of the 282 patients with chest distress and heartache,20%were in the non-phlegm and non-blood stasis group,13%were in the phlegm-turbidity group,45%were in the blood stasis group,and 22%were in the phlegm-blood stasis group.There was no statistically significant difference in age,history of chest distress and heartache,combined hypertension,and dyslipidemia among the phlegm-blood stasis syndrome element groups(P>0.05),and there was a statistically significant difference in gender,history of PCI surgery,and combined diabetes(P<0.05);Spearman correlation analysis showed that phlegm-blood stasis syndrome element groups were significantly correlated with carotid Crouse score(r_s=0.1286,P<0.05);linear regression analysis showed that blood stasis group(β=0.48,P<0.05)and phlegm-blood stasis group(β=0.59,P<0.05)were statistically significant compared with non-phlegm-blood stasis group,and phlegm-turbidity group(β=0.59,P<0.05)was not statistically significant compared with non-phlegm-blood stasis group(P>0.05).Conclusion:1.Carotid Crouse score,semi-quantitative score and grade score were significantly positively correlated with coronary artery stenosis;comparing the three carotid artery scoring methods,carotid Crouse score was more strongly correlated with coronary artery stenosis,with more significant trend and stability between groups,and carotid Crouse score may be an ideal indicator for predicting and evaluating the degree of atherosclerosis and coronary artery stenosis.2.Chest distress and heartache phlegm-blood stasis syndrome elements have certain correlation with carotid atherosclerosis.Compared with non-phlegm-non-blood stasis syndrome elements,carotid Crouse score is higher in blood stasis group and phlegm-blood stasis group.Carotid Crouse score can provide reference for the grouping of chest distress and heartache phlegm-blood stasis syndrome elements.