A Retrospective Analysis Of The Elements Of Medical Syndrome In Young And Middle-aged Patients With Acute Coronary Syndrome

Objective: The distribution characteristics of TCM syndrome elements in young and middle-aged patients with acute coronary syndrome(ACS)were analyzed,and the relationship between external symptoms and internal symptoms was explored,in order to provide a basis for prevention and diagnosis and treatment for special age groups such as young and middle-aged ACS patients.Methods: Using retrospective analysis of cases,a total of 288 valid cases were included in the study of young and middle-aged ACS patients admitted to the Department of Cardiology,Department of Cardiac Rehabilitation of Changchun University of Chinese Medicine and Department of Cardiology of the Third Affiliated Clinical Hospital of Changchun University of Chinese Medicine from January 2019 to September 2022.The four diagnoses,general information and risk factors of patients were collected,and a database was established to analyze and summarize the distribution of general symptom elements of ACS in young and middle-aged people.Results:(1)The average age of all 288 young and middle-aged ACS patients was 50.77±7.09 years,and the male-female ratio was about 5.3:1,including 242 male patients(84.03%)and46 female patients(15.97%).There were differences in the composition of smoking history in the subgroups of ACS in young and middle-aged adults(P<0.05),and dyslipidemia in the subgroups of ACS in young and middle-aged adults(P<0.05).(2)The top four TCM syndrome factors in ACS for young and middle-aged people were blood stasis(61.11%),qi deficiency(55.9%),phlegm turbidity(45.83%),and yin deficiency(28.82%).Middle-aged and young ACS patients have chest pain and chest tightness as the main clinical symptoms,and the symptoms with a high proportion of the main symptom statistics can be roughly divided into four categories: one is chest fixed pain,purple tongue,pulse astringency and other blood stasis symptoms;The first type is chest pain,chest tightness,exertional exertion and other symptoms of qi deficiency;The first type is chest pain,chest tightness,heavy limbs and other symptoms of sputum turbidity;One type is chest pain,insomnia,night sweats and other symptoms of yin deficiency.Blood stasis is the main factor in the document syndrome;In the combination of double evidence,qi deficiency + blood stasis is the mainstay;The combination of three elements accounted for the highest proportion of blood stasis + qi deficiency + yin deficiency;Blood stasis + qi deficiency + phlegm turbidity + yin deficiency ranked first in the combination of four elements.The sex of young and middle-aged ACS patients was statistically significant in qi deficiency,blood stasis and sputum turbidity(P<0.05),and the gender of young and middle-aged ACS patients with diabetes was statistically significant in the yin deficiency and non-yin deficiency group(P<0.05).Conclusion:1.The distribution of ACS TCM syndrome elements in young and middle-aged people was mainly blood stasis,qi deficiency,phlegm turbidity and yin deficiency,among which deficiency was more common with qi deficiency and empirical evidence was more common with blood stasis;Moreover,it mostly appears in the form of symptom combinations,so in the treatment,the treatment principle is to invigorate qi and nourish yin,expectorant and remove stasis,which has guiding significance for the prevention and treatment of young and middle-aged ACS patients.2.288 young and middle-aged ACS patients,female patients had higher incidence of qi deficiency than men,and male patients had blood stasis and sputum turbidity than women.