Study On The Evolution Of TCM Syndromes After Percutaneous Coronary Intervention In Patients With Coronary Heart Disease

Research purposesTo explore the distribution characteristics and evolution rules of TCM syndrome types in patients with coronary heart disease after percutaneous coronary intervention,study the influence of common risk factors of coronary heart disease on the syndrome types after intervention,and analyze and discuss the evolution mechanism of postoperative patients’ syndrome types and dialectical treatment ideas,so as to provide reference for syndrome differentiation in the formulation of Chinese medicine prescriptions for postoperative cardiac rehabilitation by stages,individual and precise.Research methodsThe in-patient and out-patient information of 353 patients with coronary heart disease undergoing percutaneous coronary intervention were collected at six time points before surgery,3 days after surgery,1 week after surgery,4 weeks after surgery,12 weeks after surgery,and 24 weeks after surgery.The patients were classified by TCM syndrome differentiation combined with eight-line syndrome differentiation,qi and blood syndrome differentiation and zang-organ syndrome differentiation.EXCEL and SPASS software were used to analyze the distribution and evolution of TCM syndromes at different stages after intervention,explore the influence of common risk factors of coronary heart disease on the distribution and evolution of various syndromes,and discuss the reasons for the evolution of patients’ syndromes and postoperative diagnosis and treatment ideas.ResultsThe basic characteristics of coronary heart disease before and after PCI are the deficiency of the original and the actual condition.Before surgery,there were mainly syndrome of blood blood stasis,phlegm-turbidity-blocking syndrome and syndrome of qi stagnation and blood stasis,and the empirical evidence was significantly more than the deficiency syndrome.However,the proportion of empirical evidence decreased after surgery,and the deficiency syndrome gradually increased.After intervention,the proportion of sthenia syndrome showed a decreasing trend,while deficiency syndrome showed a gradually increasing trend.At 4 weeks after surgery,the overall distribution of deficiency syndrome was more than sthenia syndrome,which was significantly increased compared with 3 days and 1 week after surgery,and the majority of the syndrome were qi deficiency and blood stasis and Qi Yin deficiency.The proportion of sthenia syndrome increased slowly at 12 and 24 weeks after surgery.At 12 weeks after surgery,qi deficiency and blood stasis syndrome and phlegm-turbidity-blocking syndrome were the main symptoms.At 24 weeks after surgery,the number of sthenia syndrome was significantly higher than that at 4 weeks and 12 weeks after surgery,but significantly lower than that before surgery.Phlegm-turbid-occlusive syndrome and Qi deficiency and blood stasis syndrome occupy a large proportion in each stage,and interventionism has little influence on them.Interventionary therapy mainly improves the solid evil such as blood stasis and qi stagnation,and aggravates qi deficiency,Yin deficiency and Yang deficiency.Among the common risk factors,the syndrome of blood stasis increased significantly in patients with hypertension,the syndrome of qi stagnation and blood stasis was more than patients without hypertension at 1 week,4 weeks and 24 weeks after surgery,and the syndrome of Qi and Yin deficiency increased significantly at 4weeks and 12 weeks after surgery.Intervention had a significant improvement effect on the syndrome of blood stasis.The syndrome of Qi and Yin deficiency and the syndrome of heart and kidney and Yin deficiency increased significantly in patients with diabetes,and the syndrome of qi stagnation and blood stasis improved significantly after intervention.The syndrome of phlegm-turbidity-blocking in patients with abnormal blood lipid was significantly more than that in patients with normal blood lipid in each period.PCI could significantly improve the syndrome of Qi stagnation and blood stasis caused by phlegm turbidity-induced,but had little effect on phlegm turbidity-induced phlegm itself.At the same time,the syndrome of Qi deficiency and blood stasis increased significantly.The syndrome of phlegm-turbidity-blocking in smokers was significantly more than that in non-smokers,the syndrome of qi deficiency and blood stasis was more than that in non-smokers 3 days,1 week and 12 weeks after surgery,and the syndrome of heart-kidney Yang deficiency was less than that in nonsmokers.The syndrome of phlegm turbidities was significantly more in overweight or obese patients,and the syndrome of qi deficiency and blood stasis was less in patients with normal weight before surgery,3 days after surgery,1 week after surgery and 24 weeks after surgery.ConclusionThe distribution of TCM syndrome types after PCI is dynamic and stable at the same time,4 weeks after the operation is an important turning point for the change of syndrome types,and the deficiency and deficiency of syndrome types change significantly before and after the operation.In terms of remote curative effect,intervention cannot change the basic pathological characteristics of deficiency and deficiency in patients with coronary heart disease,and "phlegm","blood stasis" and "deficiency" run through the development of coronary heart disease.Overall treatment should not only grasp the three principles of treating phlegm and blood stasis together,tonifying qi and Qi,and warming heart and Yang,but also adjust according to the characteristics of syndrome types at each stage.For example,one week after the operation,positive qi begins to decline,and supplemented by tonifying qi should be supplemented at the same time.Four weeks after the operation,positive deficiency is especially severe.Supplementing by invigorating qi and invigorating qi and warming Xinyang,activating blood and eliminating phlegm,should be taken as the main method.12 weeks after the operation,the recurrence of solid evil,activating blood and eliminating phlegm for qi can be added as appropriate;24 weeks after the operation,the number of positive evidence increased significantly,when increasing the application of dispelling pathogenic drugs,at the same time,the deficiency is still the essence of the disease,can not sacrifice the essentials.Risk factors have a certain influence on the distribution of TCM syndrome types after surgery.Patients with hypertension,diabetes,dyslipidemia,smoking and overweight or obesity have different characteristics of syndrome types.Moreover,patients with coronary heart disease are often combined with a variety of risk factors,which makes the syndrome type more complicated.Combined with traditional Chinese and western medicine,cardiac rehabilitation is a comprehensive assessment of the overall risk factors of patients,risk stratification,strengthening of traditional Chinese medicine intervention,clear thinking in syndrome differentiation,combined with the overall concept,to distinguish the primary and secondary,highlighting the unique advantages of syndrome differentiation.