Exploration Of The Distribution Of TCM Syndrome Factors In Patients With Coronary Heart Disease Based On FFR_CT

Objective:Based on the non-invasive blood flow reserve score of coronary CTA,the correlation between it and TCM elements and clinical indicators was studied,and the etiology and pathogenesis of TCM was explored,which provided an objective basis and theoretical support for the treatment of coronary heart disease by TCM.Methods:In this study,120 patients with coronary heart disease who met the inclusion and exclusion criteria in the inpatient department of Dongzhimen Hospital of Beijing University of Chinese Medicine from February 2018 to November 2021 were selected and divided into two groups according to their FFRCT values(FFRCT>0.8 group 54 cases,FFRCT≤0.8 group,66 cases).The general data of all patients,information of the four traditional Chinese medicine diagnosis,biochemical indicators,coronary CTA and FFRCT reports were collected.SPSS 26.0 software was used to analyze the distribution characteristics of the general data of the two groups of patients,the distribution of TCM syndrome elements,and the causal relationship between the lowest FFRCT value of the two groups of patients and their related indicators.P<0.05 means the difference is statistically significant.Results:1.General information:①There was no significant difference in the average age of patients with coronary heart disease between the two groups(P>0.05).The patients in the two groups were concentrated in the age group of 61-70 years old,accounting for 37.04%and 34.85%respectively.In the FFRCT≤0.80 group,patients over 60 years old accounted for more patients than in the FFRCT>0.80 group;②There was a significant difference in gender distribution between the two groups(P<0.05),and the male and female patients in the FFRCT>0.80 group accounted for 38.90%and 63.64%,respectively.Male and female patients in the ≤0.80 group accounted for 61.11%and 36.36%respectively;③ There was no significant difference in the distribution of combined diseases between the two groups of patients with coronary heart disease(P>0.05);2.Distribution characteristics of TCM syndrome elements:①The top TCM syndrome elements of 120 patients with coronary heart disease were blood stasis,yin deficiency,qi deficiency,phlegm,heat,qi stagnation,dampness,yang deficiency,dynamic wind,and yang hyperactivity.The disease location syndrome elements with higher frequency were heart,mind,spleen,liver,and kidney;② There were statistically significant differences in the distribution of disease syndrome elements of the two groups in blood stasis,yin deficiency,heat,qi stagnation,and dynamic wind(P<0.05),and the distribution of disease position syndrome elements in the liver was statistically significant(P<0.05).For patients with FFRCT>0.8,the disease syndrome elements are blood stasis,heat,qi stagnation,phlegm,yin deficiency,qi deficiency,dampness,yang hyperactivity,yang deficiency,and wind movement,and the disease location syndrome elements are heart,liver,mind,spleen,Kidneys,lungs,stomach,bladder.For patients with FFRCT≤0.8,the syndrome elements of disease nature are blood stasis,yin deficiency,qi deficiency,phlegm,heat,wind movement,yang deficiency,qi stagnation,dampness,and yang hyperactivity,and the disease location syndrome elements are heart,mind,spleen,and kidney in order,liver,stomach,lung,and bladder;③There was no significant difference in the combinations of the first syndrome,the second syndrome,the third syndrome,the fourth syndrome,and the fifth syndrome(P>0.05).In patients with coronary heart disease with FFRCT>0.8,three syndromes are the most in the combination of syndrome elements.Qi stagnation and blood stasis have the highest correlation degree,and the common combination forms are qi stagnation and blood stasis phlegm,qi stagnation and blood stasis,and phlegm and blood stasis heat;the combination of disease location and syndrome elements is mainly concentrated in the second syndrome,and the heart and mind are the most correlated.The common combination forms are heart and liver,heart and mind,and liver,spleen and mind.The combined forms of syndrome elements in CHD patients with FFRCT≤0.8 are mainly concentrated in the second syndrome and the third syndrome.Yin deficiency and blood stasis have the highest correlation,and the common combination forms are qi deficiency yin deficiency phlegm,qi deficiency yin deficiency blood stasis,blood stasis qi deficiency phlegm,qi deficiency blood stasis.The combination of disease location and syndrome elements is mainly concentrated in the second and third syndromes,with the highest degree of correlation between mind and heart,and heart and spleen.The common combination forms are heart mind mind,mind spirit,mind spirit spleen,heart spleen kidney;3.Distribution characteristics of TCM syndromes of deficiency and excess:120 patients with coronary heart disease were mainly mixed with deficiency and excess syndrome.The empirical distribution of patients in the two groups was statistically significant(P<0.05).The number of confirmed cases of coronary heart disease patients with FFRCT>0.8 is more than that of patients with coronary heart disease with FFRCT≤0.8;4.Linear regression analysis of relevant indicators and the lowest FFRCT value:① The relationship between the lowest FFRCT value of 120 patients with coronary heart disease and the left anterior descending branch(LAD),left circumflex branch(LCX)and right coronary artery(RCA)FFRCT value was significantly correlated with UA(P<0.05);②The lowest FFRCT value of patients with coronary heart disease with FFRCT>0.8 was significantly correlated with FFRCT value of LAD,LCX,RCA,FBG,and UA(P<0.05);③The lowest FFRCT value of coronary heart disease patients with FFRCT≤0.8 was significantly correlated with the FFRCT value of LAD,LCX and RCA(P<0.05).Conclusions:Patients with coronary heart disease are mainly based on qi deficiency and yin deficiency,blood stasis,phlegm and heat as the standard,and the disease mainly involves the heart,mind,spleen,liver and kidney.The distribution of medical syndrome factors in the two groups of patients with coronary heart disease was correlated with FFRCT values.Blood stasis,yin deficiency,heat,qi stagnation,and wind movement are important symptom factors that promote the change of coronary vascular function.Liver regulation is of great significance in improving coronary vascular function in patients.The pathological factors of patients with FFRCT>0.8 are mainly Qi stagnation+blood stasis,and the disease location is mainly in the heart and mind.The pathological symptoms of patients with FFRCT≤0.8 are mainly yin deficiency+blood stasis,and the disease location is mainly in the heart,mind and spleen.Uric acid and fasting blood glucose were negatively correlated with FFRCT values.