| Objective:To study the distribution characteristics of TCM syndrome types in elderly patients with blood stasis syndrome of chronic coronary syndrome,compare the indicators among different syndrome types in elderly patients with blood stasis syndrome of chronic coronary syndrome,and analyze the correlation between different syndrome types and physical and chemical indicators in elderly patients with blood stasis syndrome of chronic coronary syndrome.Methods:Clinical data of elderly patients diagnosed with chronic coronary syndrome and blood stasis syndrome admitted to the cardiovascular Department of Guang ’anmen Hospital,China Academy of Chinese Medical Sciences from June 2020 to July 2022 were retrospectively collected.Gathering the general information,clinical,physical and chemical indicators,echocardiogram,carotid artery ultrasonography and coronary angiography or coronary computed tomography(ct)scan data,through the establishment of database,Excel to the above information by using SPSS statistical analysis software,conform to the normal distribution parameter measurement data to mean±standard deviation(χ+S)said,The comparison of data groups conforming to normal distribution was performed by single factor ANOVA analysis of variance.Count data were expressed as frequency,chi-square test was used,and Fisher exact test was selected for cell<5 or sample size less than 40.The non-normally distributed data were expressed as median and percentile,and the non-parameter/rank sum test was used for comparison between groups.Multivariate Logistic regression analysis was carried out with general data,physical and chemical indexes and examination related parameters as independent variables,and TCM syndrome types as dependent variables.P<0.05 was considered to be statistically significant.Results:1 A total of 307 patients with chronic coronary syndrome were included in this study,with a sex ratio of 1:1.07,and females were more than males.The average age was 73.8±7.0 years old,and the average age of females was higher than that of males.The average age of females was stratified every 5 years,and the most patients with chronic coronary syndrome were aged 65-69 years old,87 in total,accounting for 28.3%.High blood pressure,hyperlipidemia and type 2 diabetes were the top three in the history.2 Among 307 elderly patients with blood stasis syndrome of chronic coronary syndrome,the distribution frequency of different blood stasis syndrome types from high to low was as follows:syndrome of Qi deficiency and blood stasis(30.6%)>syndrome of heat toxicity and blood stasis(19.6%)>syndrome of blood deficiency and blood stasis(16.6%)=syndrome of phlegm turbidity and blood stasis(16.6%)>syndrome of Qi stagnation and blood stasis(9.4%)>syndrome of cold coagulation and blood stasis(7.2%).3 The results of one-way analysis of variance showed that the ratio of male to female in patients with syndrome of Qi stagnation and blood stasis was statistically different from that of syndrome of Qi deficiency and blood stasis and syndrome of phlegm turbidity-blood stasis,and the proportion of drinking in syndrome of phlegm turbidity-blood stasis was higher than that of syndrome of blood deficiency and blood stasis.4 The results of multivariate Logistic regression analysis of general conditions showed that the proportion of hypertension in patients with heat poison and blood stasis syndrome(91.7%)was higher than that of patients with blood deficiency and blood stasis syndrome(80.4%)and qi stagnation and blood stasis syndrome(72.4%),and the proportion of hyperlipidemia in patients with heat poison and blood stasis syndrome(86.7%)was higher than that of patients with phlegm turbidity and blood stasis syndrome(70.6%).The proportion of type 2 diabetes in patients with heat-toxin-blood-stasis syndrome(55.0%)was higher than that with cold-coagulation blood-stasis syndrome(18.2%),suggesting that the above diseases were related to the formation of heat-toxin-blood-stasis syndrome.5 The comparison of physical and chemical indexes of different syndrome types showed that the Cr level of patients with Qi-stagnation and blood-stasis syndrome was significantly lower than that of Qi-deficiency and blood-stasis syndrome group and phlegm-turbidity-bloodstasis syndrome group;The level of HbAlc in Qi deficiency and blood stasis syndrome and heat poison and blood stasis group was significantly higher than that in cold coagulation and blood stasis syndrome group;Univariate analysis of variance showed that the UA level of patients with phlegm-turbidity and blood-stasis syndrome was higher than that of other groups.In terms of coagulation function,PT increased in patients with phlegm-turbidity-blood-stasis syndrome was higher than that with heat-toxin-blood-stasis syndrome.In terms of myocardial enzymes,the non-parametric test results showed that the Myo level in the heat-toxin-bloodstasis syndrome group was significantly higher than that in the qi stagnation and blood-stasis syndrome.The multivariate Logistic regression analysis results showed that the proportion of elevated LDH in the heat-toxin-blood-stasis syndrome patients was higher than that in the qi deficiency and blood-stasis syndrome,the blood deficiency and blood-stasis syndrome and the phlegm-turbidity-blood-stasis syndrome.6 The non-parametric test analysis results of cardiac ultrasound showed that there were statistical differences in the left anterior and posterior atrial diameter among different syndrome types.The results of multivariate Logistic regression analysis showed that the left anterior and posterior atrial diameter increased significantly in the syndrome of Qi deficiency and blood stasis,blood deficiency and blood stasis,and phlegm-turbidity and blood stasis.7 Multivariate Logistic regression analysis of coronary artery CTA/coronary angiography showed that the coronary artery stenosis site in patients with Qi deficiency and blood stasis syndrome was left anterior descending branch+left circumferent branch,which was higher than that in patients with heat toxin and blood stasis syndrome,and the coronary artery calcification score ≥400 in patients with blood deficiency and blood stasis syndrome was higher than that in patients with heat toxin and blood stasis syndrome.Conclusion:1 The syndrome types of elderly CCS patients are related to gender and previous disease history.Women are related to the formation of qi stagnation and blood stasis syndrome,drinking is related to the formation of phlegm turbid blood stasis syndrome,hypertension,hyperlipidemia,and type 2 diabetes are related to the formation of heat toxin and blood stasis syndrome,and qi deficiency and blood stasis syndrome is the most common syndrome type in elderly CCS patients.2 The differences in laboratory indicators of syndrome types in elderly CCS patients are mainly concentrated in renal function,HbA1c,NT-proBNP,and myocardial enzymes.In terms of renal function,the Cr level in patients with Qi deficiency and blood stasis syndrome and phlegm turbidity and blood stasis syndrome is significantly higher than that of Qi stagnation and blood stasis syndrome.The UA level in patients with phlegm turbidity and blood stasis syndrome is higher than other syndromes.The HbAlc level in patients with Qi deficiency and blood stasis syndrome and heat toxin and blood stasis syndrome is significantly higher than that in cold coagulation and blood stasis syndrome.Heat toxin and blood stasis syndrome is more prone to an increase in NT-proBNP.In terms of myocardial enzyme levels,the Myo level in patients with heat toxin and blood stasis syndrome is significantly higher than that in Qi stagnation and blood stasis syndrome,and they are more prone to an increase in LDH.3 Traditional Chinese medicine syndrome types can reflect heart and coronary artery diseases to a certain extent.Cardiac ultrasound segmentation shows that Qi deficiency and blood stasis syndrome,blood deficiency and blood stasis syndrome,and phlegm turbidity and blood stasis syndrome are more prone to an increase in the anterior and posterior diameter of the left atrium;In terms of coronary CTA/coronary angiography,patients with Qi deficiency and blood stasis syndrome are more likely to experience stenosis of the left anterior descending branch and left circumflex branch of the coronary artery. |
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