| Acute coronary syndrome (ACS) is a severe and critical disease in coronary heart diease (CHD), whose incidence is rising. With high mortality and disablity rate, it has brought a heavy burden for the social development and family harmony. Modern medical diagnosis and treatment of the disease has made substantial progress; However, ACS treatment costs more and mortality as well as recurrence rates remains high. This study is based on traditional Chinese medicine theory and modern medical research, discussing ACS incidence and etiological factors. The first part of this study is ACS-related reference review exploring the current regularity of Chinese medicine syndrome and objective assessment indexes for progress in coronary heart disease and summing up the relationship between inflammatory factors and clinical syndrome.The second part is about large and multi-centeral clinical trials analyzing ACS's "Toxin-stasis" characteristics and exploring pathogenesis of Chinese "Toxin-stasis" for further prevention and treatment research.Objective:The ACS patients (case group) were considered as Chinese medicine "Toxin-stasis" syndrome group, The stable coronary heart diease(SCHD) patients (control group) were considered as non-"Toxin-stasis" syndrome group, two groups were compared difference at the macro and micro indexes, for summing up the ACS Chinese "Toxin-stasis" characteristics, providing the basis for etiology of Chinese medicine "Toxin-stasis", laying a foundation for early prevention,identification, intervention of "Toxin-stasis".Methods:This study is execute since January 1,2008 to December 30,2009, and is a multi-center, cross-sectional study of modern clinical epidemiology, including Xiyuan Hospital of China Academy of Traditional Chinese Medicine, China-Japan Friendship Hospital, Anzhen Hospital, Tongren Hospital affiliated to Capital Medical University, Beijing Military General Hospital, Zhongshan Hospital affliated to Shanghai Fudan University.All the CHD patients,including 230 cases of ACS patients,510 cases of patients with stable coronary heart disease were investigated. The questionnaire included two sets of medical history, symptoms, signs, main symptoms of chinese, Subcardinal synptoms of chinese medicine, blood stasis syndrome, tongue, pulse, laboratory tests, coronary angiography,etc. We Established a database, using descriptive analysis, chi-square test, Logistic regression analysis, principal component analysis, multivariate analysis of statistical methods. combinating clinical practice of Chinese medicine extracted "Toxin-stasis" characteristics of macro indicators and micro indicators. Results:According to the results of this study, the initial results of coronary heart disease "Toxin-stasis" can be deficiency of Ben and repletion of Biao. Disease characterized by onset and fast progress; main symptoms were chest pain, chest tightness, increased the occurrence and extent, including the more often attacks, lasted longer, high angina scoring,high Chinese main symptoms scoring, and high blood stasis scoring. And patients with headaches, mouth bitter, bad breath, difficulty falling asleep, the performance of the tongue is dark red tongue and pulse, rough sublingual up, color purple, thin or weak astringent pulse. Merge main blood stasis syndrome, and patients whose symptoms were kidney yang deficiency syndrome (chills, shortness of breath, dizziness, edema, fatigue, tinnitus or deafness, heart palpitations, bad breath). The stability of the main coronary artery disease showed spleen yang deficiency syndrome (chills, cold limbs, shortness of breath, fatigue, palpitations, nausea or vomiting, spontaneous sweating, bloating, bad breath). Deficiency of the spleen yang deficiency syndrome to the conversion of the kidney yang deficiency patients with coronary heart disease is increasing, the condition from the "stasis" to "Toxin" change with characteristics.Logistic regression analysis of smoking, history of diabetes was positively associated with ACS onset, odds ratio was 2.642,1.792; laboratory microscopic characteristics showed the percentage of leukocytes and neutrophils significantly increased, the corresponding percentage of lymphocytes decreased. Red blood cell count and hemoglobin, low hematocrit, low platelet volume distribution width.low triglycerides,elevated serum alanine aminotransferase, hsCRP was significantly higher. Coronary lesions are mainly three more.Conclusion:Through the use of modern clinical epidemiology and statistical analysis to identify the risk factors associated with ACS and the Chinese "Toxin-stasis" characteristics, extracted Chinese medicine "Toxin-stasis" characteristics of macro indicators and micro indicators. providing the scientific basis for Chinese medicine for the ACS "Toxin-stasis" etiology and early identification, prevention, intervention of CHD "Toxin-stasis". |
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