The Study On Changes Of TCM Syndrome In CHD Around Intervention Treatment With DES In Selected Date

Objective:To explore traditional Chinese medieine (TCM) syndromes distribution and changing rule around intervention treatment with DES implanted, and influence of syndrome on account of PCI. To analyse correlation between changes of TCM syndromes and common risk factors for coronary heart disease(CHD). Based on such researching,To promulgate rule for TCM preventing and curing CHD with PCI, provide scientific evidence-based medicine proof for TCM in diagnosing and treating CHD with DES implanted, enrich TCM theoretical connotation of CHD.Methods:1 Literature researehSystematiec review aneient and contemporary literatures, to understand distribution characteristic and researeh progression about TCM syndromes of CHD, conclude clinical therapeutic effect for TCM in preventing and treating CHD with DES implanted, provide evidence-based medicine proof for TCM reseach in preventing and treating CHD after PCI,and provide induce for clinical decision.2 Clinical Researeh206 patients of CHD were selected in the study by PCI with DES implantated at choosed date, In accordance with TCM differentiation of symptoms and signs criterionin 1990, CHD patients were differentiated for syndrome classification around PCI at six different times. TCM syndromes distribution and change rule around PCI were analyzed. The correlation between common risk factor and TCM syndromes distribution and change rule were analyzed.Results:1 Literature researchReviewed ancient and contemporary literatures about CHD, it was founded short of unification specification and cognition although there was much TCM syndromes differentiation and treatment varition of CHD, various kinds of method and thinking of syndrome differentiation and treatment varition of CHD existed is significant to clinieal and research of CHD.2 Clinical researchThe syndromes of 206 patients of CHD with DES implantated were analyzed according to six different times around PCI:before, after 24 hours, after 1 week, after 1 month, after 3 months, after 6 months. It's found that the common characteristic of CHD syndromes was root asthenia with branch sthenia. In branch sthenia, the most syndrome type were Qi stagnation, blood stasis and Phlegm-turbid before PCI(P<0.01), the most syndrome type were blood stasis and Phlegm-turbid after 24 hours,1 week to 6 months after PCI, the most syndrome type were Phlegm-turbid. In root asthenia, Qi deficiency was the main syndrome at every times. Heat Qi deficiency was main in Qi deficiency syndrome and Kidney Yang deficiency in Yang deficiency syndrome, Heat Yin deficiency and Kidney Yin deficiency were equaled in Yin deficiency syndrome distribution.It had significant effects to Qi stagnation syndrome and blood stasis syndrome by PCI with DES(P<0.05 or P<0.01). But Qi stagnation syndrome and blood stasis syndrome were beginning to recurrence after 6 months (P<0.01); Yin deficiency syndrome had a decrease only after 1 month (P<0.05 or P< 0.01); It had no significant change about Phlegm-turbid syndrome and cold coagulation syndrome of branch sthenia or Qi deficiency syndrome and Yang asthenia syndrome (P>0.05), Qi deficiency syndrome had a significant increace after 3 month (P<0.05).In the common risk factors, CHD with dyslipoiemia, the counts of blood stasis syndrome and Phlegm-turbid syndrome had a significant increase at every times (P<0.05 orP<0.01), it had significant effects to blood stasis syndrome and Qi stagnation syndrome by PCI with DES, it increased losses of asthenic healthy qi too. With hypertension, its characteristic was that Qi stagnation had a significant increase before PCI after 24 hours,1 week, and 3 months (P<0.05 orP<0.01), blood stasis syndrome before PCI, after 24 hours,1 week,6 months (P<0.05 orP<0.01), Phlegm-turbid syndrome at every times beside after 1 month (P<0.05 orP<0.01), Qi deficiency syndrome after 24 hours,1 week,3 months (P<0.05 orP<0.01); yin deficiency syndrome before PCI, after 1 week,3 months (P<0.05 or P<0.01) too. With diabetes, the counts of Phlegm-turbid syndrome had a significant increase at every times (P<0.05 orP<0.01), After PCI a week,Qi stagnation syndrome had a increase (P<0.05), Qi deficiency had a increase too after 24 hours to 3 month (P< 0.05). it had a unique characteristic that blood stasis syndrome reduce was slowly, it had a significant decrease only after PCI 1 week than before, and 1 month than 24 hours. Analyzed syndromes distruibuted with PCI in high risk factors of sex and age, it's root asthenic syndromes had a significant decrease and Qi stagnation and blood stasis of branch sthenic syndrome had (?) significant decrease too.Conclusions:1 According to review literatures about CHD, it was evaluated that TCM could have certain therapeutic effect in preventing and treating around PCI 2 It's characteristic was root asthenia with branch sthenia. In branch sthenia, the most syndrome type were Qi stagnation, blood stasis and Phlegm-turbid before PCI(P<0.01), the most syndrome type were blood stasis and Phlegm-turbid after 24 hours,1 week to 6 months after PCI, the most syndrome type were Phlegm-turbid. In root asthenia, Qi deficiency was the main syndrome at every times. It could not change pathology of root asthenia with branch sthenia by PCI with DES implanted, it only had significant effect to Qi stagnation, blood stasis and Yin deficiency syndrome in a short period, had no significant effect to Phlegm-turbid,cold coagulation and Qi deficiency and Yang deficiency syndrome. On the contrary, it could increase Qi deficiency syndrome.3 There was a correlation between TCM syndromes of CHD and risk factors. It should be done that preventing and treating pathology stage at every time around PCI with DES implanted according to different risk factor of CHD.