Distribution Of TCM Syndrome In Perioperation Of Coronary Artery Bypass Grafting

Study Objective: TCM has been proved beneficial to patients undergoing coronaryartery bypass grafting(CABG). How is the distribution of syndrome of TCM? No experience has been offered before. As the first TCM hospital conducted CABG in the our country, we invited professor Deng Tie-tao to instruct us on the differentiation of syndrome of TCM and TCM treatment. Combinating the history,Operation and modern surveillance technology, we intend to discuss the distribution characteristics of syndrome of TCM.Design:1.By retrospecting and analyzing the articles about syndrome of TCM in perioperation of CABG, choose the main syndrome type and manifestation of TCM in perioperation of CABG2. Design survey table, collect the data about preoperation and postoperation on the first, fifth and tenth day after operation. Form the database .3.Analyze the data in the way of retrospective, case-controlled study, discuss the distribution characteristics of syndrome of TCM.Setting: California Heart Center in Guang Dong Province Hospital of TCMPatients: 168 patients who had accepted CABG procedure in our center from June, 1999to December,2004Interventions: CABG procedure, treatment based on differential diagnosis of TCM Measurement: By reviewing the 168 cases medical records, we gathered the data about the individual characteristics, operation records, cardiopulmonary bypass, ICU surveillance and differentiation of syndrom of TCM. Under the instruction of Professor Deng Tie-tao,we divided these cases into 7groups: Deficiency of Heart-Qi and Heart -Yin, Lost of Heart-Qi and Blood, Lost of Heart-Yang, Blood Stasis, Stagnation of Phlegm, Deficiency of Spleen-Qi and Stagnation of Humidity, Deficiency of Lung-Yin and Stomach-Yin. We discussed the distribution characteristics of syndrome of TCM based on the results of retrospective, case-controlled study. SPSS 10.0 software is used as the the statistical method.Main Results: Age is the important correlative factor of the TCM types Deficiency ofHeart-Qi and Heart -Yin, Stagnation of Phlegm and Deficiency of Lung-Yin and Stomach-Yin. Blood Stasis is more frequent in unstable angina pectoris than in stable angina pectoris, but is less in postoperation than in preoperation. Deficiency of Heart-Qi and Heart -Yin, Lost of Heart-Yang is significantly different between the five NYHA grades, especially between the grades more than 3 and that less than 3 (P<0.001) . The on-pump groups is significantly different from the off-pump group (P<0.01) in the syndrome types Lost of Heart-Qi and Blood, Lost of Heart-Yang, Stagnation of Phlegm, Deficiency of Lung-Yin and Stomach-Yin. Cardiopulmonary bypass cross-clamping time is the important correlative factor of these three types. There is no significant difference between the groups of variable grafts. More blood lost followed by more syndrome type Lost of Heart-Qi and Blood. CI(Cardic Index) decreases and more syndrome type Deficiency of Heart-Qi and Heart -Yin, Lost of Heart-Yang happen. PO2/FiO2 is positive correlative with syndrome type Stagnation of Phlegm.Conclusion: The main TCM syndrome types include Deficiency of Heart-Qi and Heart-Yin, Lost of Heart-Qi and Blood, Lost of Heart-Yang, Blood Stasis, Stagnation of Phlegm, Deficiency of Spleen-Qi and Stagnation of Humidity, Deficiency of Lung-Yin and Stomach-Yin, which is different from the traditional coronary diseases TCM syndrome types. Among the types, Deficiency of Heart-Qi and Heart -Yin, Blood Stasis are most seen, which is consistent with the basic factor of coronary diseases. Post- operation syndrome types are usually the results evolving from preoperational syndrome types. The types Stagnation of Qi and Stagnation of Cold are seldom. The types related with Blood and Fluid are fairly distinct. Except Blood Stasis, the other types in the first day after operation become more than that before operation. Age is the important correlative factor of the TCM types Deficiency of Heart-Qi and Heart -Yin, Stagnation of Phlegm and Deficiency of Lung-Yin and Stomach-Yin. The on-pump groups is significantly different from the off-pump group (P<0.01) in the syndrome types Lost of Heart-Qi and Blood, Lost of Heart-Yang, Stagnation of Phlegm, Deficiency of Lung-Yin and Stomach-Yin.