Study On The Relationship Between TCM Syndrome Types And Blood Lipid In The Patients With Coronary Heart Disease Combined With Diabetes Mellitus

Objective To investigate the TCM pathogenesis and rules of TCM Syndrome types in patients with CHD combined with DM,and study on the relationship between TCM Syndrome types and blood lipid,in order to discovery the changes of blood lipid between different TCM Syndrome types,and provide an objective evidence for TCM Syndrome typing on CHD combined with DM,so as to guide our clinical work effectively.Methods One hundred and seventy-two patients with CHD were enrolled in the study from Jan.1,2006 to Dec.31,2008.All of them were in-patients in cardiology department of The First Affiliated Hospital of Guangzhou University of Chinese Medicine.They were divided into two groups.The controlled group were the patients without DM,while the observed group were the patients with DM.Both of the groups were differentiated according to the syndrome differentiation criteria of CHD.Statistical software(SPSS 17.0) was used to compare the levels of blood lipid between different TCM syndrome types.Results(1)The main TCM Syndrome types of the observed group are the Qi Deficiency with Blood Stasis type(typeⅠ),the Heart-blood Stasis type(typeⅡ),the Phlegm Stagnant type(typeⅢ).The proportions of the Yin Deficiency of Heart-Kidney type(typeⅣ),and the Qi-Yin Deficiency type(typeⅤ),are higher in patients with DM than without DM.(2)The comparison between the two groups shows that the increase of TG and the decrease of HDL-C are obvious in the observed group(P＜0.05),and the increase of TC,LDL-C in the observed group has no statistic difference compared with the controlled group.(3) Among different Syndrome types of the observed group,the increase of TC and TG is obvious in the patients of typeⅠ,having statistic difference compared with that of the other four types(P＜0.05);the level of LDL-C is obviously increased in typeⅠ,compared with that of typeⅡandⅢ(P＜0.05).(4)The comparison between different Syndrome types of the controlled group shows:the level of TC in typeⅣcompared with that of typeⅠandⅤis significant difference(P＜0.05);the level of TC in typeⅢcompared with that of typeⅡis significant difference(P＜0.05);the level of TG in typeⅣcompared with that of typeⅠis significant difference(P＜0.01);the level of LDL-C in typeⅣ,shows significant difference compared with the other types(P＜0.05).(5)Compared with the controlled group,the increase of TC,TG,LDL-C and the decrease of HDL-C in the patients of typeⅠare obvious in the observed group(P＜0.05),so is the decrease of LDL-C in the patients of typeⅣandⅤ(P＜0.05).Conclusions(1)Qi deficiency,Yin deficiency,turbid phlegm and blood stasis is the elementary pathogenesis that runs through CHD combined with DM.The TCM Syndrome types of the disease are mainly the Qi Deficiency with Blood Stasis type,the Heart-blood Stasis type,the Phlegm Stagnant type,the Yin Deficiency of Heart-Kidney type and the Qi-Yin Deficiency type.(2)The degree of lipid disorders in typeⅠis the most obvious among the patients with DM,and the increase of TC,TG,LDL-C may be its important feature;while the degree of lipid disorders in typeⅣis the most obvious among the patients without DM,and the increase of TC,LDL-C may be is important feature.(3)The study shows that TCM syndrome types have relations with the levels of blood lipid in patients with CHD combined with DM.It provides the evidence for the objectification of TCM Syndromes in patients with the disease.We can infer the degree of dyslipidemia from syndrome differentiation,so that we may control blood lipid early to slow the progression of atherosclerosis.