Study On TCM Syndrome Of Chronic Coronary Syndrome Complicated With Chronic Kidney Disease

ObjectiveUnder the guidance of TCM theory, the topic studied the distribution of syndromes in different stages and the characteristics of TCM Syndromes in cases of CKD patients with ACS with the methods of retrospective and cross-sectional research.The purpose of this study is to understand the correlation between CKD and clinical indexes, cardiac function classification and 30 days survival condition,and provide the clue of TCM for the prevention and treatment of CKD patients with ACS.MethodBy querying various literatures(including TCM literatures and modern medicine literatures) during 2006.1-2016.1 in Chinese HowNet on the CKD patients with ACS, and concluding these literatures, progress of international and domestic research in this field and relevant standards for the diagnosis and treatment of famous associations at home and abroad was acquired-Retrospective investigation forms were made according to the characteristics and direction of the study,in which the inclusion, diagnosis and evaluation criterias of TCM and modern medicine were included.Cases were collected from the nephrology and cardiovascular units of Guang’ anmen Traditional Chinese Medicine Hospital of Beijing during 2006.1-2016.1.There were 149 cases which meet the research requirements.Among them, there were 49 cases without CKD, called ACS non CKD group;and 100 cases of CKD, known as the ACS+CKD group.Then general data, laboratory index, cardiac functional grading,30 day survival, TCM syndrome description content acquisition.The evaluation results were statisticaly processed by SPSS20.0.Results1.The average age of the patients in ACS non CKD group was 67.78±10.67,the average age of patients in ACS+CKD group was 71.54±11.99,men in the two groups were more than women.In ACS+CKD group there were 50 patients in CKD3 stage, the average age is 75.02±10.79;CKD4 stage 10 patients, the average age is 76.10±6.98;CKD5 stage 40 patients, the average age is 66.05±12.47.2.1n ACS+CKD group,among all the primary renal disease,patients with diabetes and kidney disease(28%) were the most common to be seen,secondly to be the patients with chronic glomerulonephritis and hypertensive renal injury (25%),thirdly to be the patients with chronic interstitial nephritis (6%).3.The eGFR, SCr, BUN and HGb in ACS group and ACS+CKD group had significant statistical difference (P<0.01) at the time of ACS occured.There were statistical differences in CTNI, PLT(P=0.020<0.05 and P=0.044<0.05).The physical and chemical indexes of the two groups were significantly different (P<0.01) in eGFR, SCr, BUN and HGb in the physical and chemical indexes in the seventh day after ACS occured,and there were statistical differences in LDH, CTNI(P=0.011<0.05, P=0.049<0.05).4.There was no significant difference in the distribution of cardiac function between the ACS non CKD group and the ACS+CKD group.In ACS+CKD group,the number of grade Ⅱ patients in CKD3 stage was the largest(34%);the number of grade Ⅲ patients in CKD4 stage was the largest(40%);the number of grade IV patients in CKD5 stage was the largest (55%).The distribution of cardiac function in patients of different stages of CKD was statistically significant (P<0.05).5.There were 2 patients died after the ACS occured in the group of ACS non CKD,and ACS+CKD 22 patients died. Cumulative survival rates of the two groups were statistically significant (P<0.05) within 30 days after ACS.In the ACS+CKD group, the 30 days mortality of CKD after ACS was stage CKD36,stage CKD43,stage CKD513;the 30 days umulative survival rates after ACS were statistically significant (P<0.05) among the CKD patients.Diabetic kidney disease is the main causes of kidney disease in ACS+CKD patients(40.91%).6.1n ACS non CKD group,qi deficiency syndrome is the most common(41.40%),the syndrome distribution of the syndrome of the total deficiency is:Qi deficiency syndrome>Qi Yin deficiency syndrom>Yin deficiency syndrom>Yang Deficiency Syndrome>Yin and yang deficiency syndrom.In ACS+CKD,Qi Yin deficiency syndrome is the most common(34.00%),the syndrome distribution of the syndrome of the total deficiency is:Yin deficiency syndrome>Yin and yang deficiency syndrom>Qi deficiency syndrome>Yang Deficiency Syndrome>Yin deficiency syndrom.There was statistical difference between the two groups (P<0.05).In stage CKD3 and stage CKD5, Qi Yin deficiency syndrome is the most common(36.00%、35.00%),in stage CKD4,Qi deficiency syndrome is the most common(30.00%).7.1n both ACS non CKD and ACS+CKD,Syndrome of blood stasis appeared the highest frequency (33.66%、26.73%).In general, the empirical syndrome distribution was Syndrome of blood stasis>Syndrome of dampness and turbidity>Phlegm syndrome>Damp heat syndrome>Water gas syndrome;in stage CKD3-5,Syndrome of blood stasis is the most common(54.00%、60.00%、52.50%).8.1n ACS+CKD group,the number of patients with a single syndrome is 18,Syndrome of blood stasis and Syndrome of dampness and turbidity are more common;in 62 patients with two syndromes,Syndrome of blood stasis with Syndrome of dampness and turbidity are more common;in 20 patients with three syndromes,Syndrome of blood stasis,Syndrome of dampness and turbidity,Phlegm syndrome ae more common.Conclusions1. As renal function gradually decresed, cardiac function classification increased in CKD patients with ACS.2. The anemia and myocardial injury in the acute phase and after the occurrence of ACS of CKD+ACS patients is more serious than that of CKD non ACS patients,and their survival rate was lower.3. Qi Yin deficiency syndrom and the syndrome of blood stasis is more common in patients of ACS+CKD,Qi deficiency syndrome and the syndrome of blood stasis is more common in patients of ACS non CKD.