| Objective:Through the analysis of AF with anxiety and depression in patients with TCM syndrome type, the elements of syndrome distribution characteristics of the anxiety and depression severity, inflammatory factor of hypersensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-a) and other indicators.Methods:We selected 146 patients with established AF in our hospital of Cardiology from January 2015 to January 2016, who was divided inio two groups with or without anxiety and depression. All subjects were divided into AF with anxiety and depression group (n=60), AF without anxiety and depression group(n==86) by me. In addition, we also have control groups (with out AF, n=44). We used the anxiety and depression scales to evaluate the state of mind of all researchers.Study:Compare AF with anxiety and depression in patients with TCM syndrome type and syndrome element distribution characteristics, and analysis the relationship with anxiety and depression; Study 2:AF with anxiety and depression in patients with inflammatory factor level changes; Study 3:To study AF with anxiety depression group in TCM syndromes and and the he levels of inflammatory factors.Results:1. In this study,146 patients with AF and included 60 (41.10%) who live with anxiety and depression. Among them,34 cases (56.67%) had depression,26 cases (43.33%), and 23 cases (38.33%) with anxiety and depression;2. The occurrence of AF with anxiety and depression were significantly related to age, sex, duration of atrial fibrillation, and there was a certain correlation between the disease and the types of atrial fibrillation;3. AF with anxiety and depression in TCM syndrome characteristics were syndrome of Qi deficiency (70%)> Yin deficiency (58.33%)> Qi Stagnation (55%)>blood stasis (48.33%)> Fire (heat)(35%)>turbid phlegm(26.67%)>blood deficiency (21.66%)>Yang deficiency(13.33%)> Damp turbidity(10%), and the syndrome of deficiency of Qi and yin deficiency, Qi stagnation, blood stasis, fire (heat) and so on. The main pathogenesis is the deficiency and excess in superficiality, the deficiency of Qi and yin deficiency, and qi stagnation and blood stasis. The distribution characteristics of syndrome types are the heart and spleen deficiency (26.67%)> Blood Stasis (20%)> Fire excess from yin deficiency (18.33%)> Syndrome of timidity due to deficiency of heart qi (15%)>Water pathogen attacking heart (3.33%)> Insufficiency of the heart-yang (1.67%). The top three syndrome types, respectively is, the heart and spleen deficiency, Blood Stasis, Hyperactivity of fire due to yin deficiency.4. The correlation between depression and TCM syndrome:In 60 cases of primary atrial fibrillation with anxiety and depression, the number of cases of mild, moderate and severe anxiety and depression were 29 cases,20 cases and 11 cases respectively. In the constituent ratio of syndrome elements. The mild anxiety and depression to Qi deficiency (33.33%), yin deficiency, qi stagnation, blood stasis, and blood deficiency are the most common. The moderate anxiety depression and qi stagnation and (26.66%), deficiency of Qi and yin deficiency, blood stasis, fire (heat) are the most common. The severe anxiety and depression on blood stasis (16.67%), Qi deficiency and fire (heat), qi stagnation, and yin deficiency are the most common. In the form of syndrome type, the various types of syndrome in Mild depression and anxiety group is in order of Deficiency of both heart and spleen>Fire excess from yin deficiency>blood stasis. The various types of syndrome in moderate anxiety depression group is in order of sequence for deficiency of both heart and spleen> Syndrome of timidity due to deficiency of heart qi= Fire excess from yin deficiency>blood stasis. The various types of syndrome in severe anxiety and depression group is in order for the stagnation of the heart blood>deficiency of both heart and spleen>Fire excess from yin deficiency.5. Compare AF group and sinus rhythm group, the serum hs-CRP, IL-6 and TNF-a level was increased significantly (P<0.05). Compare anxiety and depression group and without anxiety depression group, the serum hs-CRP, IL-6 and TNF-a level was increased significantly (P< 0.05).6. Correlation analysis between TCM syndromes and inflammatory factors in patients with AF with anxiety and depression, comparison of the levels of hs-CRP, IL-6 and TNF-a between different syndromes and syndrome types, the difference was not statistically significant (P>0.05). In elements of TCM syndromes and inflammatory factors logistic regression analysis, Qi deficiency, yin deficiency and qi stagnation these three groups of syndrome symptoms and inflammatory factor no significant difference. In blood stasis syndrome, TNF-a is positively correlated with blood stasis syndrome.Conclusion:1. There was a high incidence of anxiety and depression in patients with AF patients, which was significantly associated with age, sex, and duration of atrial fibrillation, and there was a certain correlation between the disease and the types of atrial fibrillation.2. AF with anxiety and depression in TCM Syndromes, with Qi deficiency, yin deficiency, qi stagnation, blood stasis, fire (heat). The main pathogenesis of superficiality is deficiency in origin and excess in superficiality. The deficiency is qi deficiency and Yin deficiency, the subject is Qi stagnation and blood stasis.The distribution of syndromes were heart and spleen deficiency, blood stasis, Yinxu Huowang.3. Depression degree with TCM syndrome correlation. On the constituent ratio of syndrome elements, In Mild anxiety and depression group, the Qi deficiency, yin deficiency, qi stagnation, blood stasis, blood deficiency is the most common. In Moderate anxiety and depression group, the qi stagnation, Qi deficiency, yin deficiency, blood stasis, fire (heat) is the most common. In Severe anxiety and depression group, the blood stasis, Qi deficiency, fire (heat), qi stagnation, yin deficiency, the most common. In the form of syndrome type, the various types of syndrome in Mild depression and anxiety group is in order of Deficiency of both heart and spleen>Fire excess from yin deficiency>blood stasis. The various types of syndrome in moderate anxiety depression group is in order of sequence for deficiency of both heart and spleen> Syndrome of timidity due to deficiency of heart qi= Fire excess from yin deficiency>blood stasis. The various types of syndrome in severe anxiety and depression group is in order for the stagnation of the heart blood>deficiency of both heart and spleen>Fire excess from yin deficiency.4. Compared with AF without anxiety and depression group, the serum IL-6, Hs-CRP, TNF-a levels which in the AF with anxiety and depression group were increased more significantly. It is suggested that the factors that play a key role in the occurrence and development of AF. Emotional factors such as anxiety and depression have obvious effects on inflammatory factors and to enhance the body’s inflammatory response in patients with AF.5. Correlation between TCM syndromes and inflammatory factors in patients with AF with anxiety and depression, in blood stasis syndrome, TNF-a was positively correlated with and blood stasis syndrome. It is suggested that in the diagnosis and treatment of patients with AF, in addition to consider the cause of disease with a combination of external, still need to consider the influence of emotional factors to the development of the disease syndromes. To pay attention to the psychological and social factors of the disease, a variety of psychological intervention for the prevention and treatment of cardiovascular disease was validity and necessity. |
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