| This thesis consists of two sections.The first section contains three literature summaries.The first two summaries relate to Traditional Chinese Medicine(TCM),both are discussions on the etiology,pathogenesis,syndrome differentiation,epidemiology and the therapy of Coronary Artery Disease(CAD) and dyslipidemia from the TCM point of view.The third literature summary relates to the modern medicine's approach to the treatment of CAD.The second section is a clinical study on CAD cum dyslipidemia under the guidance of TCM.The clinical study attempts to find out the distribution of TCM syndrome type of patients with CAD cum dyslipidemia in order to improve the effectiveness of TCM treatment for this group of patients.The study covered 189 patients with confirmed diagnosis of CAD cum dyslipidemia from 3 hospitals in the Beijing city.Findings:CAD affects people advancing in age.Among the 189 cases selected,80.95%came from patients in the 50-79 age-group,predominated by male patients.Average age of these patients were 61 and 65 years for males and females respectively.Family history of CAD or dyslipidemia was one of the risk factors in causing the disease.Lifestyle factors weighed heavy for the 189 patients selected.76.72%of them were physically inactive;43.92 had indication of obesity(BMI＞25);75.13%had high salt diet and 68.25%had high fat diet.We found 9 TCM syndrome type from the 189 eases,they were:①deficiency in lung and kidney;②liver stagnation;③stagnation of liver with heat;④qi deficiency cum turbid phlegm;⑤deficiency of kidney;⑥turbid phlegm;⑦blood stasis;⑧yang deficiency with excessive fluid;and⑨yin deficiency. Among the 9 syndrome types,qi deficiency cum turbid phlegm formed the largest proportion with 23.81%,followed by liver stagnation with heat and deficiency of the lung and kidney.Based on the clinical experience of Thesis Advisor, after making slight adjustment to the above classification,the syndrome type of qi deficiency with phlegm and blood clot formed the largest group with 48.15%.Syndrome type distribution was slight different between male and female. Besides qi deficiency with phlegm and blood clot,which formed the largest proportion in both men and women,the next largest group for men was with the syndrome type of deficiency of liver with heat.For women it was the syndrome type of deficiency of lung and kidney.This difference in distrbution pattern could be due to the lifestyle and biological difference between men and women.From the age-group analysis of the syndrome types,patients with qi deficiency cum turbid phlegm syndrome came from a higher age-group,with 80% of these patients in the 60-79 age-group.Patients with liver stagnation or liver stagnation with heat came from a lower age group,with 54.16%comes from the 40-59 age-group.From the analysis of CAD severity of the syndrome type,patients with single artery blockage mainly came from the liver stagnation with heat, forming 24.43%;followed by qi deficiency and turbid phlegm with 15.62%. Patients with two arteries blockage mainly had the qi deficiency cum turbid phlegm syndrome type,forming 32.91%,followed by liver deficiency with heat with 16.46%.19.56%of patients with 3 or more arteries blockage had qi deficiency cum turbid phlegm syndrome type followed by deficiency of lung and kidney with 17.39%.Dyslipidemia is the single and important risk factor in causing the development of CAD,therefore more aggressive action in the management of lipid levels of these patients is a key treatment method.As the development of dyslipidemia is slow and has no apparent symptoms,preventive measures such as regular cholesterol test for adults above 20 years of age should be encouraged.In addition to regular blood test of lipid levels and cholesterol lowering for CAD patients,therapeutic lifestyle changes are important part of the treatment for CAD. |
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