Coronary Heart Disease And Stable Tcm-related Factors

This paper contains two parts,literature review and clinical research.Literature review:Therapy based on syndrome-differentiation is one of the superiorities of traditional Chinese medicino(TCM) in preventing and treating diseases,and how to make an accurate syndrome-differentiation is critical to improve the therapeutic effect.The development of modern medicine expands TCM 'four diagnostic methods' and provides technology,and opportunity for integration of traditional macroscopic and modern microscopic syndrome-differentiation.This paper reviewed the progress on the correlated factors of syndrome-differentiation in coronary heart disease(CHD) according to coronary artery lesion,heart function,electrocardial changes,blood lipid, insulin resistance,homocysteic acid,inflammatory factor and genetic gene and suggest unified criterion of syndrome-differentiation and thought of systematic biology be adopted.Furthermore,the correlated factors of syndrome-differentiation,microscopic exosyndrome and evolving law in high-risk stable CHD patients should be highlighted in the future.Clinical research:Objective:From the blood lipid,high-sensitivity C-reactive protein (hsCRP),Fib,etc.to explore in patients with stable coronary heart disease-related factors in TCM,in order to provide reference for the Clinical Diagnosis and Treatment,and new ideas.Method:Of the past have a history of old myocardial infarction or coronary angiography in 346 cases of diagnosed coronary heart disease in patients with stable cross-sectional survey of TCM Syndrome Types in the light of the Chinese Society of Cardiovascular Institute of Integrated Traditional and Western Medicine "Coronary Heart Disease TCM standards" into the blood stasis,phlegm turbidity,Qi Stagnation,cold coagulation,Qi deficiency,Yang deficiency, Yin deficiency syndrome seven elements.Detection of all patients with selected lipids,hsCRP,and Fib,Single-factor analysis and Logistic regression methods, analysis of patients with stable coronary heart disease and blood lipid TCM, hsCRP and the relevance of Fib.Results:1.General data analysis:346 cases of patients with stable coronary heart disease,male 254,female 92,male to female ratio greater than 2:1;the average age of 60.82±9.616 years old,mainly in the elderly;a family history of coronary heart disease 126 people,accounting for 36.4%;the combined 260 patients with blood lipid,accounting for 75.1%;of 223 people with hypertension, accounting for 64.5%;of 121 people with diabetes,accounting for 35.0%;a smoking history of 196,accounting for 56.6%;obese patients(body mass index＞28) 63 people,accounting for 18.2%,A-type character of 278,accounting for 80.3%.2.The case of TCM Syndrome Types:346 cases of coronary heart disease in patients with stable syndromes involving seven elements,the frequency of high to low as follows:blood stasis(94.2%),Qi-deficiency(45.4%),phlegm turbidity (39.0%),Yang deficiency(34.4%),yin deficiency(15.0%),Qi stagnation(7.2%), cold coagulation(0.3%).3.TCM-related factors in univariate analysis:single-factor analysis showed that,TG,HDL-C,TC/HDL-C,ApoB100,ApoA1/ApoB100,FBG,Fib is the differentiation of the relevant factors phlegm turbidity;TG,HDL-C,TC/HDL-C, ApoA1/ApoB100,Lp(a),Fib,hsCRP is related to the phlegm-heat differentiation factors;Fib is the differentiation of the relevant factors Qi-deficiency; TG,TC/HDL-C is the differentiation of the relevant factors Yang deficiency.4 CM-related factors Logistic multiple regression analysis:The syndrome is a differentiation factor as the dependent variable to the above there are significant differences in serum indicator variables for multiple logistic regression analysis,and gender,age,body mass index,fat history of hyperlipidemia,history of hypertension,diabetes history,smoking history corrected results showed that,hsCRP,HDL-C,Fib-heat syndrome differentiation as to whether the independent factors(P＜0.05),Fib differentiation as to whether the independent effects of turbidity factors(P＜0.05).Conclusion:Patients with stable coronary heart disease TCM heat syndrome and hs-CRP levels,HDL-C lower close;Hs-CRP as a marker of inflammation,may be regarded as traditional Chinese medicine "toxin" one of the micro-indicators, the study as "accumulated heat to transform toxin"to the pathogenesis hub to provide a preliminary basis,and lower HDL-C may be an important transformation process of the influencing factors,it is worth in-depth study.Fib reduce heat as the independent effects of differentiation factors,has yet to be validated to further expand the sample.