Type 2 Diabetes And Clinical Observation Of Patients With Coronary Artery Disease Diagnosis And Syndrome Type Distribution Related Syndromes Assessment

Objective:To generalize the syndrome characteristics and dyndrome types of Type 2 DM patients and CHD patients for providing scientific guidance for clinical practice, the Syndrome Distribution of the two groups of patients were investigated and summarized, by analyzing the most common syndrome characteristics and common pathogenic factors, comparing the similarities and differences of the symptoms of the two group of patients, abstracting the joint core syndrome, and evaluating the relationship and syndromes in common among different groups of patients under the dividion rule of mordern medical diagnostics.Method:Clinical data of hospitalized Type 2 DM patients or CHD patients were reviewed and made clinical analysis, and the clinical oberservation was also adopted. This project was worked out in two stages, the first stage:237 in-patient medical records were collected and scrutinised, according to the diagnosis, the patients were divided into two catagories:DM(Type D1), CHD(Type C1); and further three groups:DM without CHD(D1C0), CHD without DM(D0C1), DM complicated by CHD(D1C1); based on the analysis of diagnosis records, the syndromes of the highest frequency were found, the scoring table was formulated, moreover, the relationship between DM and CHD was discovered. The second stage:30 patients with D0C1, D1C0, D1C1 diagnostic standard from each group were selected, scored, and analyzed.Results:The data analysis has shown clear relationship between CHD and T2DM. DM patients with longer history would be facing higher risk of complicating CHD, especially elder female ones. The results from the research of syndrome distributin at Stage I indicated that 79 syndromes were extracted from 237 medical records, duplicated and equivalent syndromes existed. Syndromes with the highest frequency were:Qi and Yin Deficiency, Phlegm Intermingled and Blood Stasis(27.0%),Qi deficiency and blood Stasis(8.9%),spleen and kidney Deficiency, Intermingled Phlegm and Blood Stasis (5.1%),Qi Deficiency and Yin Deficiency (4.2%), etc. The top ten syndromes altogehter accounted for 58.6% of total syndromes.the most common syndromes in D1C0 group were QD-YD and PI-BS(21.6%),QD-YD(5.9%),QD-YD and DH(5.9%). Meanwhile, the most common syndromes in D0C1 group were QD-YD and PI-BS (30.9%),QD-BS (14.7%),SD-KD and PI-BS (8.8%), After spliting the syndromes, the most common pathogenic factors were BS(77.6%),QD(59.5%),YD(57.8%),PT (55.7%).Base on the result, at StageⅡ, The scoring table of 30 patients from each group with QD, YD,BS was worked out (no PT scored due to the diversity of it); the statistical analysis of the score result pointed out that the scores of the three syndromes from 90 patients were not different significantly, the three syndromes have the same importance on the whole. However, according to the diagnosis, the emphasis observed among three syndromes: the score of BS, D1C1> D0C1>D1C0; the score of YD, D1>C1; the score of QD, C1>D1Conclusion:Morbidity statistics shown the similar trend of CHD and T2DM, DM should be considered as a vital cause of CHD, the longer history leads to higher risk of the complication. Gender and aging was also discovered as key factors, aged female could be more susceptible than others. DM reached a certain stage will regularly complicate with CHD, which may be a reliable indicator to the pathological changes. Whereas, CHD history is not remarkably linked to the DM diagnosis, that may be due to the complex cause of CHD, also the missed diagnosis of DM among CHD patients. The conclusion is CHD and DM may be separately representing a certain stage of a very disease that integrated them all together. Diagnosis of CHD and DM are only results based on the observation of a single time point on the whole route of its development.The basic pathological mechanism of DM patients and CHD patients are both asthenia in origin and excess in superficiality, different appearance at different stage. As a whole, the key pathogenic factors are QD, YD, BS, no different among the three, they are mutual connected but independent, together become the basic pathological mechanism of DM and CHD.Nevertheless, when observation was according to the diagnosism, the syndromes of the three groups of D0C1/D1C0/D1C1 were different. Syndrome of CHD patients focus on blood stasis caused by the deficiency of QI; Syndrome of DM patients focus on Inner heat caused by the deficiency of YIN; and CHD patients with the complication of DM show spectacular high score in blood stasis.The result support the idea that blood stasis is the fundamental cause of CHD, and also tell the trend about DM. Origin in the lack of yin and leads to the syndromes which not only presents heat and Dampness but also the blood stasis.The conclusion above indicated that at clinical practice,when we treat the DM+ CHD patients, to cure the root cause, reinforcing QI and nourishing YIN should attach more attention basis on activating blood and resolving stasis. For patients that have been diagnosed Type2 DM, but no heart disease complication occurs, and the score of Blood Stasis is higher, we should enhance the prevention of heart disease complication, having clear recognition of the potention dangerous.