Study On TCM Constitution And Syndrome Identification In Acute Coronary Syndrome And Treatment Of Ningxinjiedu Decoction

Objective: To identify the TCM constitution and syndrome in acute coronary syndrome, and investigate the correlation between them. In addition, to observe the clinical efficacy of ningxinjiedu decoction treated the patients with acute coronary syndrome, that providing traditional Chinese medicine in treatment of acute coronary syndrome with theory and clinical support.Methods: Select 208 cases of eligible patients with acute coronary syndrome, identify their constitution by the special evaluation system. At the same time, differentiate the syndromes by the diagnostic criteria of syndrome elements, which drawn up based on modern literatures. Then divide the 67 cases of patients with heat toxin syndrome, into two sets randomly: control group, conventional Western medicine treatment is offered, and experimental group, conventional Western medicine treatment and Chinese medicine(ningxinjiedu decoction) is offered. After four weeks treatment, observe the improvement of angina pectoris symptom score, TCM syndrome integral, the single symptom or sign scores, electrocardiogram and the quality of life.Results: The constitution of patients with acute coronary syndrome, followed by qi deficiency quality, yin deficiency quality, blood stasis quality, phlegm dampness quality, damp heat quality, yang deficiency quality, qi stagnation quality, flat and physique and special intrinsic quality, from high to low. Accordingly, the syndrome elements followed by blood stasis, phlegm dampness, qi deficiency, toxic heat, yin deficiency, qi stagnation, yang deficiency and yang exhausted, from high to low. There is significant correlation between constitution and syndrome elements.In the study of ningxin-detoxification decoction, the angina pectoris symptom score: The total efficiency of experimental group is 76.5%, and the control group is 48.5%. Comparison of the angina pectoris symptom score before and after treatment, experimental group is significantly better than the control group(P<0.01).TCM syndrome integral: The total efficiency of experimental group is 76.5%, and the control group is 48.5%. Comparison of TCM syndrome integral before and after treatment, experimental group is better than the control group(P<0.05).The single symptom or sign scores: Comparison of the all nine symptom scores before and after treatment, experimental group has significant difference on all the symptoms(P<0.01). Control group only has difference on the symptoms of chest pain, palpitations and chest tightness(P<0.05), and the rest of the symptoms have not statistically significant difference(P>0.05).Electrocardiogram: The total efficiency of experimental group is 67.6%, and the control group is 48.5%. Comparison of the electrocardiogram before and after treatment, experimental group is better than the control group(P<0.05).The quality of life: Comparison of Seattle angina questionnaire scores between two groups after treatment, experimental group is better on limitation of activity, stable state of angina pectoris and treatment satisfaction than the control group(P<0.05). The difference on circumstances anginal attack and disease recognition levels between two groups is not obvious(P>0.05).Conclusion: The most common constitutions of patients with acute coronary syndrome are qi deficiency quality, yin deficiency quality, blood stasis quality and phlegm dampness quality. The common syndrome elements of patients with acute coronary syndrome are blood stasis, phlegm dampness, qi deficiency, toxic heat and yin deficiency. Ningxinjiedu decoction has significant improvement to angina pectoris symptom score, TCM syndrome integral, the single symptom or sign scores and electrocardiogram curative effect, and has a certain role to improve the quality of life.