The Study Of Clinical Characteristics Of Acs Patients And "Toxin" And Related Pathogenesis

ObjectiveClinical Study:using the clinical statistics and clinical epidemiology method, On the basis of the"toxin" disease characteristics, and based on the clinical manifestations of the ACS, syndrome elements, clinical signs, physical and chemical results, coronary angiography, etc., an attempt to Lingnan region ACS TCM "toxin" syndrome of more objective and scientific basis. Based on traditional Chinese medicine drug laws Lingnan region ACS’s research attempts from Chinese medicine detoxification aspect, disprove the existence of the ACS "toxin", to further explain the ACS detoxification method specific connotation. MethodClinical Study:This study from August 2015 to December 2015, using small sample size, cross-sectional, prospective clinical epidemiological survey, and conduct First Affiliated Hospital of Guangzhou University of Chinese Medicine 100 cases of ACS patients survey, it includes:general information, medical history, doctors diagnose, coronary angiography, laboratory results, clinical symptoms and signs, Chinese medicine main symptom scoring, tongue and pulse, medicine, etc., to establish a database;and in accordance with the "poison "pathogenic characteristics, the ACS main clinical symptoms were scored as the ACS "toxin" identification basis, the main clinical symptoms score≥9 into "toxin", patients <9 into non" toxic "patient, and conducted clinical case-control study. Statistical Methods include frequency analysis, T test, principal component analysis, factor analysis, multivariate analysis, correlation analysis, etc. In order to try to set out clinical diagnosis Lingnan region ACS in "toxin" and quantitative criteria framework initially, to further explain detoxification Recipe meaning and application of specific detoxification method. Results1. Factors Affecting factor analysis, high UA (uric acid) of the maximum load value, indicating that is the most important factor UA (uric acid) in the present study "toxin" syndrome occurs, the load value was:0.670. Other factors that affect the degree by the size of the arrangement are:history of diabetes> high cholesterol history> old history of myocardial infarction > high LDL-C> hypertension＞ Drinking History＞ smoking history＞ history of stroke＞TNI(+), its load value respectively were:0.524,0.500,0.396,0.366, 0.335,0.309,0.301,0.286,0.109."toxin" Syndrome group factor analysis showed that the maximum load value qi deficiency, qi deficiency described in this study "toxin" Syndrome is the most influential syndromes. All syndromes arranged according to the size of the degree of influence are:qi deficiency, blood stasis, phlegm, yang deficiency, qi stagnation, Hanning, hot, yin deficiency, its load value were:0.911,0.892,0.828,0.558,0.553,0.488,0.403,0.154."toxin" group of clinical main symptoms score results of principal component analysis showed that the value of the maximum load is chest pain. Chest pain described the impact of this study is "toxin" main symptoms of the most important clinical symptoms, its score was:1.644. Other symptoms according to traditional Chinese medicine main impact of the size arrangement are:heart palpitations, fatigue, shortness of breath, chest tightness, its scores were:1.399,1.188,1.160,1.104."toxin" group of clinical symptoms and the principal components analysis showed that extraction poor circulation has chills (0.642); fever has the red face (0.705), redeyes (0.704), dry mouth, want to drink (0.475), constipation (0.540), spontaneous (0.453); phlegm has coughing disease (0.646), sputum (0.670); Blood stasis has spontaneous bleeding disorder (0.453), dry mouth, want to drink (0.475), constipation (0.540).Independent samples T-test results tongue and pulse, P value is 0.000 (P<0.05), with statistical significance. Pink tongue, P Shebai values are <0.05, indicating "toxin" Syndrome and not "poison" card, the two were statistically significant; little coating, thready pulse, slippery pulse, slippery pulse, P value is<0.01, indicating "toxin" Syndrome and not "poison" card, the more significant the tongue and pulse highly significant."toxin"syndrome factor combinations in the proportion of more are:qi stagnation+blood stasis and qi deficiency, phlegm and blood stasis+qi deficiency, blood stasis+Hanning and qi deficiency, blood stasis+fieryand qi deficiency.2. By influencing factors of Lingnan region 100 cases ACS "toxin" group and not "toxin" group, syndromes, associated clinical symptoms, tongue and pulse, syndrome elements like the four diagnostic parameters, combined with TCM viscera, gas blood and body fluid theory, preliminary draw in ACS "toxin" Syndrome clinical syndrome criteria, it is as follows.Keyindicators:(1)chestpain (moderate or severe), chest tightness (moderate or severe), heart palpitations, fatigue, shortness of breath total score^ 60% of the main clinical symptoms integral sum; (2) dark red tongue, sublingual collaterals purple or deep plum.Secondary outcomes:(1) hs-CRP> 3 mg/L; (2) enzymes (creatine kinase, creatine kinase MB) or troponin more than 2 times the upper limit of normal; (3) high blood pressure History of 2 to 3; (4) a history of diabetes, FBG> 710 mmol/L; (5) a history of high cholesterol; (6) hyperuricemia; (7) long history of smoking or drinking.ACS patients who meet one or two main indicators Secondary indicators (containing at least one biochemical indexes) can be diagnosed as "toxin" Wherein the fatigue life, impetuous, spicy greasy salty diet are the primary cause.3. "toxin" different statistics initiating evil (blood stasis, phlegm, Hanning, hot), combined with the above syndromes, syndrome elements, clinical symptoms, tongue and pulse.The basis for the comprehensive results "toxin" Syndrome classification, clinical can be divided into heat toxin syndrome, toxic stasis syndrome, phlegm syndrome, cold syndrome virus.Heat toxin syndrome:excessive heat and Yin injury, it presents Noxious Heat stasis, Qi Deficiency. Its clinical manifestations are chest pain very, chest tightness, irritability, constipation, shortness of breath, spontaneous perspiration, fatigue, palpitations, red tongue, yellow slippery pulse and other toxic heat syndrome.Ecchymosis card:heat stasis mutual knot, Yin of the two injuries, two drugs often mixed, however, is very clinical manifestations of chest pain, chest tightness, dry mouth, want to drink, then dry constipation, shortness of breath, spontaneous perspiration, fatigue, dark red tongue, sublingual collaterals or deep plum purple, yellow greasy moss, pulse slippery Ecchymosis card.Phlegm syndrome:sputum poison is highiy up, heart and spleen are deficiency, clinical manifestations are even chest, chest pain, cough, sputum, loose stools, pale mouth, shortness of breath, fatigue, palpitations, dizziness, tonguefur, slippery pulse was fine and so phlegm certificate.Cold toxic syndrome:cold poison cohesion, does not show heart yang. clinical manifestations are severe chest pain, chills, shortness of breath, obviously, cold sweats, fatigue, palpitations, pale tongue, dark, thin pulse slow poison and other cold syndrome.4. ACS and "toxin" disease associated disease machine, (inside) or very evil Kang Accumulation and not of metaplasia (internal) drug, depending on the initiator of evil, can be divided into cold virus, (fire) toxic heat phlegm, blood stasis and other drugs, impaired quality form, wasting organs, Or are bad Xie Sheng, also from into poison, evil can turn poison, poison can cause evil, and ultimately the formation of toxic stasis stroke, poison damaged heart meridian, the vicious circle of poison damaged organs. "False positive drug Sheng" is the total of the pathogenesis of ACS, ACS Ecchymosis resistance pulse is basic pathological changes (in Ecchymosis core), poison damaged heart meridian, poison damaged organs is the ultimate pathological changes.5. The present study from 100 cases in our hospital treatment statistics of the Lingnan region ACS, combined with Lingnan region Peel thin soil, the climate is hot, summer Sheng climate characteristics, drug class analysis: blood medicine＞ antipyretic＞ complement gas medicine＞ apophlegmatisant＞ qi medicine＞medicine dampness＞ yin tonic. Frequency analysis before the results of the drug, the drug Quxie arrangement flavors of traditional Chinese medicine: Chuanxiong, red peony, safflower, Salvia, dalbergia, Maodongqing; former Chinese medicine as a tonic medicine arranged flavors:licorice, astragalus, Codonopsis, Atractylodes, Poria. From the Chinese medicine class, frequency usage to drug test certificate, anti extrapolated Lingnan region ACS patients with major clinical syndromes:Noxious Heat stasis, Qi and Yin deficiency.6. In the ACS "toxin" disease system, divided into external objects, endotoxin disease. Outside poison to immunotoxin, tobacco and other drugs mainly to Quxie detoxification based method, remove immunotoxin, remove or quit alcohol and other drugs. In addition to endotoxin blood detoxification, but also can be combined to produce the toxin initiating evil establish the appropriate treatment method, such as detoxification, cold detoxification, dampness detoxification, expelling wind detoxification, detoxification dryness, Qingying detoxification, righting detoxification,etc.7. According to the study of Chinese drug laws, and drug card corresponding, the rule is "righting detoxification",so we can summarize the preliminary Lingnan region ACS TCM detoxification prescription. Party name:blood detoxification soup. ConclusionClinical Study:Results and theory through mathematical statistics, the combination of clinical experience, we can draw relatively objective ACS TCM "toxin" Syndrome clinical diagnosis and quantitative criteria, prospective clinical investigation and multivariate mathematical statistical analysis ACS is the combination of traditional Chinese medicine "toxin" Syndrome differentiation standard objective study of an effective approach worthy of further study. Chinese medicine emphasizes the local conditions, so the research on the Lingnan region more ACS clinical characteristics of patients, traditional Chinese medicine and "toxin" correlation between disease and related machine provides a basis for research and reference models for future depth study, and in favor of future large sample, multi-center, cross-sectional, prospective clinical epidemiological investigation and analysis.