The Study On The Incidence Characteristics Of MVA And Its Distribution Of TCM Syndromes

ObjectiveTo observe and analyze the characteristics of microvascular angina pectoris,TCM syndromes distribution and related laboratory indicators to improve their understanding of its possible pathogenesis of Chinese medicine,and the similarities and differences of coronary artery disease.MethodsThrough retrospective study,the first Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine was collected with chest pain as the main complaint,and 312 patients had undergone coronary angiography.The coronary angiography was negative and the diagnostic criteria of microvascular angina were included in the MVA group,Coronary angiography positive and consistent with the reference standard were included in the control group;meanwhile,the TCM syndromes of all patients,according to our hospital cardiovascular disease treatment plan of chest pain is divided into Qi stagnation and blood stasis type,Phlegm and blood stasis type,Heat and blood stasis type,Qi deficiency and blood stasis type,Qi and Yin deficiency with blood stasis type for syndrome differentiation.The main baseline data,the characteristics of the disease,the distribution of TCM syndromes,and the related test results were compared between the two groups.Results1.The incidence of the population:MVA incidence of female-based,with an average age of 57.41 ±9.80,especially in perimenopausal and menopausal women as the main group;41-70 years of age for men and women of high incidence of age,the average age of men is lower than women.The control group was mainly male,with an average age of 64.17± 13.20,46-85 years old was a high incidence of age,of which the high incidence of women was 56-85 years old,compared with men.2.Predisposing factors and risk factors:the two groups of common cause of fatigue,intense activity,mood,satiation,weather changes.Most of the patients with MVA had no obvious inducement,while the patients in control group were mainly caused by exertion or strenuous activity.Smoking,drinking,hypertension,diabetes,dyslipidemia and uric acid were the risk factors for both.3.Non invasive examination and evaluation:The highest positive rate of treadmill test in the MVA group,Holter,followed by conventional ECG,the lowest positive rate of UCG.91 patients underwent Carotid artery ultrasonography,positive in 47 cases(51.6%).Compared with the two groups,the positive rate of treadmill exercise test and Holter in the MVA group was slightly higher than that in the control group,while the UCG and conventional ECG positive rate in the control group was higher than that in the MVA group.Carotid artery ultrasonography,the positive rate of the control group was significantly higher than that of the MVA group.4.The distribution of TCM syndromes:TCM syndrome type of MVA group mainly Phlegm and blood stasis,Qi stagnation and blood stasis,and Heat and blood stasis type;the female patients with Qi stagnation and blood stasis type,Phlegm and blood stasis type;men with Phlegm and blood stasis type,Heat and blood stasis type.While the control group with Heat and blood stasis type,phlegm and blood stasis.5.Laboratory index analysis:(1)Inflammation index:The levels of Lp-PLA2 and hs-CRP in MVA group were higher than normal values,which were 202.17±103.77,5.68±13.04,and the male is higher than female;the levels of Lp-PLA2 and hs-CRP in the control group were higher than those in the MVA group,which were 239.08 ± 128.19,11.15± 16.94,respectively.(2)Blood lipid index:The level of TG in MVA group was 1.85 ± 1.36,which were higher than normal;the level of LDL-C was 3.04 ± 0.98,and the male was higher than that of female.The average level of HDL-C in control group was 0.99 ± 0.33,LDL-The C level is 3.02 ± 1.38.The average level of HDL-C in the control group was lower than the normal value,which was 0.99 ± 0.33,and the level of LDL-C was 3.02±1.38?(3)Liver and kidney function:MVA group AST,ALT,Cr,and UREA average level was lower than the control group,and in the normal range;the control group AST,and Cr levels beyond the normal range.(4)Others:MVA group of AST,HbAlc,and DDi average levels were in the normal range.The average level of HbAlc and DDi in the control group was higher than the normal range.(5)The results of t test showed that the difference of Lp-PLA2,HDL-C,HbAlc,DDi,TSH,EF,UREA,AST was statistically significant(P<0.05).And the two groups of women with Cr levels,the difference was statistically significant(P ? 0.05).Conclusion1.MVA incidence of female-based,especially perimenopausal and menopausal women as the main group;41-70 years of age for men and women of high incidence;tired,violent activities,emotions,satiation,weather changes as a common cause.Smoking,drinking,high blood pressure,diabetes,dyslipidemia,uric acid abnormalities are the risk factors of MVA.2.MVA group of TCM syndrome type mainly Phlegm and blood stasis,Qi stagnation and blood stasis,and Noxious Heat stasis type;the female patients with Qi stagnation and blood stasis type,Phlegm and blood stasis type;men with Phlegm and blood stasis type,Noxious Heat stasis type.3.MVA may be the early stage of coronary heart disease,both in the risk factors,clinical manifestations,ECG,treadmill test and laboratory results are inherent consistency,and the overall situation of the MVA group than the control group light;For a particular type of coronary heart disease.4.Coronary angiography is a reliable way to distinguish the two correctly.The treadmill exercise test,Holter,and the ECG can be used to guide the diagnosis.