Gender Differences In The Distribution And Clinical Features Of Coronary Heart Disease In TCM Syndromes

Objective:From the perspective of gender,the cases will be collected according to gender and female menopause or not grouping,comparative analysis of male and female patients with coronary heart disease(CHD),and between postmenopausal women with postmenopausal women with coronary heart disease(CHD)in various traditional and non-traditional factor for coronary heart disease,type of coronary heart disease,type of coronary lesions,TCM syndrome type distribution characteristics,etc.Through to the coronary heart disease(CHD)on gender differences between Chinese and western medicine research,to further explore the gender differences of coronary heart disease in the etiology and pathogenesis of TCM theory,at the same time for clinical differences between men and women of coronary heart disease prevention and control to provide certain reference.Methods:Collected in January 2016 to December 2016 in Beijing university of Chinese medicine hospital cardiovascular internal medicine wards in the hospital,east and confirmed by coronary angiography for patients with coronary heart disease,according to include and exclude standards into the sample.The sample can be divided into two large groups of men and women,at the same time in the group of women based on menopausal status to separate patients with postmenopausal and postmenopausal group two subgroups.Collection records each patient's gender,age,body mass index,smoking index,family history of coronary heart disease,high blood pressure,diabetes,blood lipid metabolic abnormalities,relevant biochemical results:cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),c-reactive protein(CRP)and homocysteine(HCY),uric acid(UA),plasma fibrinogen(Fib),coronary angiography results,as well as Chinese and western medicine clinical diagnosis.After various data statistics results,using SPSS 19.0 statistical software for data processing,measuring data:age,body mass index(BMI)and relevant biochemical results to mean ± standard deviation(x±s)said,comparison between groups choose t test;Count data:smoking index of amount of positive detection,family history of coronary heart disease(CHD),history,the types of coronary lesions and cumulative three highs,type of coronary heart disease and quantity of each syndrome type of traditional Chinese medicine distribution expressed as a percentage,the comparison between the groups by chi-square test,P<0.05 was statistically significant.Correlation analysis using the Spearman correlation analysis.Result:This study were collected into standard,a total of 379 cases,among which 240 were male,female 139 cases.In 127 patients with postmenopausal women group,12 patients with menopause.1.Gender differences in risk factors for coronary heart diseaseThe onset age:Women's overall onset age greater than men,postmenopausal women incidence is lower than the postmenopausal women.Smoking index is positive:Male smoking rate was 57.9%in patients with CHD,more than 8.6%of the women,but not in patients with postmenopausal women smoking rate was 33.3%,the patients with postmenopausal women smoking rate is only 6.3%.BIM:Male average BMI of 25.49±3.80,the female BMI average was 25.73±3.86,t test between the P values>0.05,is not statistically significant,but from the overall perspective,the average BMI greater than 25 men and women,belong to overweight.Postmenopausal women set of BMI average was 25.79 ± 3.45,average menstruating women set of BMI was 28.33 ± 3.77,postmenopausal women BMI range is more close to 30,the obese rangeHigh blood pressure:Male CHD patients with high blood pressure,137 people accounted for 57.1%,female CHD patients with hypertension,108 people,accounted for 77.7%.Comparison between them(P<0.05),with statistical significance.Postmenopausal group with menstruating women between the prevalence of hypertension,P>0.05,no statistical significance.Blood lipid metabolic abnormalities:Male CHD patients with a history of dyslipidemia,119 people,accounted for 49.6%and female CHD combined dyslipidemia in patients with a history of 85 people,accounted for 61.2%.Male CHD patients with TC average was 4.11±1.14,less than female patients with CHD TC average 4.59±1.45,statistical differences between them.Male CHD patients with HDL-C average was 1.25±0.32,less than female patients with CHD HDL-C average 1.43±0.32.The rest of the men and women in the comparison of TG.LDL-C has no obvious difference,P>0.05,no statistical significance.Postmenopausal group with postmenopausal women with CHD in the history of dyslipidemia,blood fat is no difference on the relevant indicators,P>0.05,no statistical significance.Uric acid:Male CHD patients with UA average was 355.13±100.43,women's average of 304.31±94.45 in patients with CHD,male uric acid levels than women,both has the obvious difference.P<0.05,with statistical significance.Homocysteine:The blood of male patients with CHD HCY average was 20.83±8.11,the median number of HCY female patients with CHD was 16.88±12.96.Comparison between them(P<0.05,with statistical significance.Fibrinogen:Male CHD patients with averages of 3.00±1.08 a Fib,female patients with CHD Fib average 2.84±1.24,there is no obvious difference between men and women,P>0.05,no statistical significance.Others:Men and women in the study of family history,diabetes and CRP in patients with coronary heart disease(CHD)there is no significant difference,P values were greater than 0.05,there is no statistical significance.May be related to the study sample size is less,limited to causes such as sample range.2.The gender differences of coronary heart disease onset typeThe onset of type of from high to low,respectively(68.3%),unstable angina st-elevation myocardial infarction(15.5%),stable angina(12.7%)and non ST segment raise sexual myocardial infarction(3.7%).Specific view,men and women in patients with CHD stable angina,unstable angina pectoris have differences comparison,ST elevation myocardial infarction(mi),with statistical significance(p<0.05).Male cases with stable angina and st-elevation myocardial infarction(mi)is given priority to.while women are more in unstable angina pectoris.3.Coronary artery lesion characteristics of gender differencesTotal sample size of 379 people,among them and the detection rate of the lesion site:before the fall of 331(39.7%),251(30.1%),right coronary cyclotron 223(26.8%),left main,28(3.4%).With the existing research results;Disease seriously affects the number and proportion of:single lesions in 113(29.7%),double branch lesions in 102(26.8%),multivessel lesions in 165(43.3%),more than three lesions of the patients,most single lesion,least double branch lesions.Moreover in this study,men and women coronary lesions in patients with CHD are obvious differences,not statistically significant(P>0.05).4.Coronary heart disease(CHD)gender differences of the distribution of TCM syndrome typesIn the total sample size,qi deficiency blood stasis license,most detection rate was 46.5%,and the phlegm stasis transresistance times,accounted for 16.3%.Men and women in ???patients account for the differences than the type of the justification of the third,male patients with phlegm turbidity resistance card 51,accounted for 14.5%,27 female patients with qi and yin deficiency syndrome,accounted for 13.8%.Men and women will be found after chi-square each card type,male and female patients exist obvious differences in the phlegm turbidity resistance syndrome,its P<0.05,with statistical significance.Prompt more men to phlegm turbidity.The rest type of syndrome have no statistical differences.For postmenopausal women with postmenopausal women different TCM syndrome types of statistics found that after not postmenopausal women patients with postmenopausal women patients exist differences in qi and blood stasis,with statistical significance(P<0.05).Nonmenopause women are more likely to be qi and blood stasis caused by depressive emotion.Conclusion:1.in patients with coronary heart disease incidence between men and women age,smoking index,high blood pressure,blood lipid metabolic abnormalities,uric acid,homocysteine and other risk factors exist obvious differences.And smoking,uric acid,homocysteine,fibrinogen more effect on the risk of suffering from coronary heart disease(CHD).And age,obesity,lipid metabolism disorder in women,especially the influence of premenopausal women suffering from coronary heart disease(CHD).2.The type of coronary heart disease clinical development,male cases with stable angina and st-elevation myocardial infarction(mi)is given priority to,while women with unstable angina pectoris.3.The coronary heart disease of TCM syndrome types in qi deficiency and blood stagnation to see.Men than women are more prone to phlegm turbidity resistance,not postmenopausal women compared with postmenopausal women are more prone to qi and blood stasis.