| Coronary heart disease caused by the occurrence of atherosclerosis in the coronary arteries and the obstruction of the vascular lumen,leading to insufficient blood supply to the coronary artery,myocardial ischemia and hypoxia.The primary cause of coronary heart disease and pathological basis is atherosclerosis.Coronary heart disease has become the leading cause of death beyond cancer and other diseases.In recent years,coronary heart disease has ranked first in the ranking of female death causes in both developed and developing countries.With the increasing incidence and rejuvenation of women with coronary heart disease,understanding the physiological characteristics of women,the status of life and the characteristics of female patients with coronary heart disease,improving women's health awareness,paying attention to risk factors and timely and effective treatments are important.In the distribution of TCM syndrome types,there are differences between female patients with coronary heart disease and male patients with coronary heart disease.This difference may be related to the abnormal of thyroid hormones and blood lipid levels.So this topic is divided into two parts:(1)Literature research:taking the characteristics of the distribution of TCM symptoms in different genders with coronary heart disease as the starting point,comprehensively analysis their distribution of TCM syndromes by meta analysis.(2)Clinical research:centered on female patients with coronary heart disease,comparatively analysis the TCM syndrome types and changes in thyroid hormone and blood lipid levels of the different genders with coronary heart disease,female patients with coronary heart disease and women who conduct coronary angiography that exclude CHD.1.Meta analysis:Objective:In order to definie the distribution characteristics of TCM syndromes in different genders of patients with coronary heart disease and to provide the references for clinical individual treatment,the paper used the Meta-analysis to analyze the distribution of TCM syndromes in different genders of patients with coronary heart disease by the published literature and master's thesis.Method:The researcher usesd computer to retrieve the Cochrane Library,Pubmed,Chinese journal full-text database(CNKI),Chinese biomedical literature database(CBM),Chinese science and technology periodical full-text database(VIP)and Wanfang database to obtain the literature.The retrieval time was from the establishment of the database to July 25,2017.Two researchers independently screened the literature and extracted the materials according to the research type,the research object and the inclusion of the literature standard.Finally,161 studies and 17 types were included.The 17 types includ blood stasis syndrome,qi stagnation and blood stasis syndrome,qi deficiency and blood stasis syndrome,both qi and yin deficiency syndrome,phlegm and blood stasis syndrome,phlegm turbidity syndrome,qi deficiency syndrome,qi deficiency phlegm and stasis syndrome,yang deficiency syndrome,yin deficiency syndrome,cold syndrome,qi stagnation syndrome,yang deficiency blood stasis syndrome,yin deficiency blood stasis syndrome,yin and yang deficiency syndrome,qi and blood deficiency syndrome,qi deficiency and phlegm syndrome..There are 36528 patients involved.Then the researcher uesd the RevMan5.3 software to Meta analysis.Results:There are five TCM types of syndromes that are more female patients than male patients,and the differences between the two groups have statistical significance(p<0.05),such as the qi and blood deficiency syndrome:[RR=0.67,95%CI(0.48,0.92),P=0.01],the yin deficiency and blood stasis syndrome:[RR=0.69,95%CI(0.53,0.90),P=0.006],the qi stagnation syndrome:[RR=0.75,95%CI(0.64,0.88),P=0.0005],the yin deficiency syndrome:[RR=0.76,95%CI(0.69,0.83),P<0.00001],the qi and yin deficiency syndrome:[RR=0.83,95%CI(0.79,0.87),P<0.00001].There are four TCM types of syndromes that are more male patients than female patients,and the differences between the two groups have statistical significance(p<0.05),such as the yang deficiency syndrome:[RR=0.89,95%CI(0.81,0.98),P=0.02],the phlegm turbidity syndrome:[RR=1.12,95%CI(1.08,1.17),P=<0.00001],the phlegm and blood stasis syndrom:[RR=1.19,95%CI(1.09,1.30),P=0.0002],and the blood stasis syndrome:[RR=1.08,95%CI(1.01,1.16),P=0.04)].There are eight TCM types of syndromes that the differences between the male p a-tients and female patients have no statistical significance(p>0.05),such as the yin and yang deficiency syndrome:[RR=0.85,95%CI(0.61,1.20),P=0.37],the qi defic-iency and bl ood stasis:[RR=0.97,95%CI(0.92,1.02),P=0.23],the qi deficiency and phlegm turbidity sy ndrome:[RR=1.04,95%CI(0.60,1.83),P=0.88],the yang deficiency and blood stasis syndro me:[RR=1.15,95%CI(0.95,1.40),P=0.15],the cold syndrome:[RR=1.13,95%CI(0.99,1.29),P=0.08],the qi de-ficiency and phlegm stasis syndrome:[RR=1.17,95%CI(0.90,1.53),P=0.24],the qi defici-en-cy syndrome:[RR=0.92,95%CI(0.83,1.02),P=0.08],and the qi and blood s tasis syndrome:[RR=0.93,95%CI(0.85,1.03),P=0.17].Conclusion:Because of female-specific physiological characteristics such as menstr uation,leucorrhea,pregnancy,production,breast-feeding,the qi and blood deficiency s yndrome,the yin deficiency and blood stasis syndrome,the qi stagnation syndrome,and t he yin deficiency syndrome are more female patients than male patients.Men because of their normal life and eating habits,the yang deficiency syndrome,the phlegm turbidi ty syndrome,the phlegm and blood stasis syndrom,and the blood stasis syndrome are more male patients than female patients.The distribution in patients with coronary heart disease of the yin and yang deficiency syndrome,the qi defic-iency and blood stasis,t he qi deficiency and phlegm turbidity syndrome,the yang deficiency and blood stasis s yndrome,the cold syndrome,the qi de-ficiency and phlegm stasis syndrome,the qi defici-en-cy syndrome and the qi and blood stasis syndrome have no gender differences.2.Clinical researchObjective:This study centers on female patients with unstable coronary angina.Collected cases are grouped according to different genders,in addition,women who conduct coronary angiography that exclude CHD were selected as control group.Comparatively analysis the characteristics of TCM syndrome types in women and men with unstable angina,women with unstable angina and female with normal physical examination.Then the researcher analysises the TCM syndromes and changes in Thyroid Hormone and Blood Lipid Levels,to explore the clinical characteristics of female patients with unstable angina pectoris,and provide some reference for the preventions and treatments in female with clinical coronary heart disease.Method:This study collected patients who had been diagnosed with unstable angina according to the inclusion and exclusion criteria in the period from January 2017 to December 2017.The patients were divided into two groups according to genders,in addition,the study collected non-UA female as control group.The researcher recorded the patient's general information such as name,gender,age,ethnicity,occupation,marriage status,medical record number;past histoey such as hypertension,diabetes and dyslipidemia;personal history such as smoking and drinking;family history such as coronary heart disease,hypertension and diabetes;related biochemical results,such as blood lipids include high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG)and cholesterol(TC)and thyroid hormone includes triiodothyronine(T3),thyroxine(T4),free triiodothyronine(FT3),free thyroxine(FT4)and serum thyroid stimulating hormone(TSH);Traditional Chinese Medicine and Western Medicine Diagnosis of unstable angina results and TCM syndrome.The the researcher used statistical software of SPSS 21.0 for data analysis.Measurement data:age,biochemical results expressed as mean±standard deviation(X±S),comparison between groups using t test.Counting data:the number of people in each group,and the amount of distribution of each syndrome in TCM syndromes expressed as a percentage,comparison between two groups using X2 test,the results obtained were statistically significant at P<0.05.Correlation analysis using spearman analysis.Results:This study collected a total of 124 cases includes 76 male patients and 48 female patients that met the inclusion and exclusion criteria,and collected 42 non-UA female that with normal physical examination as control group.?There was no significant difference in TCM syndrome types between male and female patients with unstable angina,and between female patients and non-UA females(P>0.05).?The study compares the thyroid hormone levels among syndromes of TCM of men and women with unstable angina show that the T3 and FT3 levels in male patients with phlegm blocking syndrome higher than female patients with the same syndrome,but the TSH levels lower than famale patients;the FT3 levels in male patients with qi deficiency blood stasis syndrome higher than female patients with the same syndrome,the difference was statistically significant(P<0.05).The comparison of thyroid hormone in other syndrome types shows that the difference was not statistically significant(P>0.05).?The study compares the thyroid hormone levels among syndromes of TCM in women with unstable angina and non-UA female show that the FT3 levels in non-UA female with both qi and yin deficiency syndrome higher than female patients with the same syndrome;the T3 levels in non-UA female with phlegm blocking syndrome higher than female patients with the same syndrome,the difference was statistically significant(P<0.05).The comparison of thyroid hormone in other syndrome types shows that the difference was not statistically significant(P>0.05).?The study compares the blood lipid levels among syndromes of TCM of men and women with unstable angina shows that the TC,HDL-C and LDL-C levels in,female patients with phlegm blocking syndrome higher than male patients with the same syndrome,the difference was statistically significant(P<0.05).The comparison of blood lipid levels in other syndrome types shows that the difference was not statistically significant(P>0.05).?The study compares the blood lipid levels among syndromes of TCM in women with unstable angina and non-UA female shows that the difference was not statistically significant(P>0.05).?The study shows that the TC,HDL-C and LDL-C levels in female patients higher than male patients,the difference was statistically significant(P<0.05).Other blood lipid levels show that the difference was not statistically significant(P>0.05).?The study shows that the T4,FT3 and TSH levels in female patients higher than male patients;the T3 and FT3 levels in female patients lower than the non-UA female,all the differences were statistically significant(P<0.05).Other thyroid hormone levels show that the difference was not statistically significant(P>0.05).Conclusion:This study found that women with unstable angina in qi deficiency and blood stasis syndrome,turbid block syndrome and deficiency of both qi and yin syndrome have a correlation with thyroid hormones and lipid levels.?The FT3 levels of qi deficiency and blood stasis syndrome in male patients with unstable were higher than that in female patients with unstable angina.?The T3 and FT3 levels of Phlegm blocking syndrome in male patients with unstable were higher than that in women with unstable angina.The TSH levels of Phlegm blocking syndrome in female patients with unstable were higher than that in male patients with unstable angina.?The FT3 levels of both qi and yin deficiency in female patients with unstable angina were lower than those in non-UA female.?The T3 levels of phlegm blocking syndrome in female patients with unstable angina were lower than those in non-UA female.?The TC,HDL-C,and LDL-C levels in the phlegm blocking syndrome of female patients with unstable angina were higher than male patients with unstable angina.The TC?HDL-C?LDL-C levels in female patients with unstable angina were higher than those in male patients with unstable angina.The T4?FT3?TSH levels in female patients with unstable angina were higher than those in male patients,but the T3 levels were lower in female patients with unstable angina than male patients.The T3?FT3 levels were lower in female patients with unstable angina than the non-UA female. |
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