| Objectivethrough the analysis of 267 cases of acute myocardial infarction(acute myocardial infarction,AMI)patients with ecg QT and JT dispersion degree,serum inflammatory factors,coronary lesions and the relationship between TCM syndrome type,the research on the basis of western medicine combined disease clinical examination objective indicators and the correlation of TCM syndrome types,making of traditional Chinese medicine more objectivity and provide reference for the Chinese medicine treatment of AMI.MethodsIn this study,a total of 775 AMI patients were admitted to the cardiovascular ward of suining central hospital from January 2017 to December 2018,and 267 patients were screened as subjects according to inclusion criteria and exclusion criteria.Analyze the general situation and distribution of TCM syndromes,And compare the different syndrome types of patients with AMI QT dispersion degree(QTd,QT dispersion)and JT discrete(JT dispersion,JTd),serum inflammation index [allergic C-reactive protein(high sensitivity C-reactiveprotein,hs-CRP)and interleukin-6(interleukin-6,IL-6),tumor necrosis factor ?(tumor necrosis factor ?,TNF-?)],severity of coronary artery lesions(number of coronary artery lesions,Gensini score),and prognosis [major adverse cardiac events(MACE)];Multiple linear retrospective analysis was conducted to analyze the relationship between TCM syndromes and QTd,JTd,serum inflammatory factors and Gensini score,and Logistic regression analysis was used to analyze the relationship between TCM syndromes and the number and prognosis of coronary artery disease.Results1.Among the 267 patients with AMI,the proportion of TCM syndrome types from high to low was as follows: deficiency of qi and Yin,blood stasis blocking collaterals(40.07%)> syndrome of phlegm and blood stasis blocking collaterals(34.83%)> syndrome of blood stasis blocking collaterals(14.98%)> syndrome of Yang qi weakness,phlegm and blood stasis blocking collaterals(10.11%).2.QTd and JTd comparison: QTd and JTd were higher in patients with phlegm turbidness and blood stasis,qi and Yin deficiency and blood stasis blocking collaterals than in patients with stasis poison blocking collaterals and Yang qi weakness phlegm and blood stasis blocking collaterals(P < 0.05).There was no significant difference in QTd and JTd between phlegm and blood stasis syndrome and qi-yin deficiency and blood stasis syndrome.(P >0.05).There was no significant difference in QTd and JTd between the syndrome of stasis toxin blocking collaterals and the syndrome of yang qi weakness and phlegm stasis blocking collaterals.(P >0.05).Correlation analysis: the syndrome of phlegm turbidness and blood stasis,qi and Yin deficiency and blood stasis blocking collaterals were significantly positively correlated with QTd(partial correlation coefficient 0.279,0.355)and JTd(partial correlation coefficient 0.480,0.342).3.Comparison of hs-crp,Il-6,and TNF-?: hs-crp,Il-6,and TNF-? in patients with phlegm turbidity and blood stasis syndrome,qi and Yin deficiency and blood stasis syndrome and collaterals obstruction syndrome were all higher than those with stasis and toxin obstruction syndrome and Yang qi weakness syndrome(P < 0.05).There was no significant difference between phlegm turbidness and blood stasis syndrome and qi and Yin deficiency syndrome and blood stasis syndrome(P > 0.05).There was no significant difference between the syndromes of blood stasis poison blocking collaterals and that of yangqi weakness and phlegm stasis blocking collaterals(P >0.05).Correlation analysis: the syndrome of phlegm turbidity and blood stasis,qi and Yin deficiency and blood stasis blocking collaterals were associated with hs-crp(partial correlation coefficient 0.374,0.241),Il-6(partial correlation coefficient 0.440,0.334),and TNF-level(partial correlation coefficient 0.346,0.279).4.Comparison of the number of coronary artery lesions: among the patients with phlegm turbidness and blood stasis syndrome and deficiency and Yin deficiency and blood stasis syndrome,the proportion of three lesions was the highest(70.97%,40.19%);Double-branch lesions accounted for the highest proportion(52.50%,59.26%)of the syndrome of blood stasis and toxin blocking collaterals and syndrome of yangqi weakness and phlegm blocking collaterals.Correlation analysis: the AMI patients with TCM syndrome type and pathological changes of coronary single not seen significant correlation(P > 0.05),but phlegm turbidity and blood stasis syndrome,qi and Yin deficiency of blood stasis resistance network card is AMI patients with independent risk factors for coronary angiography double branch lesions(P < 0.05),phlegm turbidity and blood stasis syndrome,qi and Yin deficiency of blood stasis resistance collaterals syndrome in patients with AMI the probability of coronary artery double branch lesions respectively is phlegm turbid blood stasis,qi and Yin deficiency of blood stasis resistance collaterals syndrome in patients with 2.368 times,2.291 times;Phlegm turbid blood stasis,blood stasis poison resistance collaterals syndrome,qi and Yin deficiency of blood stasis resistance network card are AMI patients were independent risk factors for coronary angiography three lesions(P < 0.05),phlegm turbid blood stasis,blood stasis poison resistance collaterals syndrome,qi and Yin deficiency of blood stasis resistance collaterals syndrome patients coronary artery pathological changes of three probability is phlegm turbid blood stasis,blood stasis poison resistance collaterals syndrome,qi and Yin deficiency of blood stasis resistance collaterals syndrome patients with 5.099 times,2.284 times,2.535 times.5.Gensini score: the highest Gensini score was obtained in patients with phlegm turbidness and blood stasis,followed by deficiency of qi and Yin,blood stasis blocking collaterals,and blood stasis blocking collaterals;The syndroms of phlegm turbidness and blood stasis,blood stasis and poison blocking collaterals,deficiency of qi and Yin,and blood stasis blocking collaterals were significantly positively correlated with Gensini score(P < 0.05),with partial correlation coefficients of 0.275,0.270 and 0.330.6.MACE events: 267 patients had a total of 39 macecases in the hospital,with an incidence of 14.60%.Among them,the proportion of sputum turbidity and blood stasis in the MACE group was significantly higher than that in the non-mace group(P < 0.05).Logisric regression analysis showed that the syndrome of phlegm turbidness and blood stasis,qi and Yin deficiency and blood stasis blocking collaterals were closely related to the occurrence of MACE in AMI patients(P <0.05).Conclusion 1.The TCM syndrome type of AMI patients in central Sichuan is the most common syndrome of deficiency of both qi and yin and blood stasis blocking collaterals.2.In patients with AMI,QTd and JTd were prolonged most obviously in patients with phlegm-turbid blood stasis syndrome,and there was a significant linear correlation between phlegm-turbid blood stasis syndrome,qi-yin deficiency and blood stasis syndrome and QTd and JTd.3.In patients with AMI,hs-CRP,IL-6 and TNF-? in patients with phlegm-turbid blood stasis syndrome were significantly higher than those in other syndrome types,and phlegm-turbid blood stasis syndrome,qi-yin deficiency and blood stasis syndrome were positively correlated with serum hs-CRP,IL-6 and TNF-?.4.Among the patients with AMI,the patients with phlegm-turbid blood stasis syndrome had the highest proportion of three-vessel lesions,the highest Gensini score and the highest incidence of MACE. |
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