A Study On The Correlation Between The TCM Syndromes Of Chest Obstruction And The Degree Of Coronary Artery Disease, Blood Lipids And Inflammation

Objective To explore whether there is a correlation between the TCM syndrome types of chest paralysis and the degree of coronary artery disease,blood lipids,inflammation indicators and the degree of coronary artery disease,and the relationship between the different TCM syndrome types and the expression levels of blood lipids and inflammation indicators,and to discuss the relationship and clinical significance of the three.Methods(1)In this study,we selected 150 patients from the Department of Cardiology,the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2019 to January 2020 due to chest tightness,chest pain or chest discomfort for concurrent coronary angiography.The results of angiography were divided into two groups: 25 patients with negative coronary angiography(Gensini score=0)were used as the control group,and 125 patients with positive coronary angiography diagnosed as coronary heart disease were used as the observation group.(2)Improving and recording clinical baseline data,coronary angiography results,blood lipid routine,blood routine,C-reactive protein,blood glucose,liver and kidney function and other detection indexes of patients included in the study after admission.(3)The coronary heart disease group was divided into coronary Gensini scores and TCM syndromes,and the differences between the groups were compared,and then the correlation between the TCM syndromes of chest paralysis and the severity of coronary artery disease,blood lipids,and inflammation indexes was analyzed.(4)Statistical methods: All data were processed using SPSS19.0 statistical analysis software.The statistical analysis results were considered to be statistically significant with P<0.05.Results1.The levels of LDL-c,white blood cell count,neutrophil count,and C-reactive protein in patients with coronary heart disease are higher than those in the control group(P<0.05),but there is no significant difference between the two groups of TC,TG,LDL-c,and NLR(P >0.05).2.According to the Gensini score,it is divided into a mild lesion group,a moderate lesion group and a severe lesion group,in which HDL-c is significantly different between different lesion groups(1.14±0.37 vs1.12±0.80 vs 0.97±0.28,P=0.044)As the degree of coronary atherosclerosis worsens,HDL-c levels show a downward trend.White blood cell count,neutrophil count,NLR,and C-reactive protein are significantly different among different coronary artery disease groups,with P values ??of 0.038,0017,0.008,and 0.001,respectively.As the degree of coronary atherosclerosis worsens,inflammation The indicator level shows an upward trend.3.Multivariate logistic regression analysis showed that males(OR=3.651,P=0.000),diabetes(OR=4.047,P=0.004),CRP(OR=1.085,P=0.001),NLR(OR=1.585,P= 0.011)is an independent risk factor for the degree of coronary artery disease,and HDL-c(OR=0.180,P=0.016)is an independent protective factor for the degree of coronary artery disease.4.The distribution rules of TCM syndromes of chest paralysis are as follows: Heart and Blood Stasis Syndrome(36.8%)> Qi and Yin Deficiency Syndrome(19.2%)> Qi Deficiency and Blood Stasis Syndrome(17.6%)>Phlegm and Blood Stasis Syndrome(15.2%)> Qi stagnation and blood stasis syndrome(11.2%).5.The syndrome of heart-blood stasis is the basic TCM syndrome of thoracic paralysis.The syndrome of heart-blood stasis is mainly distributed in the severe disease group with Gensini score> 40,and most of them are manifested as multi-vessel disease;Phlegm-blocking heart pulse syndrome and qi stagnation and blood stasis syndrome are mainly manifested as mild lesions,but there is no significant difference in the distribution of coronary artery disease counts among the four syndromes.6.Through the comparison of different TCM syndrome groups and pairwise comparison,it was found that the Gensini score of each syndrome group was significantly different(P<0.001),and the central blood stasis syndrome Gensini score was higher than that of Qi deficiency blood stasis syndrome and Qi deficiency syndrome.Cardiac syndrome of phlegm obstruction(P<0.05).The analysis of blood lipid index showed that there was no significant difference between the TC,TG and LDL-c syndrome groups,the difference between the HDL-c levels was statistically significant(p<0.05),and the HDL-c level of heart blood stasis syndrome was low Yu Qi deficiency and blood stasis syndrome(p<0.05).Inflammation index analysis showed that there were no significant differences between C-reactive protein and NLR syndrome groups,and white blood cell count and neutrophil count were significantly different between syndrome groups(p<0.05).The comparison between two groups showed that the white blood cell count and neutrophil count were both higher than those of Qi-yin deficiency syndrome(p<0.05).7.Through correlation analysis of different risk factors and TCM syndrome types,it is found that compared with heart-blood stasis syndrome,high HDL-c and low Gensini score are more likely to be qi-deficiency blood stasis syndrome;high NE count,low WBC count,low NLR value It is more likely to be a syndrome of qi stagnation and blood stasis;a low NLR value and no history of diabetes are more likely to be a cardioplegia syndrome.Conclusion1.The traditional Chinese medicine syndrome of thoracic paralysis ranks first in the heart-blood stasis syndrome,followed by qi-yin deficiency syndrome,qi-deficiency blood stasis syndrome,phlegm-blocking heart pulse syndrome,qi stagnation blood stasis syndrome.2.Men,diabetes,NLR,and C-reactive protein are independent risk factors for the severity of coronary artery disease,while HDL-c is an independent protective factor for the severity of coronary artery disease.3.There is a certain correlation between TCM syndrome types of chest paralysis and blood lipids,inflammation indicators and Gensini score,which can be used as an objective quantitative reference basis for TCM syndrome differentiation of TCM syndromes.4.The Gensini score of the heart-blood stasis syndrome is the highest,and most of them are severe coronary artery lesions and multi-vessel lesions,which are the dangerous syndromes of various TCM syndromes of chest paralysis.Clinically,patients with severe coronary artery disease and multi-vessel disease,decreased HDL-c value,and increased inflammation indicators often see blood stasis syndrome as the main syndrome,so we should focus on promoting blood circulation and removing blood stasis.