| Objective1.By studying the distribution of TCM syndrome types of coronary heart disease combined with diabetes mellitus and exploring the key pathogenesis,we can provide a reference for treatment according to syndrome and pathogenesis2.By studying the distribution of ApoE gene polymorphism and studying its correlation with coronary heart disease and diabetes risk factors,It can provide a reference for the prediction of high-risk people of coronary heart disease and diabetes.3.By exploring the correlation between ApoE gene polymorphism and TCM syn dromes of coronary heart disease with diabetes,we hope to explain the essence of TCM syndromes from the perspective of genes.Furthermore,through ApoE gene scre ening,targeted prevention and treatment of traditional Chinese medicine will be help ful to prevent disease before it happens and prevent disease from changing.MethodIn this study,152 patients with coronary heart disease and diabetes who were treated in Dongzhimen Hospital of Beijing University of traditional Chinese medicine from December 2017 to December 2018 were selected according to the corresponding inclusion and exclusion criteria.Case observation table was used to collect the patient's basic situation(gender,nation,age,BMI),The main diagnosis of admission,Past medical history(history of hypertension,hyperlipidemia,etc.),Basic vital signs,four diagnosis information of traditional Chinese medicine,ApoE genotyping and other clinical data.Finally,data processing and statistical analysis were carried out.Result1.152 patients with coronary heart disease and diabetes mellitus were aged from 41 to 88 years,with an average age of 66.64 years;the ratio of male to female was about 1.2:1;49 patients with BMI<24kg/m2,103 patients with BMI? 24kg/m2;89 patients with family history of coronary heart disease and 90 patients with family history of type 2 diabetes mellitus.Statistics show that the average age of female patients is significantly higher than that of male patients(P<0.01).The number of patients with BMI?24kg/m2 is significantly more than the number of patients with BMI<24kg/m2(P<0.01)2.In 152 patients with coronary heart disease and diabetes,The distribution of syndrome types is mainly based on the two syndromes of deficiency of qi and yin and the mutual syndrome of phlegm and blood stasis,accounting for 36.2%and 34.2%,respectively;after comparison between multiple groups,it can be seen that the Qi and Yin deficiency group and the phlegm and blood stasis group are more distributed than the other syndrome groups(P<0.05).In terms of disease location,there were 73 cases(48%)in the heart and spleen,41 cases(27%)in the heart and kidney,23 cases(15.1%)in the heart and lung,and 15 cases(9.9%)in the heart and liver.The location of the disease is mainly in heart,spleen and kidney3.In 152 patients with coronary heart disease and diabetes,the proportion of E3/E3+E2/E4 genotype and E3 allele of apoE was more than 60%,and the proportion of E2/E3+E2/E2 and E3/E4+E4/E4 genotype and E2 and E4 allele was less than 40%.The distribution frequency of E4 allele was higher than that of E2 allele.4.In 152 patients with coronary heart disease and diabetes,the average TC value of E4 and E3 groups was higher than that of E2 group(P<0.05),and the average LDL-C of E4 group was higher than that of E2 group(P<0.05).Compared with E2 and E3 groups,E4 group had higher levels of glycated hemoglobin(P<0.05).The age of coronary heart disease in the E4 group was earlier than that in the E2 and E3 groups(P<0.05);Judging from the average onset time of coronary heart disease in the course of diabetes,the average incidence of coronary heart disease in diabetes patients in the E4 group was 3.3 years earlier than that in the E2 group(P<0.05).The average number of coronary lesions and coronary stenosis in the E4 group were significantly higher than those in the E2 and E3 groups(P<0.01)5.In 152 patients with coronary heart disease and diabetes,There was correlation between ApoE allele and TCM syndrome type of coronary heart disease with diabetes mellitus(P<0.05).Examination results afterwards showed:the E4 Distribution Frequency of Phlegm and Blood Stasis Syndrome is higher than other syndrome groups(P<0.05).Conclusion1.The TCM syndrome types with the highest frequency of coronary heart disease and diabetes are Qi-Yin deficiency syndrome and phlegm-stasis syndrome.Combined with the study of the course of disease,it is mostly a comorbid state in which diabetes develops into the stages of deficiency of qi and yin,and then phlegm and stasis block the heart.For the early intervention of traditional Chinese medicine in diabetes,cutting off the evolution of the pathogenesis is of great significance for delaying the occurrence of co-morbidity;The key pathogenesis of deficiency of both qi and yin,phlegm and blood stasis block the heart,has certain guiding value for clinical syndrome differentiation and treatment based on pathogenesis2.The distribution of ApoE4 genotype is significantly increased in people with coronary heart disease and diabetes,and the carriers of E4 gene have the characteristics of poor control of blood pressure,blood lipid and blood sugar,and the severity of coronary artery disease,suggesting that E4 gene carriers are a high-risk group of coronary heart disease with diabetes.Through ApoE genetic testing,it can provide a reference for disease risk assessment.3.Carriers of coronary heart disease and diabetes with E4 gene are prone to phlegm and blood stasis,and unhealthy diet will increase their risk.Those who carry the E4 gene should take phlegm and blood stasis as the focus of prevention before the disease and prevention disease from changing.When clinical treatment is carried out,on the basis of strengthening the spleen and reducing phlegm and promoting blood circulation and collaterals,diet therapy should be carried out throughout. |
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