Correlation Study Of Coronary Heart Disease And Its TCM Syndromes And Vitamin K1, MK-4, MK-7 Levels

This article includes two parts:literature review and clinical researchPart1 Literature ReviewThe fist review:This paper was mainly discussed the correlation between the risk of coronary heart disease(CHD)and vitamin K1 and vitamin K2(mainly about MK-4 and MK-7).CHD is the first cause of death in the world.Researchers started the correlation study between the risk of coronary heart disease and vitamin K levels as early as the last century,and to a certain extent affirmed the protective role of vitamin K1 and vitamin K2 in the pathogenesis of coronary heart disease.Through the summary and analysis of previous research results,it was shown that high level of vitamin K(mainly vitamin K2)may have a positive effect on CHD,while it had no significant relationship with risk factors of coronary heart disease such as blood lipid and vascular endothelial function.At the same time,this paper discussed the problems of previous research methods,and pointed out that the differences of clinical results may be related to the test method,region,and race.Finally,this review put forward suggestions and prospects for next research.The second review:This paper was mainly discussed the characteristics of TCM syndromes of CHD and their diet guidance.Modern research guides dietary intake through the content of sugar,protein,fat,and vitamins in food,which is obviously different from the principles of traditional Chinese medicine.Studies on TCM syndromes of CHD had made some achievements,but the diet guidance of TCM for coronary heart disease has not been well summarized.This paper summarized the characteristics of coronary heart disease syndrome.By analyzing the ancient records,this article summarized the dietary guidance about CHD.In order to make the diet more specific,this article put forward different suggestions with different syndrome types.Finally,combined with the results of modern medical research,it was expected to provide a reasonable,effective,and targeted diet guidance for patients with CHD.Part2 Clinical ResearchObjective:Previous studies have shown that a high vitamin K diet can reduce the risk of coronary heart disease(CHD).By detecting the differences in serum levels of vitamin K1 and vitamin K2(MK-4,MK-7)in patients with CHD and the general population,this study analyzed correlation of CHD,coronary artery results,and TCM syndromes of CHD with vitamin K1,MK-4,MK-7,in order to provide guidance for the prevention and treatment of CHD.Methods:In this study,a cross-sectional survey method was used to select 133 patients with CHD diagnosed by coronary angiography from the Department of Cardiology of Chinese and Western Medicine at the China-Japan Friendship Hospital from September 2019 to January 2020 as the case group.We received 266 medical examination personnel as a control group from the physical examination center.After admission,the general condition(age,sex,height,weight,medical history)was recorded and the TCM syndrome was collected through observation,listening,interrogation,and pulse-taking.The fasting blood was drawn from the next morning to measure vitamin K1,MK-4,MK-7 and blood lipid-related indicators(LDL-C,HDL-C,TG,CHO).Then,we recorded the medication plan and coronary angiography results after doing it.SPSS26.0 software was used for analysis.According to whether the data between the two groups conformed to the normal distribution and the homogeneity of variance,the independent sample t-test and the non-parametric test of the two independent samples were used for the measurement data.Chi-square test was used for counting data between two groups,and single-factor analysis of variance and non-parametric test were used for data between multiple groups.As for the correlation between MK-7 and CHD,we used binary logistic regression analysis to build the model.P<0.05 was considered statistically significant.Results:1.Comparison of basic data between coronary heart disease group and control groupThe clinical data of the coronary heart disease group and the control group were analyzed by independent sample t-test,non-parametric test of two independent samples and chi-square test.The results showed that BMI,TC,LDL-C,HDL-C,AST,ALT,DBIL,age,gender,hypertension,diabetes,had significant differences(all P<0.05),and TG,TBIL levels had no statistical differences.2.Correlation between vitamin K and other clinical data in the general populationIn the control group,according to the reference range of vitamin K1,MK-4,MK-7 serum concentration levels,they were divided into groups 1,2 and 3 from high to low.Through single factor analysis of variance,rank sum test of multiple independent samples,the results found:?The differences of TG,TC in vitamin K1 groups were statistically significant(all P<0.05).There were no statistically significant difference in BMI,LDL-C,HDL-C,age among-vitamin K1 groups;?The differences of TG,HDL-C,BMI were statistically significant in the MK-4 groups(all P<0.05),while TC,LDL-C,and age were not statistically significant among the MK-4 groups;?The differences of TC,TG,LDL-C,BMI,and age were statistically significant among the MK-7 groups(All P<0.05).There was no statistically significant difference in HDL-C among the MK-7 groups.3.Correlation between vitamin K and CHDIn the comparison of vitamin K between the coronary heart disease group and the control group,through independent sample non-parametric test analysis,MK-7 had a significant difference between the two groups(P=0.000),while vitamin K1 had no significant difference.Vitamin K1,MK-4,MK-7 were divided into 2 groups according to whether they are in the normal range for chi-square test.The difference of MK-7 was statistically significant(OR=2.118,P=0.001),while Vitamin K1,MK-4 were not statistically significant.The binary logistic regression analysis of vitamin K1 and MK-7 showed that the serum concentration of MK-7 was positively correlated with the incidence of CHD(P=0.019).The prediction model after adjustment in this study was:Y=0.285*MK-7+0.091*age+0.228*BMI-1.069*TC-7.099.Vitamin K1 had no statistical significance.According to age,it was divided into middle-aged group and elderly group.The correlation between middle-aged group coronary heart disease and MK-7 was more obvious,and the difference was statistically significant(OR=0.393,P=0.025).4.Correlation between vitamin K and coronary heart disease type and degree of coronary artery stenosisThe coronary heart disease group is divided into stable coronary heart disease group and acute coronary syndrome group.The independent sample non-parametric test and chi-square test analysis show that there was no statistically significant difference between vitamin K1,MK-4 and MK-7.MK-7 and Gensini scores were positively correlated(P=0.051).Vitamin K1,MK-4,MK-7 and Gensini scores were not statistically different.5.Correlation between TCM syndromes and vitamin K in CHDAccording to the scores of TCM syndrome elements,each patient can have two or more syndromes.Blood stasis,phlegm,qi stagnation,heat accumulation,cold coagulation was classified as excess syndrome,and qi deficiency,yang deficiency and yin deficiency was classified as weak syndrome.The traditional Chinese medicine syndrome was divided into empirical group and deficiency group.Through independent sample non-parametric tests,vitamin K1 was higher in the empirical group(P=0.094),but the levels of vitamin K1 and MK-7 were not statistically significant between the two groups.Vitamin K1 and MK-7 were not significantly different in blood stasis syndrome,phlegm syndrome and qi deficiency syndrome.Conclusion:1.In the general population,vitamin K1 was positively correlated with TG,TC.MK-4 was positively correlated with TG,BMI,and negatively correlated with HDL-C.MK-7 serum concentration was correlated with TC,TG,LDL-C,BMI,age was positively correlated.2.The serum concentration of MK-7 in the coronary heart disease group was higher,and the middle-aged population was more obvious,which may be a risk factor for CHD.Vitamin K1 and MK-4 was not related to CHD.3.MK-7 was positively correlated with Gensini score,while vitamin K1,MK-4 had no correlation.Vitamin K1,MK-4,MK-7 had no correlation with the type of coronary heart disease.4.Vitamin K1 has a higher serum concentration in patients with excess syndrome.MK-7 has no correlation with TCM syndrome of CHD.5.Gensini score of CHD patients with blood stasis syndrome was higher.