Correlation Between TCM Syndrome Patterns And The Degree Of Coronary Artery Disease In Patients With CHD Complicated With Abnormal Glucose Metabolism

ObjectiveClarifying the distribution of TCM syndrome patterns and coronary artery lesions in patients with CHD complicated with abnormal glucose metabolism.To explore the correlation between TCM syndrome patterns and the degree of coronary artery disease,provide a theoretical basis for objective syndrome differentiation,take individualized treatment programs for patients with different TCM syndrome patterns,and provide diagnosis and treatment ideas and basis for the clinical prevention and treatment of CHD complicated with abnormal glucose metabolism.MethodA total of 128 patients hospitalized in the Department of Cardiology,Wuhan First Hospital from 2019.01.01 to 2019.12.31 were selected.These patients who were selected need to complete coronary angiography and meet the diagnostic criteria for CHD and abnormal glucose metabolism.According to the established TCM syndrome differentiation standards,collect the patients’ TCM symptoms and classify their TCM syndrome pattern.According to the data collection table,the general situation of patients,medical history,coronary angiography results,TCM syndrome patterns,and other information were collected.Then enter the obtained data into EXCEL to create a form,and then use SPSS25.0 software for statistical analysis.The number of diseased coronary arteries,the degree of coronary artery stenosis,and the coronary Gensini score were compared to determine whether there is any difference between different TCM syndrome pattern groups.Result1.Basic information: A total of 128 patients were included with an average age of 64.30 ± 8.52.Among them,there were 112 patients with CHD and T2 DM and 16 patients with CHD and IGT.There were 88 males,82 smokers,98 hypertension,95 dyslipidemia,27 hyperuricemia,26 revascularization,and 25 cerebrovascular diseases.2.Distribution of TCM syndrome patterns: Among the patients included,the frequency of TCM syndrome pattern distribution was as follows: pattern of qi deficiency with blood stasis> pattern of heart blood stasis> pattern of heart block of phlegm> pattern of dual deficiency of qi and yin> pattern of deficiency of yang qi.3.The characteristics of coronary artery disease: the distribution of the number of diseased coronary arteries was:multi-vessel disease>double-vessel disease>single-vessel disease.The total number of diseased vessels was 289,and the average number of diseased vessels was 2.26.The degree of coronary stenosis distribution was level Ⅲ> level Ⅳ> level Ⅱ.The distribution of coronary artery vessels diseased were: LAD lesions> LCX lesions> RCA lesions> LM lesions.Among the included patients,the Gensini score was 37.0(15.75,57.00),of which the highest score was 212 points and the lowest score was 2points.4.Correlation between TCM syndrome patterns and degree of coronary artery disease: There was no statistically significant difference in the number of diseased coronary arteries between the TCM syndrome pattern groups of CHD combined with abnormal glucose metabolism(P>0.05).There were differences in the classification of coronary stenosis between different TCM syndrome pattern groups(P<0.05).Further pairwise comparison showed that the degree of coronary stenosis of the pattern of heart blood stasis,the pattern of heart block of phlegm,and pattern of deficiency of yang qi was more severe than the pattern of qi deficiency with blood stasis(P<0.005);The degree of coronary stenosis in the syndrome of the pattern of heart blood stasis and pattern of deficiency of yang qi was more severe than the pattern of dual deficiency of qi and yin(P<0.005);the pairwise comparisons among the other groups were not statistically significant.There are differences in Gensini scores between different TCM syndrome pattern groups(P<0.05).Further pairwise comparisons,Gensini score of the pattern of heart blood stasis,the pattern of heart block of phlegm,pattern of deficiency of yang qi was higher than the pattern of qi deficiency with blood stasis(P<0.005);Gensini score of the pattern of heart blood stasis was higher than the pattern of dual deficiency of qi and yin(P<0.005);the pairwise comparisons among the other groups were not statistically significant.Conclusion1.The pattern of qi deficiency with blood stasis was the most common in the TCM syndrome patterns of CHD complicated with abnormal glucose metabolism.Blood stasis and phlegm were important pathological factors causing the occurrence and development of CHD complicated with abnormal glucose metabolism.2.The number of diseased coronary arteries in patients with CHD and abnormal glucose metabolism was usually multi-vessel disease.The degree of coronary stenosis is mainly level Ⅲ(severe stenosis)and level Ⅳ(complete occlusion).The diseased vessels mainly involved LAD and LCX.3.In patients with CHD and abnormal glucose metabolism,there was a correlation between TCM syndrome patterns and the degree of coronary artery disease.There was no obvious correlation between TCM syndrome patterns and the number of diseased coronary arteries in patients with CHD complicated with abnormal glucose metabolism.TCM syndrome patterns and degree of coronary stenosis,and coronary Gensini scores were correlated in patients with CHD complicated with abnormal glucose metabolism.Besides,the degree of coronary artery disease in the two groups of the pattern of qi deficiency with blood stasis and the pattern of dual deficiency of qi and yin is relatively mild,while the degree of coronary artery disease in the pattern of heart blood stasis,the pattern of heart block of phlegm and pattern of deficiency of yang qi is relatively severe.