Research On TCM Syndrome Type Distribution Of Chronic Coronary Syndrome Based On "New Qi,Blood,Body Fluid And Syndrome Differentiation"

Objective:This study explored the distribution of TCM evidence patterns of chronic coronary syndrome from the perspective of the "new qi-blood-liquid identification",that is,"qi-blood-liquid identification fused with the theory of five internal evils",and explored the correlation between them and TCM evidence patterns through the analysis of cardiovascular disease risk factors.The aim was to provide a reference basis for clinical diagnosis and treatment.Methods:In this study,300 patients with chronic coronary syndrome who met the diagnostic,inclusion and exclusion criteria were studied in the outpatient and inpatient departments of the Cardiology Department of the Affiliated Hospital of Changchun University of Chinese Medicine by using a clinical questionnaire and collecting information on the four diagnoses of Chinese medicine.Based on the clustering results,we summarized the distribution pattern of TCM symptoms in chronic coronary syndrome based on the theory of "new qi-blood-fluid discernment",and explored the inner connection between cardiovascular disease risk factors and TCM discernment classification through single-factor and multi-factor analysis.Results: In this study,300 cases of chronic coronary syndrome were collected,including 138 males and 162 females,and the ratio of males to females was 1:1.17.The results of the survey collected a total of 120 symptoms,88 chest and peripheral symptoms and 32 tongue and pulse symptoms.The results of the systematic clustering analysis were based on the experts’ clinical experience,and the nine categories were most consistent with clinical practice,namely,Qi deficiency and blood stasis,Qi deficiency and blood stasis with phlegm,Qi and Yin deficiency,phlegm and blood stasis with mutual obstruction,Qi stagnation and blood stasis,Yang deficiency and cold condensation,fluid deficiency and dry heat,and internal heat toxicity;the results of the univariate analysis of cardiovascular disease risk factors suggested that the history of smoking,diabetes mellitus,and dyslipidemia were the most important factors in the classification of chronic coronary syndrome.The results of multi-factor logistic regression analysis showed that dyslipidemia was a risk factor for Qi deficiency,blood stasis,phlegm blockage(P=0.000<0.05,B=2.571,OR=13.082)and phlegm-stasis mutual blockage(P=0.000<0.05,B=1.973,OR=7.193).P=0.002<0.05,B=2.455,OR=11.647)and heat toxicity(P=0.000<0.05,B=2.805,OR=16.532);patients with a history of diabetes mellitus were more likely to be diagnosed with Qi and Yin deficiency(P=0.000<0.05,P=0.000<0.05,B=3.339,OR=28.187)and deficiency of fluid and dry heat(P=0.000<0.05,B=3.045,OR=21).Conclusion:In this study,it was concluded by cluster analysis that chronic coronary syndrome could be classified into nine types of evidence,specifically,Qi deficiency and blood stasis evidence,Qi deficiency and blood stasis and phlegm stasis evidence,Qi and Yin deficiency evidence,phlegm and blood stasis evidence,Qi stagnation and blood stasis evidence,Yang deficiency and cold condensation evidence,fluid deficiency and dry heat evidence,and heat toxicity internalized evidence.The results of the univariate analysis of cardiovascular risk factors suggested that there was a statistical difference in the distribution of TCM evidence of chronic coronary syndrome among smoking history,diabetes mellitus,and dyslipidemia(P<0.05);multi-factor analysis indicated that patients with chronic coronary syndrome accompanied by a history of dyslipidemia tended to be identified as Qi deficiency,blood stasis,phlegm obstruction,and phlegm-stasis mutual obstruction,and patients with chronic coronary syndrome accompanied by a history of smoking tended to be identified as Patients with chronic coronary syndrome with a history of smoking tend to be identified as evidence of deficiency of fluid and heat and evidence of internal heat toxicity,while patients with chronic coronary syndrome with a history of diabetes tend to be identified as evidence of deficiency of both qi and yin and evidence of deficiency of fluid and heat.