| Background and objective:In recent years,the exploration of coronary atherosclerosis se x heart disease patients(coronary heart disease,CHD)the laws between the related param eters of syndrome types of TCM and western medicine has become a hot research topic,there are a lot of scholars use combine traditional Chinese and western medicine diagnos is and treatment way from different angles of unstable angina for clinical research,and m ade the basis of the results.In this paper,by comparing the unstable angina pectoris(UA P)in patients with general information,inflammation,related factors,lipid metabolism,blood coagulation fibrinolytic indexes,blood rheology,the physical and chemical indexes such as the heat and blood stasis and qi deficiency syndrome and clinical common of each on th e objective index of blood stasis syndrome,the difference of the exploration of stasis heat exchange and qi deficiency and blood stasis their strong correlation degree of the sensiti vity of the objective indicators and specific,in order to provide UAP stasis hot alternating knot in the clinical diagnosis of combining modern laboratory test index of more simple and quick,specificity,precision,for TCM syndrome differentiation and treatment is relatively early,objective,quantitative and accurate clinical reference.Methods:By epidemiological method,the selection range of nanjing university of Chinese medicine affiliated hospital from May to December,a diagnosis of unstable angina of outpatient and inpatient,reference in,zheng xiaoyu,editor of<Chinese medicine new medicine c linical research guiding principles Gui>,can-dong li,editor of<diagnostics of TCM>,Sh en Shaogong code for<the heart disease diagnosis standard and curative effect of traditi onal Chinese medicine>,professor Zhou Zhongying of<the stasishot alternating knot of TCM syndrome differentiation guide and mentor and another illnesses of doctor of vice director of the above,disease,syndrome differentiation and unified conclusion>,It is plan ned to include cases of the syndrome of heat stasis and qi deficiency and blood stasis,an d cases of healthy people in the same period were selected as the control group.Within hours of the patient’s clinical general information collection(clinic or hospital number,na me,sex,BMI,smoking history,hypertension history,diabetes history),four diagnostic informatio n,hospital routine inspection,the related inflammation index,blood lipid,blood clotting,blood rheology and other physical and chemical indicators,using SPSS.statistical software for d ata analysis,and on patients with UAP stasis heat exchange by the relevance and differen ce of qi deficiency and blood stasis,explore the UAP stasis hot alternating knot in clinica 1 of traditional Chinese medicine combined with modern physical and chemical indicators of specificity,sensitivity index.Results:1.A total of 160 patients with UAP were collected in this study,including males,with an average age of 69.34,smokers,and a body mass index of 24.75.kg/m2.Compared with the control group,there were differences in age,gender,smoking,hypertension,diabete s between the two groups(P<0.05),which were consistent with the risk factors of UAP.2.In this study,160cases of UAP patients and 60 cases of control group were tested an d compared,and it was found that UAP patients had significant difference in serum UA 1 evel(P=0.000<0.01).There was a significant difference in LP-PLA2 level between the tw o groups(P=0.000<0.01).There was a significant difference in HCY level between the tw o groups(P=0.000<0.01).The level of IL-6 in UAP patients was significantly different be tween the two groups(P=0.009<0.01).The hs-CRP level of UAP patients was significantl y different between the two groups(P=0.008<0.01).There was no difference in TC level between the two groups(P=0.567>0.05).There was no difference in serum TG level betwe en the two groups(P=0.052>0.05).The LDL-C level of UAP patients was significantly diff erent between the two groups(P=0.000<0.01).The HDL-C level of UAP patients was sig nificantly different between the two groups(P=0.000<0.01).LP(a)between the two group s,UAP patients in the blood LP(a)level was significantly different(P=0.000<0.01).The D-dimer level of UAP patients was significantly different between the two groups(P=0.000<0.01).ESR levels of UAP patients were significantly different between the two groups(P=0.000<0.01).There was no significant difference in HCT level between the two groups(P=0.606>0.05).3.There were no differences in gender,age and BMI between the two groups(P=0.206>0.05),age(P=0.763>0.05)and body mass index(P=0.899>0.05)(P>0.05).There were s ignificant differences between the two groups in the history of smoking(P=0.000<0.01),history of diabetes(P=0.017<0.05)and history of hypertension(P=0.004<0.01).There was a difference in the blood UA between the two groups(P=0.000<0.01),and the UA level in the group with the combination of blood stasis and heat stasis was significantly highe r than that in the group with the syndrome of Qi deficiency and blood stasis.LP-PLA2(P=0.000<0.01),HCY(P=0.000<0.01),IL-6(P=0.000<0.01)and hs-CRP(P=0.007<0.01)were different between the two groups(P<0.01),and the levels of LP-PLA2,HCY,IL-6 and h s-CRP in the intercombination group were significantly higher than those in the syndrom e of Qi deficiency and blood stasis group.TC(P=0.620>0.05)and TG(P=0.103>0.05)we re not significantly different between the two groups(P>0.05),while LDL-C(P=0.028<0.05)was different between the two groups(P<0.05),HDL-C(P=0.001<0.01)and LP(a)(P=0.004<0.01)were significantly different between the two groups(P<0.01).The levels of LDL-C and LP(a)in the intercombination of blood stasis and blood stasis group were signific antly higher than those in the syndrome of Qi deficiency and blood stasis group,and the level of HDL-C was significantly lower than that in the syndrome of Qi deficiency and blood stasis group.There was no significant difference in D-dimer between the two grou ps(P=0.876>0.05).There were differences in ESR(P=0.000<0.01)and HCT(P=0.010<0.05)between the two groups(P<0.05).The levels of ESR and HCT in the group with mut ual association of blood stasis and blood stasis were significantly higher than those in th e group with syndrome of Qi deficiency and blood stasis.4.With TCM syndrome type as dependent variable,unconditional multivariate binary Lo gistic regression analysis was conducted.The results showed that UA(P=0.024<0.05),HCY(P=0.026<0.05),LP-PLA2(P=0.004<0.05),LDL-C(P=0.008<0.05),LP(a)(P=0.034<0.05)and ESR(P=0.020<0.05)were positively correlated with stasis and heat intercombination synd rome,which could be used as an independent risk predictor of unstable angina pectoris.HDL-C(P=0.000<0.05)was negatively correlated with the syndrome of Qi deficiency and blood stasis,while LDL-C(P=0.003<0.05)and LP(a)(P=0.004<0.05)were positively correlat ed,indicating that HDL-C could be an independent protective factor for the syndrome of Qi deficiency and blood stasis of unstable angina pectoris,and LDL-C and LP(a)were in dependent risk factors for the syndrome of Qi deficiency and blood stasis.5.The area under the ROC curve of UA in the diagnosis of unstable angina pectoris w as 0.705(P<0.05),LP-PLA2 was 0.869(P<0.05),HCY was 0.840(P<0.05),LP(a)was 0.779(P<0.05),LDL-C was 0.718(P<0.05),and ESR was 0.821(P<0.05).The optimal critical v alues of UA and LPA2 were 50umol/L and 200.025ng/mL,respectively.HCY was 10.09u mol/L,LP(a)was 314.50mg/L,LDL-C was 1.93mmol/L,and ESR was 13.50 mm/h,among which LPA2,LP(a)and ESR had the highest sensitivity and specificity.Conclusion:1.Compared with the healthy group,there were significant differences in ge nder,history of smoking,history of hypertension,history of diabetes,UA,Lp-PLA2,HCY,IL-6,hs-CRP,LDL-C,HDL-C,LP(a),D-dimer and ESR in patients with unstable angina pectori s,which can be used as auxiliary diagnostic basis for unstable angina pectoris.2.There was no significant difference in gender,age and body mass index among the collected cases in the interconnection between stasis and heat,but the history of smoker s,hypertension and diabetes was significantly higher than that of the syndrome of qi def iciency and blood stasis,which indicates that the history of smoking,Hypertension and di abetes could be used as a certain reference basis for the syndrome differentiation of the interconnection between stasis and heat.3.Stasis heat exchange by qi deficiency and blood stasis,compared to the LP-PLA2,HC Y,IL-6,Hs-CRP,LDL-C,LP(a),ESR,HCT group obviously higher than that of qi deficiency b lood stasis,HDL-C was lower than that in group qi deficiency blood stasis,were statistical ly significant,indicating that the LP-PLA2,HCY,IL-6,Hs-CRP,LDL-C,HDL-C,LP(a),ESR,HCT can be used as heat and blood stasis syndrome differentiation and treatment by each objective indicators on the basis of quantitative diagnosis further guide clinical d isease syndrome differentiation of traditional Chinese medicine and using drugs.4.The changes in UA,LP-PLA2,HCY,LP(a),LDL-C and ESR levels have high specificit y and sensitivity in the diagnosis of the syndrome of stasis and heat interaction,which ca n be used as the diagnostic basis for the differentiation and treatment of the syndrome o f stasis and heat interaction.5.The levels of HDL-C,LDL-C and Lp(a)have high specificity and sensitivity in the d iagnosis of Qi deficiency and blood stasis syndrome,which can be used as the quantitativ e basis for the objective index diagnosis of Qi deficiency and blood stasis syndrome diff erentiation and treatment,and further guide the clinical TCM disease differentiation and sy ndrome differentiation and prescription medication. |
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