Tongue Characteristics And Their Correlation In Patients With Acute Coronary Syndrome With Phlegm And Blood Stasis Syndrome

Purpose : Based on the theory of "Heart Resuscitation in the Tongue" to explore the characteristics of the tongue picture in patients with acute coronary syndrome(ACS)with the syndrome of phlegm and blood stasis and its relation to Gensini score,coronary artery disease number,infarction-related artery(IRA)TIMI blood flow classification,the correlation between blood lipids and left ventricular ejection fraction(LVEF)is expected to provide a basis for clinical evaluation of ACS patients with phlegm and blood stasis syndrome,disease judgment,disease control,and blood lipid management.Method:Select inpatients from 2019.9 to 2020.10 in the Second Department of Cardiology,Liaoning Provincial Hospital of Traditional Chinese Medicine,with ACS as the inpatient diagnosis and TCM differentiation of phlegm and blood stasis syndrome and coronary angiography(CAG).On the day of admission,ask for medical history and basic information,and record the tongue.Information such as symptoms,gender,age,smoking history,drinking history,hypertension,diabetes,dyslipidemia and cerebrovascular disease,etc.,record blood lipids and LVEF levels according to the test results,and record the number of coronary artery lesions according to CAG results And IRA TIMI blood flow classification and calculation of Gensini score.According to the acceptance criteria and rejection criteria,combined with clinical groups,they were grouped according to different tongue colors and different types of fur.The data is processed by SPSS22.0 statistical software: first analyze the general data,then compare the differences and correlations of the above indicators in different tongue color groups,then compare the differences and correlations of the above indicators in different fur groups,and finally compare blood lipids,The number of coronary artery lesions,IRA TIMI blood flow classification and the correlation between LVEF and Gensini score.Results:1.A total of 134 patients were enrolled,and they were divided into dark red tongue group,petechiae tongue group and purple tongue group according to different colors.They were divided into thin coating group,greasy coating group and thick greasy coating group according to different coating quality;including 72 males(53.73%)with an average age of56.94±1.67 years old;62 females(46.27%)with an average age of 68.00±1.85 years old;the youngest was 34 years old,the oldest was 85 years old,and the average age was 62.06 ±1.41 years old,the majority of middle-aged and elderly patients,accounting for 77.62%;68 cases(50.75%)with a history of smoking,16 cases(11.94%)with a history of drinking;78 cases(58.21%)with hypertension(58.21%),48 cases with type 2 diabetes(35.82%),8 cases of dyslipidemia(5.97%),22 cases of cerebrovascular disease(16.42%),118 cases of hyperlipidemia and discharge diagnosis;the final diagnosis was 62 cases of unstable angina(UAP)and 24 cases of non-ST segment Elevated myocardial infarction(NSTEMI),48 cases of ST-segment elevation myocardial infarction(STEMI).The effect of gender on the tongue color of ACS with the syndrome of phlegm and blood stasis was statistically significant(P<0.05),and age,personal history,and past disease history were not statistically significant(P>0.05).Gender,age,personal history,and past history had no statistically significant effects on the fur quality of ACS with the syndrome of phlegm and blood stasis(P>0.05).2.Correlation between tongue picture and blood lipid:TG and LDL-C have statistically significant effects on tongue color and fur of ACS patients with phlegm and blood stasis syndrome(P<0.05),and TC and HDL-C are not statistically significant(P>0.05);TG and LDL-C are positively correlated with tongue color and fur quality in ACS patients with phlegm and blood stasis syndrome.3.Correlation between tongue picture and CAG results:(1)Correlation between tongue picture and the number of coronary artery diseased branches:The influence of the number of coronary artery diseased branches on the tongue color and fur of ACS patients with phlegm and blood stasis syndrome is statistically significant(P<0.01);The number of coronary artery diseased branches was positively correlated with tongue color and fur quality in patients with ACS with phlegm and blood stasis syndrome.(2)Correlation between tongue picture and Gensini score: Gensini score has significant effects on tongue color and fur quality of patients with ACS phlegm and blood stasis syndrome(P<0.01);Gensini score and ACS phlegm and blood stasis patients' tongue Color and moss quality are positively correlated.(3)Correlation between tongue picture and IRA TIMI blood flow classification:IRA TIMI blood flow classification has statistically significant effects on the tongue color and fur of ACS patients with phlegm and blood stasis syndrome(P<0.05);IRA TIMI blood flow classification is related to Tongue color and fur quality of ACS patients with phlegm and blood stasis syndrome are negatively correlated.4.Correlation between tongue picture and LVEF: LVEF has a statistically significant effect on the tongue color and fur of ACS patients with phlegm and blood stasis syndrome(P<0.05),and the tongue color and fur of patients with LVEF and ACS phlegm and blood stasis syndrome are both There is a negative correlation.5.Correlation between the number of coronary artery diseased branches,IRATIMI blood flow classification,LVEF and Gensini score:TG,LDL-C and the number of coronary artery diseased branches of ACS patients with phlegm and blood stasis syndrome are positively correlated with Gensini score,IRA TIMI blood Flow classification and LVEF were negatively correlated with Gensini score,while TC and HDL-C were not correlated with Gensini score.Conclusion:1.ACS patients with phlegm and blood stasis syndrome with purple tongue or thick greasy coating have higher levels of TG and LDL-C.Tongue color and fur are the reference indicators for predicting blood lipid levels in patients with ACS with phlegm and blood stasis syndrome.2.ACS patients with phlegm and blood stasis syndrome with purple tongue or thick greasy coating have more severe coronary artery disease,more coronary artery disease,and lower IRA TIMI blood flow grade.Tongue color and fur are used to assess ACS phlegm and blood stasis An important basis for the severity of the condition of patients with mutual syndromes.3.The heart function of ACS patients with phlegm and blood stasis syndrome with purple tongue or thick greasy coating is worse.Tongue color and coating quality have important clinical value in evaluating the heart function of ACS patients with phlegm and blood stasis syndrome.