Analysis Of TCM Syndrome Characteristics And Related Factors Of Ischemia With No Obstructive Coronary Arteries Disease

Background:Angina pectoris is the most common symptom of ischaemic heart disease,with approximately 112 million people worldwide suffering from coronary angina.As many as 70%of patients undergoing invasive angiography do not have obstructive coronary artery disease and the majority have ischaemic with non-obstructive coronary artery disease(INOCA).with a greater proportion of women than men.patients with INOCA are often misdiagnosed as having non-cardiac disease,leading to inadequate follow-up treatment and compromising patient prognosis.However,INOCA may be caused by a variety of mechanisms including coronary vasospasm and microvascular dysfunction and is not a benign condition.INOCA is associated with an increased incidence of cardiovascular events,hospital readmission,impaired quality of life and increased healthcare costs compared to asymptomatic individuals.The core theory of TCM is the identification and treatment of evidence,but there are few studies on the TCM evidence of INOCA.Objectives:1.To visualise and analyse domestic and international literature on ischaemia with non-obstructive coronary artery disease,to grasp the current status of domestic and international research,and to explore the frontier hotspots in this field.2.To use retrospective analysis to explore the characteristics and factors associated with the TCM syndromes of ischaemia with non-obstructive coronary artery disease,and to provide references and ideas for its diagnosis and treatment.Study 1:CiteSpace-based visualisation of ischaemia with non-obstructive coronary artery disease1.Method:Based on the China Knowledge Network(CNKI)and Web of Science(WOS)databases,the domestic and international literature of INOCA was searched,and the annual publication volume of relevant studies was analysed using CiteSpace 6.1.R6 software,and the co-occurrence analysis of authors,institutions,countries and keywords was performed,and the keywords were clustered and emergent words were analysed to draw the corresponding The visualization chart was created.2.Results:A total of 953 articles were included in CNKI and 3453 articles in WOS,with a fluctuating upward trend in the number of articles published;the top three authors in the number of articles published in CNKI database were Mao Jingyuan,Wang Xianliang and Wang Henghe,while the top three authors in the number of articles published in WOS database were Merz,C Noel Bairey,Crea,Filippo and Kaski,JC;the top three institutions in the number of articles published in CNKI database The top three institutions in terms of number of articles published are Tianjin University of Traditional Chinese Medicine,The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and Shandong University of Traditional Chinese Medicine;the top three institutions in terms of number of articles published in the WOS database are Cattolaca University,Cedars-Sinai Medical Center and Mayo Medical Center;there is a lack of cooperation between teams and institutions in China compared to foreign countries;the top three countries in terms of number of articles published in the WOS database are USA.Japan and Italy,with China The top three countries in terms of number of articles published in the WOS database are the United States,Japan and Italy,with China ranking sixth;there is close cooperation between countries;combined with the co-occurrence,clustering and emergence analysis of keywords in the CNKI and WOS databases,it can be predicted that the focus in this field will be on the development of therapeutic approaches and international standards for INOCA.3.Conclusion:This study is the first visual analysis of the domestic and international literature on INCOA.The results of the analysis reveal the trends and hotspots of domestic and international research and provide directions and references for subsequent scientific work.Study 2:A retrospective study on the characteristics of Chinese medical evidence and related factors in ischaemic with non-obstructive coronary artery disease1.Methods:Patients who were hospitalized and treated with coronary angiography from 2020 to 2022 in the Cardiovascular Department of Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine were retrospectively analyzed,and 142 cases meeting the requirements were finally included after screening by nadir criteria.The gender,menstrual history,age,smoking history,drinking history,TCM symptoms and signs and laboratory indexes of the study subjects were counted and the data were statistically analyzed by SPSS25.0 software,including chi-square test,Fisher’s exact test and multiple unordered logistic regression analysis.2.Results:1.Among the 142 cases included in this study,the top 10 TCM symptoms in terms of frequency were chest tightness,chest pain,poor sleep,dizziness,shortness of breath,fatigue,palpitations,dry mouth and bitterness,constipation and back pain.The top 3 rankings in terms of frequency were dark red tongue,light red tongue,and red tongue;the top 3 rankings in terms of coating were white and greasy,thin white coating,and yellow and greasy coating;and the top 3 rankings in terms of pulse were stringent and slippery,stringent and slippery pulse;2.The most common symptoms in Chinese medicine were Qi deficiency and blood stasis,followed by phlegm stagnation and blood stasis,accounting for 35.92%and 35.21%of the total number of patients respectively,followed by 9.86%for phlegm obstruction,7.04%for Qi stagnation and blood stagnation,and 7.04%for Qi and Yin.3.Among the included cases,the male to female ratio was 1:1.25,with more female patients than male patients,and about 87%of female patients were menopausal;4.There was no statistically significant difference in the mean values of age among the evidence types(P>0.05);5.28%and 24%of patients had a history of smoking and drinking respectively,and there was no statistically significant difference in the history of smoking and drinking among the evidence types(P>0.05);6.There was a statistically significant difference in the mean values of UA among the TCM evidence types(P<0.05).The UA levels in patients with Qi deficiency and Blood stasis evidence were significantly lower than those in patients with Phlegm and Blood stasis evidence and Phlegm and Cloud occlusion evidence(P<0.05),and the UA levels in patients with Phlegm and Blood stasis evidence were significantly higher than those in patients with Qi and Yin deficiency evidence(P<0.05);7.The mean values of HCY were statistically different among the TCM evidence types(P<0.05).The HCY levels in patients with Qi Deficiency and Blood Stasis Certificate were lower than those in patients with Phlegm and Cloud Closure and Blockage Certificate,Qi-Yin Two Deficiency Certificate and Qi Stagnation and Blood Stasis Certificate(P<0.05);8.The mean LDL-C values were significantly different among the evidence types(P<0.05),and the LDL-C levels in patients with phlegm-stasis evidence were higher than those in patients with qi-deficiency and blood stasis,qi-yin deficiency,qi-stasis and yang-deficiency and cold coagulation evidence(P<0.05).9.The results of the logistics regression analysis showed that UA,HCY,and LDL-C were all correlates of TCM evidence classification and had a significant effect on TCM evidence classification.3.Conclusion:This study retrospectively analysed the relationship between the TCM evidence of INOCA and related factors,and found that the gender,female menstrual status and age distribution of INOCA patients were in line with the current status of the study;there were significant differences in UA,HCY and LDL-C among the evidence types;UA,HCY and LDL-C were influential factors in the classification of TCM evidence,which can provide reference for the classification of TCM evidence.