Objectified Study Of Traditional Chinese Medicine Syndrome Of Obstructive Sleep Apnea Hypopnea Syndrome

Objective:To observe and analyze the differences of related clinical indicators in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）between different TCM syndromes,explore the distribution and characteristics of various indicators in different TCM syndromes,and objectively explain the etiology and pathogenesis of OSAHS in TCM.To provide more reliable and evidence-based objective quantitative indicators for the differentiation and treatment of OSAHS in traditional Chinese medicine,so as to improve the curative effect on patients and prognosis.Methods:209 patients who complained of snoring or daytime sleepiness were collected from the inpatient Department of Cardiovascular Disease,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine.The general condition,TCM syndrome,related physiological indexes reported in polysomnia monitoring were recorded,and serum MPV,PLT,PDW,NEU,LYM,TC,TG,HDL-C,LDL-C,UA,h-CRP,D-Di,PT,APTT,FPG and Hb A1c values were measured.excel was used to create a database,SPSS 23.0 and Graphpad Prism 8.0.2 were used for data analysis and legend making,so as to explore the relationship and rule between different TCM syndrome types and various objective indicators of OSAHS.Results:1.The majority of OSAHS patients were male,mainly middle-aged and elderly.The overall BMI level exceeded the normal value.The main complications were hypertension,coronary heart disease,atrial fibrillation,and diabetes;2.Age,BMI,L-Sa O₂,T-Sp O₂<90%,PLT,TG,UA levels were related to the severity of OSAHS（P<0.05）;3.The number of syndrome types of OSAHS patients in descending order is phlegm and blood stasis syndrome,phlegm dampness internal obstruction syndrome,phlegm heat internal accumulation syndrome,qi deficiency and phlegm blood stasis syndrome,spleen and kidney deficiency syndrome,which is more manifested as evidence（phlegm dampness internal obstruction syndrome,phlegm heat internal accumulation syndrome,phlegm and blood stasis syndrome;accounting for 74.16%）.With the growth of age,deficiency syndrome（spleen and kidney deficiency syndrome;accounting for 10.05%）and deficiency and excess mixed syndrome（qi deficiency and phlegm blood stasis syndrome;15.79%）tend to occur in the later stage of the disease;4.There were significant differences in age and BMI between different syndromes of OSAHS（P<0.05）;5.AHI and T-Sp O₂<90%levels were different among different syndromes of OSAHS（P<0.05）,and L-Sa O₂ levels were not statistically significant（P>0.05）.6.The expression levels of PLT,MPV,PDW and NEU were different among different syndromes of OSAHS（P<0.05）,while the levels of h-CRP,PLR and NLR were not statistically significant（P>0.05）.7.The expression levels of TG,HDL-C,LDL-C,Hb A1c and UA were different among different syndromes of OSAHS（P<0.05）,while the levels of TC and FPG were not statistically significant（P>0.05）.8.The levels of D-Di,PT and APTT were not statistically significant（P>0.05）.9.In the correlation analysis of different TCM syndromes and clinical indicators of OSAHS,age was negatively correlated with phlegm dampness syndrome（OR=0.961,95%CI 0.934-0.989,P=0.007<0.01）,and positively correlated with qi deficiency phlegm stasis syndrome（OR=1.060,95%CI 1.027-1.094,P=0.000<0.01）.There was a negative correlation between phlegm dampness syndrome and AHI（OR=0.976,95%CI 0.953-0.999,P=0.037<0.05）.There was a negative correlation between spleen kidney deficiency syndrome and PLT expression level（OR=0.984,95%CI 0.972-0.997,P=0.017<0.05）.There was a positive correlation between phlegm dampness syndrome and PDW expression level（OR=1.223,95%CI 1.017-1.471,P=0.032<0.05）.The expression level of LDL-C was positively correlated with phlegm and blood stasis syndrome（OR=2.026,95%CI 1.263-3.251,P=0.003<0.01）.The expression level of HDL-C was negatively correlated with phlegm heat syndrome（OR=0.160,95%CI0.032-0.810,P=0.027<0.05）.The expression level of UA was positively correlated with phlegm heat syndrome（OR=0.006,95%CI 1.002-1.011,P=0.006<0.01）.The expression level of Hb A1c was positively correlated with phlegm-dampness internal obstruction syndrome（OR=0.777,95%CI 1.318-3.589,P=0.002<0.01）.Conclusion:1.Age,BMI,L-Sa O₂,T-Sp O₂<90%,PLT,TG,UA levels are related to the severity of OSAHS;The age level of patients with severe OSAHS was lower than that of patients with mild to moderate OSAHS,and the levels of BMI,PLT and UA were higher;The level of L-Sa O₂in patients with moderate and severe OSAHS was lower than that in patients with mild OSAHS,and the level of T-Sp O₂<90%was higher than that in patients with mild OSAHS.2.OSAHS patients are more manifested as excess syndrome（phlegm dampness internal resistance syndrome,phlegm heat internal accumulation syndrome,phlegm blood stasis syndrome）.With the growth of age,deficiency syndrome（spleen and kidney deficiency syndrome）and deficiency and excess syndrome（qi deficiency and phlegm blood stasis syndrome）are likely to occur in the later stage of the disease.Therefore,the treatment is mainly focused on clearing heat,strengthening spleen and resolving phlegm,regulating qi and activating blood circulation,and in the later stage,methods such as promoting yang and replenishing qi,tonifying kidney and spleen may be more conducive to the treatment and prognosis of the disease.3.Age,AHI,T-Sp O₂<90%,BMI,MPV,PLT,PDW,NEU,TG,LDL-C,HDL-C,UA,Hb A1c level may be used as objective reference indicators for the diagnosis of OSAHS syndrome type.4.Gender,L-Sa O₂,h-CRP,PLR,NLR,TC,FPG,D-Di,PT and APTT cannot be used as auxiliary indicators for syndrome differentiation of OSAHS.5.Low age level is closely related to the occurrence of phlegm-dampness syndrome,high age level is closely related to the occurrence of qi deficiency phlegm-stasis syndrome;Low AHI level was associated with the occurrence of phlegm-dampness syndrome.High level of PDW was related to the occurrence of phlegm-dampness internal obstruction.Low level of PLT is related to the occurrence of spleen and kidney deficiency syndrome.Low level of HDL-C was associated with the occurrence of phlegm-heat syndrome.High level of LDL-C is closely related to the occurrence of phlegm-stasis interjunction syndrome.The high level of UA is closely related to the occurrence of phlegm-heat syndrome.High level of Hb A1c phlegm-dampness syndrome is closely related to the occurrence.