| Objective: By collecting the case data of patients with stable angina pectoris of coronary heart disease,evaluate the weakness level of patients with coronary heart disease,analyze the correlation of clinical indicators and influencing factors,and explore the distribution law of TCM Syndrome Types under different weakness degrees,so as to provide reference basis for early identification,diagnosis,treatment and early intervention of combination of traditional Chinese and Western medicine for patients with coronary heart disease.Materials and methods:Using the cross-sectional survey method,according to the acceptance and exclusion criteria,180 patients with stable angina pectoris confirmed by previous medical history or coronary angiography in the first and second departments of Cardiology in the Affiliated Hospital of Liaoning University of traditional Chinese medicine from October 2020 to December 2021 were collected as the research objects.The clinical case data,TCM symptoms,tongue and pulse information,laboratory test results and cardiology specialist reports were collected,and the weakness level was evaluated and graded in combination with frail weakness scale.They were divided into non weakness group,pre weakness group and weakness group.Summarize the clinical characteristics of patients with stable angina pectoris.Establish an electronic database of observation data,and use spss24 0software,the results were statistically significant(P < 0.05).Results:1.Distribution of general clinical data: a total of 180 patients with coronary heart disease were collected this time,with an average age of 66.36 ± 9.77.Most patients aged 61-70 and over 71 years old.There were 87 male patients and 93 female patients.46.11% had a history of smoking,42.22% had a history of drinking,and 26.67% had a family history of cardiovascular disease.The number of people with education level of high school or technical secondary school is the largest,accounting for 38.8%.Daily occupational physical labor and mental labor account for 35% at most.Living with others accounted for 60.56%.The number of people who exercise regularly more than twice a week is less than twice a week.According to frail scale,the debilitation level of patients with coronary heart disease was evaluated.The proportion of combined debilitation was 70%,a total of 126 people.Patients with coronary heart disease were divided into non debilitating group,pre debilitating group and debilitating group according to frail debilitating evaluation.The factors with statistical differences among the three groups include age,BMI,residence,exercise,duration of coronary heart disease,previous PCI history,previous history of hypertension,cardiac function grade,angina symptom score,CCI index and Barthel index.2.According to the distribution of TCM symptoms,the frequency of asthenia and other symptoms increased by 71.56%,and the frequency of asthenia and other symptoms decreased by 2.56%.The patients were dialectically divided into five syndrome types: 51 with Qi deficiency and blood stasis syndrome,32 with qi stagnation and blood stasis syndrome,55 with phlegm and blood stasis syndrome,27 with Qi Yin deficiency syndrome and 15 with Yang Qi deficiency and decline syndrome.On the whole,the proportion of phlegm and blood stasis syndrome was the highest,followed by qi deficiency and blood stasis syndrome.In the distribution of syndrome types at different ages,19 patients under the age of 60 witnessed the most,followed by qi stagnation and blood stasis and Qi deficiency and blood stasis.Qi deficiency and blood stasis syndrome and phlegm and blood stasis syndrome are common in patients aged 61-70.Patients over 71 years old mostly see Qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,Qi and yin deficiency syndrome.In the comparison of different debilitating levels,the number of phlegm and blood stasis syndrome in the non debilitating group was 17 at most,followed by 16 with qi stagnation and blood stasis syndrome.There were 23 patients with phlegm and blood stasis syndrome and 19 patients with Qi deficiency and blood stasis syndrome in the early debilitation group.The maximum number of qi deficiency and blood stasis syndrome in the asthenia group was 20.In the distribution of tongue image,the tongue is light and dark,the fur is thin,the tongue body is fat,the edge has tooth marks,the fur is white and slippery,or there are ecchymosis spots,which account for 28.3% and 20.0% respectively.The most common pulse is stringy and smooth pulse,accounting for 31.1%,followed by fine and astringent pulse,accounting for26.7%.3.Comprehensive clinical evaluation of debilitating level: through correlation test,in the comparison of general data of patients in non debilitating group,pre debilitating group and debilitating group,the positive correlation factors are: age,BMI value,course of coronary heart disease,previous PCI history,cardiac function grade,angina symptom score and CCI index;The negative correlation factors are: living together,regular exercise and Barthel index.The comparison of clinical examination results showed that the positive correlation indexes included BNP,neut,hs CRP,FIB,LDL-C,apo(b),LP(a),Pt,D-D,ESV,left atrial diameter,ventricular septal thickness,carotid intima-media thickness and common carotid artery diameter;Negative correlation indexes include ALB,HDL-C and carotid blood flow velocity.4.Analysis of influencing factors: ordered logistic regression analysis showed that BMI value,course of coronary heart disease,symptom score of angina pectoris,CCI index,Barthel score,hs CRP,HDL-C,Pt and ESV were independent influencing factors of debilitating state in patients with coronary heart disease.Conclusion: Patients with coronary heart disease are prone to debilitation.Compared with age,longer course of coronary heart disease,more combined diseases,higher BMI and lack of regular exercise are more important for debilitation.Patients with coronary heart disease combined with debilitating state are mostly manifested in abnormal inflammatory indexes,disorder of glucose and lipid metabolism,abnormal coagulation function and so on,and are more prone to the reconstruction of heart and vascular structure and function.In terms of traditional Chinese medicine,coronary heart disease combined with weakness presents complex pathological characteristics of deficiency based and phlegm and blood stasis combined.Most of them progress from the deficiency loss of a single viscera to the decline of Qi,blood and Yin and Yang of multiple viscera,and finally see the deficiency of five zang organs,Qi,blood and Yin and Yang.The syndrome of phlegm and blood stasis has a high rate in patients with weakness of coronary heart disease,and runs through the evolution of the pathogenesis of coronary heart disease combined with weakness. |
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