Study On The Correlation Between Plasma Syndromes And Plasma Homocysteine ​​in Elderly Patients With Carotid Atherosclerosis

Objective:To discuss the TCM syndrome distribution regularity of elderly patients with carotid atherosclerosis and its correlation between age, sex, merger disease, serum homocysteine and other factors. To provide a method for syndrome differentiation of TCM in elderly patients with carotid atherosclerosis. Clarifying the relationship between carotid atherosclerosis and serum homocysteine levels, improving the TCM Therapeutic of the elderly patients with carotid atherosclerosis or high homocysteine, controlling the serum homocysteine level timely, and actively controlling the development of carotid atherosclerosis, thereby reducing the risk of cardiovascular disease.Method:Collected randomly 265 cases of outpatient and inpatient elderly patients with carotid atherosclerosis, according to the "Chinese medicine clinical research guidelines (2002 edition) ", and refer to" Diagnostics of Traditional Chinese Medicine (second edition) edited by Zhu Wenfeng, "Practical Integrative Cardiovascular Diseases" edited by Wang Jie, and the State Bureau of Technical Supervision issued the "People’s Republic of China national standard · Chinese medical syndromes term portion (GB/T16751-1997) ",and combining the clinical experience of my mentor, according to the patients’main symptoms, secondary symptoms, divided carotid atherosclerosis into seven syndromes, including phlegm stasis syndrome, qi stagnation and blood stasis syndrome, deficiency syndrome of both liver and kidney yin and superimposed syndromes between each other. Using the unified questionnaire to collect basic data from patients with four diagnostic information, carotid ultrasound, the serum homocysteine results, etc. Then organizing the basic data. All data are analysised by SPSS 21.0 statistical software package.Result:1. In 265 cases of elderly patients with carotid atherosclerosis, the frequency of each TCM syndrome were phlegm stasis syndrome group 9 cases (3.4%), qi stagnation and blood stasis syndrome group 4 cases (1.5%), deficiency syndrome of both liver and kidney yin group 6 cases (2.3%), phlegm stasis syndrome+qi stagnation and blood stasis syndrome group 66 cases (24.9%), phlegm stasis syndrome+deficiency syndrome of both liver and kidney yin group 38 cases (14.4%), qi stagnation and blood stasis syndrome+deficiency syndrome of both liver and kidney yin group 39 cases (14.7%), phlegm stasis syndrome+qi stagnation and blood stasis syndrome+deficiency syndrome of both liver and kidney yin group 103 cases (38.9%). Multi-combination between syndromes appears more frequently than it appears by itself.2 Among elderly patients with carotid atherosclerosis, the frequency of occurrence of phlegm stasis syndrome group and qi stagnation and blood stasis syndrome group alone and in combination show differences in age distribution (P< 0.05); Carotid atherosclerosis in patients with Hypertension, coronary heart disease, cerebral infarction, diabetes, hyperlipidemia, the prevalence shows significant differences between different TCM syndrome types (P< 0.05)3. In 265 cases of elderly patients with carotid atherosclerosis, the moderately elevated levels of homocysteine is most, followed by normal, moderate and severe patients with elevated less (P<0.05).4.The proportion of elderly patients with carotid atherosclerosis, merging high homocysteine was 75.5%, the incidence of high homocysteine in man is higher than in women (P<0.05)5. In 265 cases of elderly patients with carotid atherosclerosis, the carotid IMT,largest plaque length, maximum plaque thickness, homocysteine were associated with age, show a significant positive correlation. Carotid IMT, plaque maximum length, plaque maximum thickness and homocysteine levels were positively correlated. Patients in phlegm stasis syndrome+qi stagnation and blood stasis syndrome group, artery intima, the maximum plaque thickness show a positive correlation with homocysteine levels, correlation is not significant. The maximum length of the plaque was significantly positively correlated with homocysteine levels.Patients in phlegm stasis syndrome+deficiency syndrome of both liver and kidney yin group, carotid IMT and homocysteine levels were significantly positive correlated, the maximum plaque length, maximum plaque thickness and homocysteine levels of correlation is not significant. Patients in qi stagnation and blood stasis syndrome+ deficiency syndrome of both liver and kidney yin group, and in phlegm stasis syndrome+qi stagnation and blood stasis syndrome+deficiency syndrome of both liver and kidney yin group, carotid IMT, maximum plaque length, maximum plaque thickness are not correlated with homocysteine levels significantly.Conclusion:1.In elderly patients with carotid atherosclerosis, the TCM syndrome of phlegm stasis syndrome and qi stagnation and blood stasis syndrome appeared alone and combined are mainly distributed in 60 to 69 year-olds, followed by 70 to 79 years,80 years of age or older population is relatively small. Carotid atherosclerosis in patients with Hypertension, coronary heart disease, cerebral infarction, diabetes, hyperlipidemia, the prevalence shows significant differences between different TCM syndrome types.2. In elderly patients with carotid atherosclerosis, the incidence of bilateral carotid artery is much higher than unilateral carotid artery.3. In elderly patients with carotid atherosclerosis, the moderately elevated levels of homocysteine is most, followed by normal, moderate and severe patients with elevated less.4. In elderly patients with carotid atherosclerosis,who combined with high homocysteine, the incidence of high homocysteine in man is higher than in women.5. In elderly patients with carotid atherosclerosis, with the growth of age, carotid IMT, maximum plaque length, maximum plaque thickness and homocysteine also increased. Phlegm stasis syndrome+qi stagnation and blood stasis syndrome group, maximum plaques length associated with homocysteine closely, the incidence of plaque increasing with elevated levels of homocysteine. Phlegm stasis syndrome+deficiency syndrome of both liver and kidney yin group, the carotid intima associated with homocysteine level closely, the incidence of carotid atherosclerosis increasing with elevated levels of homocysteine.