The Correlation Between TCM Syndromes Of Coronary Heart Disease(CHD) And The Degree Of Arteriosclerosis

objective:1. To explore the correlation between TCM syndromes of thoracic obstruction and cardiodynia and Coronary artery disease, carotid artery, and lesions degree of coronary artery.2. By selective coronary angiograPhy (SCAG) and dual-source CT (DSCT) clinical study to explore the diagnostic value of SCAG and DSCT for evaluation of coronary artery disease and find the clinical value and feasibility of macroscopic index in different TCM syndrome tyPes of CHD.3To explore the correlation among the degree of carotid artery atherosclerosis, TCM syndromes of CHD and lesions degree of coronary artery. To clear the value of the degree of carotid artery atherosclerosis between TCM syndromes of CHD and lesions degree of coronary artery。4to explore the correlation among HCY,TCM syndromes of CHD and lesions degree of coronary artery.5to explore the correlation among endothelial function indexes,TCM syndromes of CHD and lesions degree of coronary artery.Methods:All140cases who were diagnosed asthoracic obstruction and cardiodynia received SCAG, DSCT,and the carotid artery with color doppler ultrasound examination,and then Blood biochemistry, HCY, and endothelial function indexes were measured by ELISA.The140Patients were divided into the CHD group (98cases, The degree of coronary artery stenosis>50%) and the control group (42cases, The degree of coronary artery stenosis<50%) by SCAQthen analyzed the diagnostic value of SCAG and DSCT for evaluation of coronary artery disease。To explore the correlation among the degree of carotid artery atherosclerosis(Carotid artery intima-media thickness IMT, carotid plaque incidence, homocysteine(HCY), endothelial function indexes(NO and ET), TCM syndromes of CHD and lesions degree of coronary artery.Results:1、Lesion degree of coronary artery was more severe (Multivessel artery lesions,severe Coronary stenosis and total occlusion of coronary artery), more common in phlegm turbid retention, Heart blood stasis and the cold-coagulation type, mild disease(single artery lesions,mild coronary stenosis) in patients with focus on type of heart kidney Yang Deficiency, heart kidney Ying Deficiency, and Heart qi deficiency in which Mainly heart kidney Ying Deficiency syndrome.Gensini score of the Phlegm-turbid type and the blood-stagnation type is the highest in the empirical; Gensini score of heart kidney Yang Deficiency is the highest in the deficiency(heart kidney Yang Deficiency>the phlegm-turbid type>the blood-stagnation type> Heart qi deficiency>heart kidney Ying Deficiency)2、DSCT and SCAG in evaluating Lesions degree of coronary artery are consistent.3、The correlation among the degree of carotid artery atherosclerosis, TCM syndromes of CHD and lesions degree of coronary artery:①arotid artery intima-media thickness (IMT) of the single-artery lesion group and the Multivessel-artery lesion group were significantly higher than the normal control group.(P<0.05)。 Carotid artery intima-media thickness (IMT)of the Multivessel-artery lesion group were also higher than the single-artery lesion group (P<0.05). Carotid plaque incidence in CHD groups were obviously higher than the normal control group (P<0.05), and the Carotid plaque incidence increase with the number of diseased coronary artery(P<0.05).②Carotid artery intima-media thickness (IMT) and carotid plaque incidence were higher than the normal control group(P<0.05). IMT of the blood-stagnation type, the phlegm-turbid type, and the cold-coagulation type were significantly higher than the other syndromes(P<0.05),(the blood-stagnation type>the Phlegm-turbid type>the cold-coagulation type), but there was no statistical significance in the other syndromes (heart kidney Yang Deficiency, heart kidney Ying Deficiency, and Heart qi deficiency)(P>0.05)。 Carotid plaque incidence of the blood-stagnation type, the Phlegm-turbid type, and the cold-coagulation type were significantly higher than the other syndromes (P<0.05), but there was no statistical significance in this three types(P>0.05).③IMT of the total occlusion group and severe stenosis group in CHD groups were higher than the moderate stenosis group (P<0.05). Carotid plaque incidence of the total occlusion group were higher than the moderate stenosis group (P<0.05).4、The correlation among endothelial function indexes,TCM syndromes of CHD and lesions degree of coronary artery:①Serum NO of the single-artery lesion group and the Multivessel-artery lesion group were lower than the normal control group (P<0.05).Serum NO of the Multivessel-artery lesion group were also lower than the single-artery lesion group (P<0.05)。 Plasma ET in CHD grouPs were obviously higher than the normal control group (P<0.05), and Plasma ET increase with the number of diseased coronary artery.(P<0.05)。②Serum NO of the blood-stagnation type, the Phlegm-turbid type, the cold-coagulation type, heart kidney Yang Deficiency, heart kidney Ying Deficiency, and Heart qi deficiency were significantly lower than the normal control group (P<0.05),and serum NO of the blood-stagnation type, the cold-coagulation type, heart kidney Yang Deficiency were lower than the Phlegm-turbid type, heart kidney Ying Deficiency, and Heart qi deficiency (P<0.05).But there was no statistical significance in the blood-stagnation type, the cold-coagulation type, and heart kidney Yang Deficiency (P>0.05). Plasma ET of the blood-stagnation type, the Phlegm-turbid type, and the cold-coagulation type, and heart kidney Yang Deficiency were higher than the other syndromes, and the blood-stagnation type, the cold-coagulation type, heart kidney Yang Deficiency were higher than the Phlegm-turbid type (P<0.05)。③Serum NO of the total occlusion group and severe stenosis group in CHD groups were lower than the moderate stenosis group (P<0.05). BUT Plasma ET of the total occlusion grouP and severe stenosis group in CHD groups were higher than the moderate stenosis group (P<0.05). BUT there was no statistical significance in the total occlusion group and severe stenosis group (P>0.05)5、The correlation among HCY,TCM syndromes of CHD and lesions degree of coronary artery:①HCY of the single-artery lesion group and the Multivessel-artery lesion group were significantly higher than the normal control group.(P<0.05). HCY of the Multivessel--artery lesion group were also higher than the single-artery lesion group (P<0.05). Homocysteine positive rate were higher than the normal control group(P<0.05), but Homocysteine Positive rate and of The Carotid Plaque incidence increase with the number of diseased coronary artery.(P<0.05), But there was no statistical significance in the single-artery lesion group and the Multivessel-artery lesion group (P>0.05)②Homocysteine Positive rate in CHD groups were higher than the normal control group (P<0.05). Homocysteine positive rate of the blood-stagnation type, and the Phlegm-turbid type were higher than the other syndromes (P<0.05), But there was no statistical significance in the blood-stagnation type, and the Phlegm-turbid type (P>0.05)。 Homocysteine Positive rate of the blood-stagnation type, the Phlegm-turbid type, the cold-coagulation type, and Heart qi deficiency were higher than the other syndromes(P<0.05), But there was no statistical significance in them (P>0.05)③HCY of the total occlusion group and severe stenosis group in CHD groups were higher than the moderate stenosis group (P<0.05). HCY of the total occlusion group were higher than the moderate stenosis group (P<0.05).Conelusion:1、Lesions degree of coronary artery. were correlated with TCM Syndromes of thoracic obstruction, The results of DSCT and SCAG are consistent,and they may be the objectification basis in estimating the TCM syndrome of thoracic obstruction.2、Lesions degree of coronary artery of TCM syndrome of thoracic obstruction.were correlated with arteriosclerosis of carotid artery atherosclerosis. It could be clear IMT.which could be basic index of evaluating Lesions degree of coronary artery, and be the objective indexes for TCM syndrome of thoracic obstruction3、Endothelial function indexes and HCY were correlated with lesions degree of coronary artery and TCM syndromes of CHD. HCY, NO, and ET may be the objective indexes for TCM syndrome of thoracic obstruction.