The Epidemiological Comparative Study On Syndrome Elements Of CHD And T2DM

Objective:To Study on the correlation between CHD(coronary heart disease) and T2DM( type 2diabetes mellitus) from the viewpoint of syndrome elements of traditional Chinese medicine, so as to explore and clarify the mutual influence and difference between the CHD and T2 DM.Method:The research used the method of retrospective. It was respectively collected what is the two kinds of medical records of the first diagnosis of CHD or T2 DM in the Second Affiliated Hospital of Shanxi University of TCM. And we totally collected 195 cases of the effective medical record of CHD and 205 cases of the effective medical record of T2 DM.The information was input into the software of Epidata 3.1 and converted into the Excel data, which included the demographic information, data of hospitalization, complains, the information of TCM four-diagnosis, related laboratory index and imaging examination, the diagnosis of TCM and the diagnosis of modern medicine. The general statistic of the data was processed with the Excel. The comparison and analysis of the data was processed with the Spss 17.0. The comparison of the syndrome elements of groups between C1D1(the CHD patients with T2DM) and C1D0(the CHD patients without T2DM), D1C1(the T2 DM patients with CHD) and D1C0(the T2 DM patients without CHD) were with chi square test. The analysis of the risk factors to affecting on the CHD patient being to suffer the T2 BM,either do affect on the T2 DM patients being to suffer the CHD was used the method of multinomial Logistic regression analysis.Result:Through the analysis and comparison between the two kinds of medical records, it was discovered the characteristics and the relationship between CDH and T2 DM.(1)The distributional characteristics of two diseases①The distributional characteristics of CHD: During the age less than the age of 51, the male patients are more than the female patients. From the age of 51 to the age of 60, the the number of male patients is same with the number of female patients. And during the ages more than the age of 60, the female patients are more than male patients. The numberof CHD patients shows the tend of growing with the age.② The distributional characteristics of T2DM: During the age less than the age of 60,the male patients are more than the female patients. From the age of 61 to the age of 70,the number of male patients is same with the number of female patients. During the age more than the age of 70, the female patients are more than male patients. The number of the T2 DM patients shows the tend of first increase and then decrease.(2)Syndrome distribution:The top ten syndromes of the CHD are deficiency of both Qi and Yin, blood stasis block>deficiency of both Qi and Yin>deficiency of Qi and Yin, phlegm intermingled and blood stasis >Qi deficiency and phlegm intermingled >the deficiency of both Qi and Yin,phlegm resistance>heart-qi deficiency, blood stasis block> the deficiency of both Yin and Yang, blood stasis block >Yang deficiency and blood stasis >Yin deficiency of heart and kidney >phlegm intermingled and blood stasis. The top ten syndromes of CHD altogether account for 76.92% of total syndromes of CHD.The top ten syndromes of T2 DM are deficiency of both Qi and Yin,blood stasis block >internal heat due to Yin deficiency, blood stasis block > deficiency of both Qi and Yin,phlegm intermingled and blood stasis > the Yin deficiency of liver and kidney, blood stasis block >the deficiency of both Qi and Yin, damp-heat endogenous > the deficiency of both Qi and Yin,blood stasis block, internal production of damp-heat > the deficiency of both Qi and Yin>spleen deficiency and damp resistance > internal heat due to Yin deficiency> the deficiency of both liver and spleen, Qi stagnation and dampness. The top ten syndromes altogether account for 82.93% of the total syndromes of T2 DM.(3)the Characteristics of syndrome elements:The main syndrome elements of CDH are Qi deficiency>Yin deficiency> blood stasis>phlegm> Yang deficiency>others. The CDH is in the heart, and the relationship with other Zang and Fu organs are kidney> spleen and stomach >liver> lung.The main syndrome elements of T2 DM are Yin deficiency> blood stasis> Qi deficiency>damp> phlegm>Yang deficiency > dryness-heat>.The related Zang and Fu organs are stomach> kidney > spleen> liver> heart> lung.The same syndrome elements of CHD and T2 DM are Yin deficiency, Qi deficiency and blood stasis. From the perspective of pathogenesis, they both have the deficiency of Qi,blood and Yin-liquid and the sluggish running of Qi and blood. It closely relate to the two diseases which is the function of kidney,spleen and stomach, finally, it will affect the normal function of the heart dominating blood circulation and vessels. The two diseases have a certain relationship with whether the procurement of liver-Qi and deficiency of liver-yin being or not.(4)The relationship between two diseases:Trough the comparison between the syndrome elements of C1D1 and the syndrome elements of C1D0, they are different in these syndrome elements of Qi deficiency, Yin deficiency and blood stasis, which reflect,in some extent, they play a promoting role for the CHD patients having a risk of impaired glucose or even T2 DM. Trough the comparison between the syndrome elements of D1C1 and the syndrome elements of D1C0, they are different in the syndrome elements of Yin deficiency and Yang deficiency,Dampness, and internal-heat. The Yin deficiency and Yang deficiency account for a large proportion in the of D1C1 patients, which reflect that T2 DM make the deficiency syndromes of CHD(Yin deficiency and Yang deficiency) much worse. Trough the analysis of factors to influencing on whether the CHD patient being to suffer T2 DM or not, in some extent, we found that the pathological changes of Yin deficiency and blood stasis have a great influence on the CHD patients being to suffer the insulin resistance or even T2 DM. Through the analysis of the factors to influencing on whether the T2 DM patients being to suffer the CHD or not,we found that these factors showed significant difference, which were age and dampness.Summarize:The diabetes mellitus is one of the risk factors of CHD. A lot of CHD patients have a risk of impaired glucose regulation and even diabetes mellitus after a period of time when they have suffered the CHD. Diabetes mellitus and CHD are often mutual influence,which make the condition of a patient worse and more complex. The two diseases have common pathological foundation such as obesity, lipid metabolism disorder, insulin resistance and so on.The study discovered the same main syndrome elements of CHD and T2 DM are Qi deficiency, Yin deficiency and blood stasis. From the perspective of related Zang and Fu organs, it closely relate to the two diseases which is the function of kidney,spleen and stomach, finally, they will both affect the normal function of the heart dominating blood circulation and vessels. By analyzing the factors to the two diseases,which are discoveredthat the pathological changes of Yin deficiency and blood stasis play a role of promoting the CHD patient to suffer T2 DM. However, these of factors to T2 DM are age to have a positive effect on the T2 DM patients being to suffer CHD. In addition, through the analysis of the medical record cases of T2 DM patients with CHD from the medical record cases of CHD, we found that diabetes mellitus makes the Yin deficiency of CHD patients much worse in one way, and the other way, the syndrome of Yin deficiency makes the condition of the patient who suffering the CHD and T2 DM much worse and more complex.