Analysis Of The Distribution Characteristics Of TCM Syndromes Of Coronary Heart Disease Based On Follow-up Cardiovascular Events

Object:According to analysis of the syndromes of the patients with coronary heart disease(CHD), angina and myocardial infarction (the two main subtypes of CHD), diabetes and hypertension and hyperlipidaemia (the three main joint diseases of CHD), we hope to find the relationships between syndrome and foll owed-up cardiovascular event.Methods:We collected the in-hospitalized patients conformed to gold standard for CHD diagnosis from 12 hospitals in Beijing by the "coronary heart disease individualized diagnosis and treatment system". The syndrome diagnoses of patients were split into syndrome factors. The syndrome factors consist of deficiency of'Qi, deficiency of yin, deficiency of yang, deficiency of blood, phlegmatic hygrosis, blood stasis, heat, stagnation of Qi, water, cold. All patients were followed for 1 year by the telephone. Results:We finally collected 3537 in-hospi tali zed patients with coronary heart disease. The average age is 64.88±11.97 years; 2314 male patients accounted for 65.4%; 1223 female patients accounted for 35.6%; 312 patients lost to follow-up in, accounting for 8.82%. The distribution of syndromes of Coronary heart disease patients with different subtypes?different combined disease was different, but the distribution of syndromes is concordant with the past conclusion. The main syndrome of CHD is blood stasis; the secondary syndrome of CHD is mostly deficiency of Qi. The distribution of syndrome of angina is similar to the distribution of CHD. The secondary syndrome of myocardial infarction is phlegmatic hygrosis which has a higher proportion than other subtypes or joint diseases; the proportion of blood stasis is higher than other subtypes or joint diseases, too. The proportions of deficiency of Qi and Yin in the patients of CHD combined with diabetes are higher than other subtypes or joint diseases. The main syndromes of CHD combined with hypertension or hyperlipidaemia are also blood stasis and deficiency of Qi. The result analysis of logistic between syndrome factors and followed-up cardiovascular events are the follows. The deficiency of QI can raise the risk of followed-up cardiovascular events in the patients of CHD, CHD combined with hypertension. The deficiency of Yin can raise the risk of followed-up cardiovascular events in the patient of CHD, angina, CHD combined with hypertension or hyperlipidaemia. The deficiency of Yang can raise the risk of followed-up cardiovascular events in the patient of CHD, CHD combined with hyperlipidaemia. The deficiency of Yang combined with water can raise the risk of followed-up cardiovascular events in the patients of CHD combined with hypertension. The stagnation of Qi can raise the risk of followed-up cardiovascular events in the patients of CHD, CHD combined with diabetes. Besides, the cold can raise the risk of followed-up cardiovascular events in the patients of CHD, CHD combined with hypertension; the deficiency of blood can reduce the risk of followed-up cardiovascular events in the patients of CHD combined with hypertension, the proportion of the two syndromes are low, therefore, we need more research.Conclusion:According to the distribution of syndromes, we can make some conclusion. The distribution of syndromes of CHD reflects the attitude.of "root deficiency and branch excess" in traditional Chinese medicine (TCM). Angina is the main subtype of CHD, therefore, the distribution of syndromes in the patients with angina is similar with CHD. The distribution of syndromes in the patients with AMI reflects the characteristic that the main pathogenesis is branch excess in the patients with onset AMI. The distribution of syndromes in the patients with diabetes reflects the attitude of "deficiency of both QI and Yin". The distribution of syndromes in the patients with CHD combined with hypertension or hyperlipidaemia is also reflects the pathogenesis of "root deficiency and branch excess". According to the result of analysis of logistic between syndrome factor and followed-up cardiovascular event, we can make some conclusion, "qi being a master of blood", deficiency of Qi cannot make blood supply sufficient, therefore, the level of blood stasis increased. That maybe the reason that deficiency of Qi increase the risk of followed-up cardiovascular event. The deficiency of Yin can cause intrinsic heat, then, it produces toxicity. The result is accord with the hypothesis of "blood-stasis and toxin causing catastrophe engender acute cardiovascular event". Deficiency of Yang can cause excessive fluid, it was always appeared in the patients with heart failure. This group of patients always appears deterioration of heart failure. They need in-hospital treatment. This may be the reason why the risk of followed-up cardiovascular event increased.