Correlation Between The TCM Syndromes Of Unstable Angina Pectoris Of Coronary Heart Disease With Carotid Intima-media Thickness(IMT) And Thromboela-stogrm(TEG)

ObjectiveTo observe the correlation between TCM syndromes of unstable angina pectoris of coronary heart disease and Carotid Intima-Media Thickness(IMT),parameter of the Thromboela-Stogrm(TEG),reaction time(R),kinetics(K),maximum amplitude(MA),Blood clot formation rate(Angle),Coagulation index(CI).To explore the regular pattern of TCM syndromes,Accumulate experience for the syndrome differentiation of unstable angina pectoris of coronary heart disease.To provide a simple and quick clinical basis for the prevention and treatment of unstable angina pectoris of coronary heart disease.MethodCollect 240 patients with standard of unstable angina pectoris of coronary heart disease,By 2 deputy director or above level of Chinese medicine doctors to conduct the classification of TCM syndrome differentiation.Among them,the number of cases of heart and kidney yin deficiency syndrome,yin cold stagnation syndrome,yang qi deficiency and decline syndrome was less,not included in statistical analysis,So the final number of 236 cases.Biochemical,carotid doppler ultrasound,and blood clot elasticity were performed on them,make unified questionnaires and record IMT,TEG parameters and blood lipids index.Results1.Distribution of TCM syndromes of unstable angina pectoris of coronary heart disease is qi deficiency and blood stasis syndrome(27.9%)> blood stasis syndrome(22.9%)> phlegm obstruction syndrome(20.8%)>qi and yin deficiency syndrome(15.5%)> qi stagnation and blood stasis syndrome(13.1%);There was significant statistical difference in gender distribution of TCM syndrome types(P<0.01),qi deficiency and blood stasis syndrome and blood stasis syndrome were mostly male patients,qi stagnation and blood stasis syndrome and qi and yin deficiency syndrome were mostly female patients.2.In terms of age distribution,The syndromes of qi stagnation and blood stasis,phlegm obstruction were significantly different from qi deficiency and blood stasis,blood stasis and qi and yin deficiency(P<0.01);Between 40 and 50 years old,qi stagnation and blood stasis was the most common syndromes,In the age of 50-60 years,phlegm obstruction was the most common syndromes,With the increase of age,the TCM syndrome tend to be qi deficiency and blood stasis,blood stasis and qi and yin deficiency.3.Patients with unstable angina pectoris of coronary heart disease were often accompanied by history of smoking,hypertension and diabetes,and there was no statistical difference in the distribution of these medical history among the syndromes(P>0.05).4.The BMI of phlegm obstruction syndrome was significantly higher than that of other TCM syndromes(P<0.01),The BMI from high to low was: phlegm obstruction syndrome >blood stasis syndrome > qi deficiency and blood stasis syndrome > qi stagnation and blood stasis syndrome >qi and yin deficiency syndrome.5.The distribution of TC and TG in TCM syndromes of unstable angina pectoris of coronary heart disease was significant statistical different(P<0.01);There was no statistical difference in the distribution of LDL-C and HDL-C in the TCM syndrome types of unstable angina pectoris of coronary heart disease(P>0.05);The levels of TC,TG and LDL-C in phlegm obstruction syndrome were higher than other TCM syndromes,The level of TC andTG of qi and yin deficiency syndrome was the lowest.6.Among the 236 cases of unstable angina pectoris of coronary heart disease,Carotid IMT was normal in 41 cases,accounting for 17.4%,and 195 cases(82.6%)had thickening or plaque formation;The carotid IMT of blood stasis syndrome was higher than other TCM syndromes(P<0.01),The carotid IMT of qi and yin deficiency syndrome was the lowest.7.The distribution of R value,K value,MA value,Angle value and CI value for TEG in TCM syndromes of unstable angina pectoris of coronary heart disease showed significantly differences(P<0.01);The R value and K value of blood stasis syndrome were the lowest,while the MA value,Angle value and CI value were the highest,The Angle value and CI value of the phlegm obstruction syndrome were the lowest.8.Carotid IMT is negatively correlated with R and K values in TEG(r=-0.46,P<0.01,r=-0.782,P<0.01);Carotid IMT is positively correlated with MA,Angle and CI values in TEG(r=0.631,P<0.01,r=0.668,P<0.01,r=0.269,P<0.01).9.The GRACE score of TCM syndrome of unstable angina pectoris of coronary heart disease was mostly found in the moderate risk group and the high risk group,qi stagnation and blood stasis syndrome had the lowest GRACE score,As GRACE scores rise,TCM syndrome type to blood stasis syndrome,qi deficiency and blood stasis syndrome evolution.Conclusion1.The TCM syndrome of unstable angina pectoris of coronary heart disease was mainly qi deficiency and blood stasis.2.The carotid IMT of blood stasis syndrome was the highest,and the R and K values were the lowest,Carotid IMT thickening,R and K value reduction can be used as one of the objective indicators of syndrome differentiation of blood stasis syndrome.3.The BMI of phlegm obstruction syndrome was the highest,The TC,TG and LDL-C were significantly higher than other TCM syndromes,Elevated levels of BMI,TC,TG and LDL-C can be used as one of the objective indicators of syndrome differentiation of phlegm obstruction syndrome.4.The carotid IMT,BMI,TC and TG levels with qi and yin deficiency syndrome were the lowest,The reduction of carotid IMT,BMI,TC and TG levels can be regarded as one of the objective indexes for the syndrome differentiation of qi and yin deficiency.5.Carotid IMT was negatively correlated with R value and K value of TEG,and positively correlated with MA value,Angle and CI value value.6.Blood stasis syndrome had the highest score for GRACE,It is the most dangerous TCM syndrome of unstable angina pectoris of coronary heart disease,which should be emphasized in clinical practice.