| This paper includes two literature reviews and one clinical study.The title of the first literature review is "Overview of modern medicine on the study of coronary heart disease with abnormal glucose metabolism".It mainly expounds the incidence of coronary heart disease,diabetes,impaired blood glucose regulation in recent years,and summarizes the relationship between coronary heart disease and abnormal glucose metabolism.Diabetes is the "equal risk" of coronary heart disease.As blood sugar rises,the incidence of coronary heart disease-related symptoms increases,as well as the risk of cardiovascular events.Diagnostic criteria for diabetes are based on the degree of retinopathy,but vascular complications such as coronary lesions,intraeranial vascular disease,and peripheral arteries occur earlier than that.Therefore,coronary artery disease has already occurred in the early stage of diabetes,that is,the stage of impaired blood glucose regulation and impaired fasting glucose.At the same time,relevant clinical research has confirmed the above viewpoints from the molecular mechanism.In order to find out the blood sugar problem of patients with coronary heart disease earlier,it is necessary to strengthen the blood glucose screening work and improve the blood glucose screening method for patients with coronary heart disease.Understanding and Exploration to the Etiology and Pathogenesis of Coronary Heart DiseaseThe title of the second literature review "Understands to the etiology and pathogenesis of coronary heart disease with abnormal blood glucose metabolism and the summary of research on TCM constitution types in patients with coronary heart disease".As early as in the "Huang Di Neijing",there are records of the names of coronary heart disease,such as"chest","heartache","true heartache","heartache",etc." and there are also records of the names of diabetes,such as "thirst" and "pi-dan".It shows that ancient Chinese medicine has a very early understanding of coronary heart disease and diabetes.Later generations of doctors have perfected and developed the etiology,pathogenesis,and prescriptions of then,and have a clear understanding of pi-dan(pre-diabetes),and believe that the phlegm-dampness produced by eating sweet and fatty taste is the main cause of it.Ancient medical doctors had already known about the combination of coronary heart disease and diabetes,but did not study it in depth.It was not until the modern times that people gradually paid attention to it and clearly pointed out the close correlation between them.And the theory of etiology and pathogenesis of it gradually formed.However,at present,it is still in the stage of contention of a hundred schools of thought.The ideas of the doctors are different,and a unified understanding has not yet been formed,which needs further clinical confirmation.Therefore,in order to determine whether TCM syndrome differentiation can be the basis for blood glucose screening in patients with coronary heart disease,it is necessary to explore the TCM syndrome type and the laws of TCM constitution of patients who has coronary heart disease with abnormal blood glucose metabolism,.Clinical research:Objective:To investigate the relationship between the degree of coronary heart disease and glucose metabolism and the constitution of TCM by investigating the glucose metabolism and TCM constitution of patients with coronary heart disease.METHODS:Coronary heart disease patients admitted to the Department of Cardiology of Hospital from September 2018 to February 2019 were collected.According to the inclusion criteria,a total of 129 patients were selected.According to their blood sugar levels,they were divided into normal blood glucose group(NGT group),blood glucose regulation group(IGR group),and diabetes group(DM group).In order to analyzing the correlation between blood glucose metabolism status and TCM constitutional classification and related influencing factors,general patient data,serum biochemical indexes,coronary angiographic results,and TCM syndromes related to TCM constitution were collected.RESULTS:Of the 129 patients with coronary heart disease,36(27.9%)were in the NGT group,26(20.2%)in the IGR group,and 67(51.9%)in the DM group.Serum biochemical indexes:TG:DM group and IGR group were significantly higher than NGT group,the difference was significant(P<0.05).The incidence of single coronary vascular disease was significantly higher in the NGT group than in the IGR group and the DM group(P<0.05).The incidence of double coronary vascular disease was significantly higher in the IGR group than in the NGT group and the DM group(P<0.05).The incidence of three coronary vascular disease was significantly higher in the DM group than in the NGT and IGR groups(P<0.05).TCM constitution:Composite constitutions accounted for 57.4%of all the patients,and the most common constitution were blood stasis constitution>phlegm-dampness constitution>qi deficiency constitution>yin deficiency constitution,accounting for 75.9%.Blood stasis constitution accounted for a large proportion(22.7%-31.4%)in DM group,IGR group and NGT group.Except blood stasis constitution,Yin deficiency constitutions,phlegm-dampness constitution,and qi deficiency constitutions were common in the DM group while phlegm-dampness constitution and qi deficiency constitutions in the IGR group,and phlegm-dampness constitution,qi deficiency constitutions and Yang deficiency in the NGT group.The independent risk factors for diabetes mellitus patients with coronary heart disease are:family history of diabetes,3 vascular lesions,and yin deficiency constitution.Independent risk factors for impaired blood glucose regulation in patients with coronary heart disease are:obesity,alcohol consumption,family history of diabetes,and phlegm-dampness constitution.Conclusion:With the increase of abnormal glucose metabolism in patients with coronary heart disease,the extents of coronary artery disease also increase.Patients with coronary heart disease and diabetes mellitus are mostly yin deficiency constitution and the range of coronary vascular disease is wide.Coronary hea rt disease patients with impaired blood glucose regulation are mostly phlegm-dampness constitution,accompanied by body weight obesity and drinking history. |
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