The Analysis Of The Distribution Of Chinese Medicine Elements Of Unstable Angina Pectoris And The Degree Of Coronary Artery Lesions

ObjectiveIn this study,retrospective case data were collected to analyze the distribution of TCM elements in patients with unstable angina pectoris(UAP),to explore the pathogenesis and prevention of TCM of UAP and the correlation between TCM elements,modern medical indicators and the degree of coronary artery lesions was analyzed to enrich and guide the diagnosis and treatment of UAP.MethodsThe UAP patients who underwent coronary angiography in the First Affiliated Hospital of Guangzhou University of Chinese Medicine on January 1,2018 and December31,2019 were screened.The general information,personal history,past history,laboratory indicators,coronary angiography results,TCM symptoms and other data of the patients were collected.The degree of coronary stenosis score(Gensini score)was calculated according to the results of coronary angiography,and the TCM elements were analyzed according to TCM symptoms.The database was established by Excel,and SPSS23.0software was used for statistical analysis.Results1.A total of 375 patients with UAP were included in this study,among whom the majority were males(252 cases in total,accounting for 67.2%).The age distribution of the overall population ranged from 24 to 89 years old,with female patients aged 66.32±9.34 years old and male patients aged 59.73±11.53 years old.2.There were 130 cases with single,126 cases with double,119 cases with three or more coronary artery lesions,respectively.There were 150 patients(40.0%)with the maximum stenosis degree ≤75%,followed by patients(25.6%)with the stenosis degree of76-90%,73 patients(19.5%)with complete vascular occlusion(100%),and 56 patients(14.9%)with the stenosis degree of 91-99%.3.The order of occurrence frequency of TCM elements was:blood stasis>toxic heat>phlegm turbidity>qi stagnation>qi deficiency>yin deficiency>yang deficiency>cold stagnation.Chi-square test results showed that there were significant statistical differences in the distribution of heat toxicity,phlegm turbidity and Qi deficiency syndrome elements among different genders(P<0.05).Heat toxicity and phlegm turbidity syndrome elements were more common in males,while Qi deficiency syndrome element accounted for a higher proportion in females.4.The order of syndromes combination was: two syndromes>three syndromes >four syndromes>a single syndromes.The distribution law of the attributes of syndrome element void and real was as follows: pure excess syndrome> combination of excess syndrome and deficiency syndrome>pure deficiency syndrome.There were a total of 29 kinds of syndrome element combinations,including more than 5% of the total of 7 kinds of combination form,including toxic heat+blood stasis(75 cases),toxic heat+blood stasis+phlegm turbidity(53),blood stasis+phlegm turbidity(44 cases),blood stasis+phlegm turbidity and qi stagnation(28 cases),toxic heat + phlegm turbidity(23cases),qi deficiency+blood stasis(22 cases),and qi stagnation and blood stasis +(21cases).5.The TCM element of heat toxicity,blood stasis and phlegm turbidities were correlated with the number of vessels in coronary artery lesions(P < 0.05).Patients with syndrome of heat toxicity,blood stasis and phlegm turbidities were more prone to multi-vessel lesions.6.Multivariate analysis showed that diabetes,HDL-C,LDL-C,homocysteine,heat toxicity,blood stasis,and phlegm turbidity were significantly correlated with Gensini score(P < 0.05).Diabetes,LDL-C,homocysteine,heat toxicity,blood stasis,and phlegm turbidity were positively correlated with Gensini score,while HDL-C was negatively correlated with Gensini score.ConclusionsThe TCM elements of UAP patients are mainly excess,mainly blood stasis,heat toxicity and phlegm turbidity,and the distribution of TCM elements indicates that there are more pure excess combinations,showing that the pathogenesis of this disease is excessive in superficiality.The patients with blood stasis,heat toxicity,and phlegm turbidity syndrome are more prone to multi-vessel lesions,the degree of coronary stenosis score(Gensini score)is higher,that can provide certain reference value for the evaluation of the degree of coronary stenosis in UAP patients,the TCM elements and medical indicators.