Study On The Distribution Characteristics Of TCM Syndromes Of Acute Coronary Syndrome And Its Correlation With The Severity Of Coronary Artery Disease

Purpose:Through a retrospective study of the case data of patients with acute coronary syndrome（ACS）in the emergency medicine department of Wuhan Hospital of Integrated Traditional Chinese and Western Medicine,this paper summarized and analyzed the TCM syndrome types and their distribution characteristics of ACS patients,and discussed the correlation between different TCM syndrome types of ACS and clinical indicators and the degree of coronary artery lesions,so as to provide ideas for early intervention and treatment of ACS patients with Chinese and Western medicine.Method:The patients who were diagnosed with ACS from February 1,2021 to January 31,2022 in the Department of Emergency Medicine of Wuhan Hospital of Integrated Traditional Chinese and Western Medicine were collected.Among them,92 patients who met the inclusion and exclusion criteria were selected.The general materials,four diagnostic data,related clinical indicators,coronary artery disease degree and other information of the patients were collected,and the data of the patients were set up in Excel database and statistically analyzed.Results:1.General information:（1）Sex and age: 71 males（77.2%）and21 females（22.8%）,with an average age of 62.68 13.67 years,mainly ranging from 51 to 70 years old.（2）History of smoking and drinking:66 cases（71.7%）had a history of smoking,22 cases（23.9%）had a history of drinking,and 26 cases（28.3%）had no history of smoking and drinking.（3）Complications: 54 cases of hypertension（58.7%）,43 cases of hyperlipidemia（46.7%）,24 cases of diabetes（26.1%）,15 cases of cerebral infarction（16.3%）and 76 cases of carotid plaque（82.6%）.（4）ECG localization: Among 59 patients with STEMI,33 cases（55.9%）were inferior wall,18 cases（30.5%）were anterior wall,7 cases（11.9%）were anterior wall and anterior wall,4 cases（6.8%）were extensive anterior wall and 1 case（1.7%）was posterior wall,among which 11 cases（18.6%）（5）Chest CT: 85 cases were examined by chest CT.Pulmonary inflammation was found in 26 cases（30.6%）,enlarged heart shadow in 37 cases（43.5%）,pleural effusion in 18 cases（21.2%）,and calcification or partial calcification of aorta and coronary artery in 76 cases（89.4%）.（6）Number of coronary artery lesions: 22 cases with single-vessel lesions（23.9%）,13 cases with double-vessel lesions（14.1%）and57 cases with multi-vessel lesions（62.0%）.（7）Grading: Grade IV in 49 cases（53.3%）,Grade III in 38 cases（41.3%）and Grade II in5 cases（5.4%）.（8）The average Gensini score of coronary angiography was 61.76±29.77.2.Distribution of TCM syndromes: 26 cases of qi deficiency and blood stasis syndrome（28.2%）,22 cases of phlegm and blood stasis syndrome（23.9%）,18 cases of qi and yin deficiency syndrome（19.6%）,15 cases of qi stagnation and blood stasis syndrome（16.3%）,11 cases of yang deficiency and cold coagulation syndrome（12.0%）.3.Comparison of data between syndromes: There is no statistical difference between different syndromes and gender（P >0.05）.There was no statistical difference among age groups with different syndrome types（P > 0.05）.There is statistical difference in smoking history among different syndromes（P < 0.05）,and there is significant statistical difference in drinking history among different syndromes（P < 0.01）.There was no significant difference between TCM syndrome types and CK-MBM and MYO（P > 0.05）,but there was significant difference with hs Tn I（P < 0.05）.There was no significant difference between different syndrome types and WBC and CRP inflammatory indexes（P > 0.05）.Gensini score of coronary artery lesions showed significant differences among TCM syndromes（P < 0.05）,and there were significant differences between Qi-Yin deficiency syndrome and Qi-Deficiency and Blood Stasis syndrome,phlegm and blood stasis syndrome,Qi-Deficiency and Blood Stasis syndrome（P < 0.01）,and between Qi-Deficiency and Blood Stasis syndrome and Yang-Deficiency and Cold Coagulation syndrome（P < 0.01）There was no significant difference between the other two groups（P > 0.05）.Conclusion:1.The onset type of ACS patients is STEMI,and the onset age is 51-70 years old.The incidence rate of male patients is higher than that of female patients,and most of them have a history of smoking and drinking.The main complications are hypertension,hyperlipidemia and diabetes,and most of them have carotid artery plaque.The number of coronary artery lesions is mainly multi-branch,and the grade ⅳ is mainly complete occlusion.The average Gensini score is 61.76±29.77.2.The TCM syndrome types of ACS are as follows: 26 cases of qi deficiency and blood stasis syndrome（28.2%）> 22 cases of phlegm and blood stasis syndrome（23.9%）> 18 cases of qi and yin deficiency syndrome（19.6%）> 15 cases of qi stagnation and blood stasis syndrome（16.3%）> 11 cases of yang deficiency and cold coagulation syndrome（12.0%）.3.There is a correlation between TCM syndrome types and the history of smoking and drinking,troponin,the number of coronary artery lesions,the grade of lesions,and Gensini score.The coronary Gensini score of Qi deficiency and blood stasis syndrome group is the highest,while that of Qi and Yin deficiency syndrome is the lowest.