| Premature ventricular contraction combined with anxiety state is one of the common physical and mental diseases in clinical practice today,which has a high incidence rate,great harm and high occult.However,there are currently few studies and theoretical explorations related to traditional Chinese medicine syndrome of this disease,which limits the development of traditional Chinese medicine treatment for ventricular premature beats combined with anxiety.Objective:To explore the distribution characteristics of Traditional Chinese Medicine(TCM)syndrome elements in patients with premature ventricular contraction combined with anxiety state,and their correlation with clinical data.Methods:A cross-sectional questionnaire survey was used to investigate premature ventricular contraction combined with anxiety state from June 1,2022 to December 31,2022 at the outpatient and inpatient departments of cardiology in the Dongfang Hospital of Beijing University of Chinese Medicine.Based on the relevant research literature reviewed,the clinical information collection table,TCM symptom collection table and TCM syndrome element diagnostic criteria of premature ventricular contraction combined with anxiety state were developed.Input the collected case information into Excel to form a basic information database,and then use the software SPSS25.0 to carry out statistical analysis of all the data.Use statistical methods such as frequency statistics,non parametric tests,chi-square test,logistic regression,and etc to analyze the characteristics and distribution of TCM syndrome elements in patients with premature ventricular contraction combined with anxiety state.Results:A total of 159 patients with premature ventricular contraction combined with anxiety state were included in this study.Compared to 47(29.6%)male patients,112(70.4%)female patients were more common.The average age of patients was 56.62 ± 1.3 years old,with the most common middle-aged and elderly patients over 49 years old,a total of 109 cases(68.5%).The age distribution is 6 people aged 18-28(3.77%),21 people aged 29-38(13.21%),23 people aged 39-48(14.46%),31 people aged 49-58(19.50%),40 people aged 59-68(25.16%),20 people aged 69-78(12.58%),and 18 people aged 79-88(11.32%).61 cases(38.4%)of patients with premature ventricular contraction had a course of ≤3 months.The average score of Hamilton Anxiety Scale was 19.41 ± 0.351,with mild anxiety being the most common,acount 95(59.7%).There were 60 patients with frequent sleep disorders,accounting for the highest proportion of the total patients(37.7%).75 patients were complicated with hypertension,with the highest frequency(46.5%).According to Hamilton Anxiety Scale score,patients were divided into mild anxiety group and moderate and severe anxiety group.There was no statistical difference between the two groups in gender,age,duration of premature ventricular contraction,comorbidities,Myerburg morphological grading,SDNN value,and rMSSD value(P>0.05),but there was significant statistical difference in ventricular premature load,Myerburg frequency grading,and pNN50 value(P<0.01).There was a linear correlation between ventricular premature load and anxiety score,and the linear equation was:ventricular premature load=0.576+0.385 × anxiety score.This study showed that the main symptoms of patients with premature ventricular contraction combined with anxiety state included palpitation(93.7%),insomnia(64.8%),thirst(62.3%),chest tightness(58.5%),poor sleep(55.3%),and shortness of breath(51.0%).Red tongue(66.6%),dull tongue(45.9%),pale tongue(31.4%)were common in tongue quality.Tongue coating was more common with greasy coating(49.1%),white coating(43.4%),and thin white coating(34.0%).The pulse symptoms were mainly slippery pulse(40.3%),fine pulse(39.6%),stringed pulse(31.4%),knot pulse(25.8%),sinking pulse(23.9%)and number pulse(22.6%).According to the diagnostic criteria of TCM syndrome elements of premature ventricular contraction combined with anxiety state,the patients were diagnosed with disease location and disease pathogenic syndrome elements.The results showed that the disease location syndrome elements involved heart in 117 cases(73.6%),liver in 50 cases(31.4%),spleen in 43 cases(27%),gallbladder in 43 cases(27%)and kidney in 19 cases(11.9%).The disease pathogenic syndrome elements involved 59 cases(37.1%)of qi deficiency,43 cases(27.0%)of blood deficiency,40 cases(25.2%)of retained fluid,38 cases(23.9%)of yang deficiency,35 cases(22.0%)of phlegm turbidity,34 cases(21.4%)of qi stagnation,30 cases(18.9%)of blood stasis,30 cases(18.9%)of heat evil,17 cases(10.7%)of yin deficiency and 16 cases(10.1%)of dampness evil.This study found that the independent influencing factor of syndrome elements in patients with premature ventricular contraction combined with anxiety state was sleep disorder,which was a positive correlation(r>0);The independent influencing factor of syndrome elements in the liver was anxiety score,which was a positive correlation(r>0);The independent influencing factors of syndrome elements in the spleen were anxiety score,gender and age,which were positively correlated with anxiety score and age(r>0),negatively correlated with male patients(r<0);The independent influencing factors of retained fluid syndrome were gender and age,which were positively correlated with age and male patients(r>0).The independent influencing factor of blood stasis syndrome was concomitant coronary heart disease,which was a positive correlation(r>0).The independent influencing factor of blood deficiency syndrome was sleep disorder,which was a positive correlation(r>0).The independent risk factors for Yang deficiency syndrome were concomitant coronary heart disease and rMSSD,which were negatively correlated with concomitant coronary heart disease(r<0),positively correlated with rMSSD(r>0).The related factors of frequent premature ventricular contractions combined with moderate to severe anxiety state included the disease location and syndrome elements of heart and gallbladder,course of premature ventricular contractions,sleep disorders and pNN50.Among them,course of premature ventricular contractions,sleep disorders,and pNN50 were independent risk factors and positive correlation(r>0).Conclusion:1.In patients with premature ventricular contraction combined with anxiety state,the main factor of TCM disease location syndrome was heart,closely related to liver,spleen and gallbladder.The elements of disease syndrome were mainly qi deficiency syndrome,blood deficiency syndrome,retained fluid syndrome,yang deficiency syndrome and phlegm turbidity syndrome.The disease nature was a mixture of deficiency and excess,based on the deficiency of qi,blood,yin and yang and retained fluid,phlegm turbidity and other solid evil.2.The independent influencing factor of syndrome elements were sleep disorders in the heart,anxiety score in the liver;anxiety score,gender and age in the spleen;gender and age in retained fluid;concomitant coronary heart disease in blood stasis;sleep disorder in blood deficiency;concomitant coronary heart disease and rMSSD in Yang deficiency.3.The independent risk factors of frequent ventricular premature beats combined with moderate and severe anxiety state included the course of premature ventricular contraction,sleep disorders and pNN50. |
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