Acute Coronary Syndrome In Traditional Chinese Medicine Syndrome Factors And The Relationship Between The C825t Polymorphism Of Gnb3 Gene

ObjectiveAccording to the methods and principles of clinical epidemiology,using modern statistical methods,his study probed into the TCM syndrome pattern of ACS sampling from Beijing of Han People.To investigate the relationship between the changes of coronary angiography(CAG),laboratory indices and the types of TCM syndromes,in order to present the basis in microcosmic determination of treatment based on differentiation of syndromes.To explore the relationship between the types of TCM syndromes and G-proteinβ3 submit(GNB3) C825T polymorphisms.Methods315 clinical cases diagnosed as ACS hospitaled in Anzhen hospital in Beijing of Han People.Using the factor analysis method,this study explored the types of syndrome.This study explored the realationship between the affection branches and the types of syndrome,compared the difference between Gensini accumulated points also.Using Canonical analysis method,this study investigated the relationship between the laboratory indices(TC,TG,LDL-C,hs-CRP,TNI,HCY,FIB)and the types of syndrome.The influencing factor was analyzed by using Binary-Logistic regresstion. The difference between male whose age＜60 and male whose age≥60 was compared. 103 health adults was enrolled as control group.The relationship between the types of TCM syndromes and GNB3 C825T polymorphisms was investigated.Results1.The number of TCM symtorns of ACS in the frenqency was as follows:chest distress,cardiopalmus,short breath,perspiration when chest pain,oral lips cyanosis, lack of power,pricking pain,anesthesia and heavy,waist soreness,loss of memory.2.Using the factor analysis method,8 types of TCM syndromes were found.There was no significant statistical difference in the gender,age groups,clinical categorization of ACS over the distribution of TCM syndromes(P＞0.05).3.There were correlations between the types of TCM syndromes and coronary arteriongraphy(P＜0.05).There was significant statistical difference in the number of coronary artery pathologic changes over the distribution of the 8 types of TCM syndromes(P=0.007).The grades of Gensini were different in the different types of TCM syndromes(P=0.001).The accumulation-syndrome of pathogenic cold was more than other syndromes in the number of coronary artery pathologic changes (P＜0.05).The sequence from the first to the last one by the grades of Gensini:the accumulation-syndrome of pathogenic cold＞the syndrome of blood stasis＞the deficiency-syndrome of yang＞heat＞the deficiency-syndrome of yin＞the syndrome of sputum-turbid＞the deficiency-syndrome of qi＞stagnation-syndrome of qi.While consider the deficiency-syndrome of essence,the degree of aeteria coronaria pathologic changes was more and more severious with the appearance of the deficiency-syndrome of qi,the deficiency-syndrome of yin,the deficiency-syndrome of yang.The accumulation-syndrome of pathogenic cold and the syndrome of blood stasis was the more serious than other syndromes,because their numbers of coronary artery pathologic changes and grades of Gensini were both high.4.Canonical analysis showed that FIB was correlated with the deficiency-syndrome of qi;hs-CRP was correlated with the syndrome of sputum-turbid; cTNI was correlated with the accumulation-syndrome of pathogenic cold.5.This study investigated the influential factors of such syndromes of ACS:the deficiency-syndrome of qi,the deficiency-syndrome of yang,the syndrome of blood stasis,the syndrome of sputum-turbid.The times of smoking and history of heart failurethe was influential factors of the syndrome of blood stasis.BMI and the western style of diet were the influencing factor of the syndrome of sputum-turbid.Family history of essential hypertension,essential hypertension and heart function were the influencing factor of the deficiency-syndrome of yang.Exertion was the influencing factor of the deficiency-syndrome of qi.6.Comparing the male those age＜60 and male those age≥60,the male patients those age＜60 were correlated with cigarettes and western style of diet.While the male patients whose age≥60 were correlated with essential hypertension(P＜0.05).7.The TT gene type of GNB3 was significantly higher in patients of ACS than control group,while CC gene type of GNB3 was significantly lower than control group and TT gene type was significantly higher than control group(P＜0.05).The frequence of T allele was higher than control group(P＜0.05).Comparing with control group, the sthenia syndrome had significant difference both in distribution and frequency of T allele.Those were no significant difference in frequency of TT genotype and T allele in compared the sthenia syndrome with the deficiency syndrome,and compared the deficiency syndrome with the control group(P＞0.05).8.This study investigated the risk of the appearance of the sthenia syndrome and the deficiency syndrome due to TT genotype or T allele.Those carriers of the TT genotype and T allele of ACS were easier to become ACS than the control group(OR＞1,P＜0.05).TT genotype and T allele may be the predisposing genes to ACS.The value of OR in the sthenia syndrome was exceed 1 than the control group(P＜0.05). But comparing not only control group but also the sthenia syndrome,the value of P in the deficiency syndrome was larger than 0.5.For this reason,the TT genotype and T allele were not affirmed the association with the sthenia syndrome and deficiency syndrome of ACS.Conclusion1.The syndromes of ACS:the syndrome of sputum-turbid,the syndrome of blood stasis,the deficiency-syndrome of yang,the deficiency-syndrome of qi,the stagnation-syndrome of qi,the accumulation-syndrome of pathogenic cold,heat,the deficiency-syndrome of yin.2.There were correlations between the types of TCM syndromes with coronary arteriongraphy.3.FIB was correlated with the deficiency-syndrome of qi,hs-CRP was correlated with the syndrome of sputum-turbid,cTnI was correlated with the accumulation-syndrome of pathogenic cold. 4.The times of smoking and history of heart failurethe was influential factors of the syndrome of blood stasis.BMI and the western style of diet were the influencing factor of the syndrome of sputum-turbid.Family history of essential hypertension, essential hypertension and heart function were the influencing factor of the deficiency-syndrome of yang.Exertion was the influencing factor of the deficiency-syndrome of qi.5.The male patients whose age＜60 were correlated with cigarettes and western style of diet.While the male patients whose age≥60 were correlated with essential hypertension.6.The TT allele C825T of GNB3 gene may be one of the genetic risk factors of ACS.The TT genotype and T allele were not affirmed the association with the sthenia syndrome and deficiency syndrome of ACS.