Circular Statistical Analysis Of The Two-hour Periods Circadian Variation In The Frequency Of Acute Myocardial Infarction Onset And Its Syndrome Type In Traditional Chinese Medicine In Foshan

Objective:To determine whether different syndrome types in Traditional Chinese Medicine (TCM) of acute myocardial infarction (AMI) outbreaks randomly throughout the day, and study the central tendency and the mechanism. Methods: We recorded the patients'age, sex and the time of AMI onset and the syndrome types in TCM about who admitted to Foshan Hospital of Traditional Chinese Medicine (FSTCM) from January 2000 to December 2009. Calculated the constituent ratio of each syndrome types and observed whether each syndrome type had peak time of AMI onset by circular statistical analysis. Results:We observed that the number of sthenia syndrome cases was the most during January 1,2000 to December 31,2009 in Foshan, which in the frequency of 65.6%. The incidence rate of each syndrome type was:phlegm turbidity obstruction (40.48%)> qi stagnantion and blood stasis (25.20%)> insufficiency of yin-blood(18.1%)> yang qi debilitation (16.22%). The onset of myocardial infarction occurs most frequently throughout the day at 10:36, as the sixth of the twelve two-hour periods, mainly occurred in the fifth, sixth, seventh and eight of the twelve two-hour periods, and the peaks gently. The peak of qi stagnancy and blood stasis onset was 12:45, the seventh of the twelve two-hour periods, mainly occurred in the forth, fifth, sixth, seventh, ninth and tenth of the twelve two-hour periods; and a marked circadian rhythm in the frequency of onset in the phlegm turbidity obstruction was detected, with a pick time in 10:17, the sixth of the two-hour periods, mainly in the forth, fifth and sixth of the twelve two-hour periods; there was no significant circadian variation of insufficiency of yin-blood onset; and the peak of yang-qi debilitation onset was 23:08, the first of the twelve earthly two-hour periods, mainly occurred in the first and the last of the twelve earthly two-hour periods. Conclusion: The major syndrome types of AMI in Foshan are phlegm turbidity obstruction and qi stagnancy and blood stasis. There is a marked circadian rhythm in the frequency of AMI onset. AMI mainly occurs in the morning and at dusk, sthenia syndrome occurred mainly in the morning and at dusk, and the deficient syndrome occurred mainly in midnight. Those circadian rhythm indicating that the main treatment for AMI is to sweep phlegm turbidity, activate blood to transform stasis and free the vessel to relieve pain. For AMI prevention in different periods, we should give attention to different population at high rick of different constitution; for those sthenic, we should take attention in the morning and at dusk, and for those asthenic, we should take more attention in midnight. It is very helpful to improve ability and efficiency of TCM following the prognosis of AMI clinically, if basing on TCM theory of correspondence between man and nature, complying with wane and wax as well as the variation of yin-yang, according to the features of AMI onset rhythm, combining with the results of modern researches, and emphasizing abidance by triple pathogens. Meanwhile, it is valuable to carry forward and develop the method that applying the theory of chronomedicine in TCM to analyze and study the rule and the internal mechanism of onset time.