| Coronary heart disease (CHD) is a common disease which is seriously harmful to people's health,and it is the first obituary reason of the non-infection in the world. Modern treatment of coronary heart disease over the last 10 years means has been made rapid progress, especially as a means of catheter interventional therapy rapid progress coronary angiography for the diagnosis of coronary heart disease provides a reliable information, the diagnosis of coronary heart disease known as the "gold standard." Syndromes of traditional Chinese medicine (TCM)is the target and on the basis for its governance. To study TCM Syndromes of coronary heart disease in-depth improves the combination of traditional Chinese and western medicine treatment of coronary heart disease, and contribute to the integration of traditional and western medicine treatment of coronary heart disease research to provide reliable standards. The coronary angiography using the gold standard for diagnosis of coronary artery disease. reference to "standards of TCM Syndrome coronary heart disease," to study coronary heart disease syndromes, and the distribution of factors, and the use of factor analysis for the four clinics to collect information, to investigate coronary heart disease-specific symptoms and syndromes characterized.METHODS : (1) The objects of research are 348 in-patients who have been examined by CAG and the Donfang Hospital , the Shijitan Hospital and the Chuyangliu Hospital. (2) We finish the collections of syndromes of TCM and history-taking within 48 hours afer CAG which has been done by Judkin's method. (3) Statistical Methods : SPSS13.0 statistical software for statistical analysis, Measurement data using t-test or analysis of variance, calculators information is chi-square test, grading information is rank sum test; for the diagnosis of coronary heart disease with Binary logistic regression analysis (forward wald).The selected value is 0.05,and the removed value is 0.1.(4) Use Factor-Analysis analyze the symptoms, feature-value greater than 1, and select the fourth largest party orthogonal rotation.Results : (1) Risk factors for coronary heart disease : hypertension, dyslipidemia, smoking in patients with coronary heart disease and non-CHD group with a statistical significance was found diabetes and coronary heart disease-related; (2) TCM Syndrome:in the part of CHD,blood stasis is 228 patients (74.3%),the deficiency-syndrome of Qi is 238 cases(77.5%), the stagnation-syndrome of qi is 29 cases (9.4%); and in the part of Non-CHD ,blood stasis is 21 cases (51.2%), the deficiency-syndrome of Qi is 26 cases (63.4%), the stagnation-syndrome of qi is 10 cases (24.4%); by chi-square test, the deficiency-syndrome of Qi (P = 0.047), blood stasis (P = 0.002), the stagnation-syndrome of qi (P = 0.004) in patients with CHD group and Non-CHD group gain statistical significance. In portfolio syndrome, a combination of three- syndromes is the most, a total of 163 cases, followed by the two- syndromes combinations (108 cases), again for signal- syndrome(27 cases) and four- syndromes (46 cases), five- syndromes and six- syndromes are the least.Of the 307 patients with coronary artery disease, the combination of syndromes of the deficiency-syndrome of Qi and blood stasis are 165 cases,for the total number of cases of coronary heart disease by 53.7%. The deficiency-syndrome of Qi and blood stasis always combine with the deficiency-syndrome of yin and phlegm. (3) TCM Syndrome regression analysis :Seeing CHD and non-CHD group as the dependent variable.And seeing phlegm, blood stasis, the stagnation-syndrome of qi, accumulation of pathogenic cold,the deficiency-syndrome of Qi,the deficiency-syndrome of yang, deficiency-syndrome of yin as self variable, and using Binary logistic regression analysis(forward wald).The results showed that the coefficient of blood stasis is 0.911, the relative risk is 2.487,relative risk with 95% confidence interval is 1.265～4.891; the coefficient of qizhi is -0.966. the relative risk is 0.381, relative risk with 95% confidence interval is 0.166～0.873. (4) Coronary Heart Disease Syndrome Factor Analysis : remove samples that which positive rate is less than 20% of the variables (symptoms) and selected 51 variables factor analysis, and get a total of 16 factors. The contributing of the 16 common factors is 64.677%.And classifying the factors,then the factors can be sorted into 12 categories of permits.Conclusion : (1)In the CHD Syndromes of TCM ,the qixu and xueyu is the main syndromes. The deficiency-syndrome of Qi and blood stasis are the common combination of syndromes .Among them, blood stasis for coronary heart disease is the specific syndrome.And clinical diagnosis of blood stasis of Chest Pain patients more susceptible to coronary heart disease. (2) Factor analysis, the deficiency-syndrome is the first factor, indicating that the deficiency-syndrome is a major cause of coronary heart disease factors .Meanwhile ,there is phlegm, the stagnation-syndrome of liver,the heat, blood stasis and other factors. The deficiency-syndrome also includes the deficiency-syndrome of qi, the deficiency-syndrome of yin and deficiency of viscera.The deficiency of viscera includes the deficiency-syndrome of qi in heart,spleen and kidney,and the deficiency-syndrome of yin of liver.This suggest that ,the heart,the liver,the spleen and the kidney,the four viscera in dysfunction are likely to cause coronary heart disease, and of these , the deficiency-syndrome is in the main.And the deficiency-syndrome of qi and the deficiency-syndrome of yin is the main factors in xuzheng.Meanwhile inclusion phlegm, heat, blood stasis and the stagnation-syndrome of qi . By this analysis, we can sum up the overall coronary heart disease pathogenesis as "the imaginary superficiality." (3) To ensure that the results of factor analysis is even better, we should further expand the sample size, guarantee that the sample volume and variables (symptoms)≥10:1 ratio will be the best. (4) This subject trys to use the application of the factor analysis methods analyze CHD TCM Syndrome .And the research provides new ideas and methods for reference. |
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