| 1 ObjectivesTo study the distribution regularity of syndrome elements of the disease property and location in ACS patients with PCI, and make extraction of risk syndrome elements in relation to endpoint events. Furthermore, to explore possible objective evidence of modern medicine.2 MethodsThis study was a multi-center longitudinal observational study. According to the provisions of the protocol,120 patients from 4 hospitals were enrolled and clinic visit were performed 3,6,12 months after the enrollment, by follow-up of telephone calls and outpatients, and the follow-up lasted 1 year. The relative four diagnostic information, coronary angiography results and endpoint events during follow-up were recorded. The follow-up was ended when endpoint events happened. Syndrome elements were divided into syndrome elements of the disease property and location, we analyzed their distribution regularity respectively. We used Logistic regression analysis to analyzed the correlation between disease property location and endpoint events during the period of follow-up and made extraction of risk syndrome elements. The Gensini score was used to evaluate the risk syndrome elements, furthermore objective evidence would be explored.3 Results3.1. Cross-sectional study:3.1.1 Major syndrome elements of the disease property and their combination of 120 ACS cases.Seven syndrome elements of the disease property were extracted totally. Blood stasis(81.7%), qi deficiency(51.6%), yin deficiency(42.5%) were in the top three,and qi stagnation(1.6%) was the fewest. It indicated that the blood stasis and qi deficiency were the major syndrome elements. The two syndrome elements combination(52.2%) was the major form in the different combinations. Blood stasis and phlegm syndrome elements accounted for 34.17% of excess syndrome elements, blood stasis and qi deficiency accounted for 44.17% of deficiency-excess mixing syndrome elements, qi deficiency and yin deficiency accounted for 26.67% of deficiency syndrome elements.3.1.2 Major syndrome elements of the disease location and their combination analysisNine syndrome elements of the disease location were extracted totally. According to the proportion, heart(70.8%)> kidney(40%)> stomach(30.8%)> large intestine (25.8%)> lung(21.7%)> small intestine (10.8%)>spleen(10%)> liver(1.7%)>gall bladder(0.8%). It reflected that the major disease location of ACS was in the heart. Of the combination of the disease location,2 or 3 disease location combined form were the most commom style, they accounted for 26.7% and 19.2%. Of the combined disease locations form, heart combined kidney was the most common type, accounting for 20.1%.3.1.3 Endpoint events analysisDuring the period of 1 year follow-up,7 cases of cardiovascular endpoint event occurred in, and the incidence was 5.8%. In different clinical classification groups,6 cases occurred in UA patients. In different criminal vessel groups,1 case who occurred endpoint had single criminal vessel,2 cases had two criminal vessels,4 cases had three criminal vessels.3.2 The correlation of syndrome elements and endpoint events analysisThe syndrome elements of the disease property were named independent variable, endpoint events were named dependent variable. Using Forward:LR method for Logistic regression analysis. The independent variable of yin deficiency was in regression and coefficient test, P=0.997,OR=0.00. The conclusion indicated that syndrome elements and endpoint events had no significant correlation.The syndrome elements of the disease location were named independent variable, endpoint events were named dependent variable. Using Forward:LR method for Logistic regression analysis.2 locations were choosed as variables, they were stomach and spleen. Of the spleen, model parameter test was used to made analysis, P=0.068,OR=7.079,95%CI(0.863,58.054), showed no significant difference. Of stomach, P=0.009,OR=20.183,95%CI(2.099,194.053), showed significant differences.3.3 Using Gensini score to evaluate the relative syndromes elements.First, test of goodness for fit about Gensini score about the test data was performed. There was significant difference between groups of unstable angina and st-segment elevation myocardial infarction. The difference had statistical significance (P=0.016),95% CI (-17.74-1.40). There was significant difference between single vessel group and two vessels group(P=0.00),95%CI (-30.62,-10.01);there was significant difference between single lesion group and three lesions group(P=0.00), 95%CI (-24.57,-14.04).Comparison was made about the mean of Gensini score in different combination of syndrome elements of the disease property, the results of F test is F=0.311,P=0.817. The means between groups had no differences. About the desease location comparion, the results of Welch test was P=0.364,and Brown-Forsythe test was P=0.363. The means between groups had no differences. Gensini scores between the group stomach location and non-stomach location had no differences by F test, the result was F=0.926,P=0.338.4 Conclusions4.1 Blood stasis and qi deficiency are main disease properties of syndrome elements of ACS. The combination of Qi deficiency and Blood stasis is the main combined syndrome factors types.4.2 Disease location of Heart and kidney are the main syndrome factors of disease location of ACS. the combination of heart+kidney is the common type of combined disease locations syndrome elements.4.3 Disease location of "stomach" is relative to endpoint events occurring.4.4 There was no significant difference in Gensini score between group with disease location of "stomach" and "non-stomach". |
PDF Full Text Request