Study On The TCM Syndrome Of Patients After Percutaneous Coronary Intervention In Kunming District

ObjectiveTo study the distribution and evolution rule of TCM syndromes of patients after percutaneous coronary intervention in Kunming district and to explore the risk factors and features of TCM syndromes of patients with restenosis after percutaneous coronary intervention in order to provide some references for the clinical prevention and treatment of restenosis after percutaneous coronary intervention.MethodsThe questionare used in this study is constructed based on Criterion of Syndrome Differentiation System of Coronary Heart Disease in Traditional Chinese Medicine(revised in 1990). Though questionare, four diagnostic information of patients after percutaneous coronary intervention with the interval of one week, three month and six month and other information is collected and SPSS 22.0 is adopted to do the statistical analysis to analyze the distribution features of TCM syndrome and evolution rules of patients after percutaneous coronary intervention along with the risk factors and features of TCM syndromes of patients with restenosis after percutaneous coronary intervention.Results1.In this study, 207 effective cases after percutaneous coronary intervention are collected. After gathering the clinical infromation and its statistical analysis, it is foun d that: The commonest syndrome type in patients after intervention studied at one week was blood stasis which were 114 cases and accounted for 55.1% of all the cases,the second was phlegm(99 cases,47.8%) and qi deficiency(79 cases, 38.2%), then followed by qi stagnation, yin deficiency, cold stagnation and yang deficiency which indicates main syndromes type of patients after intervention studied at one week wereblood stasis, phlegm and qi deficiency; main syndrome type of patients after intervention studied at three month also were qi deficiency, blood stasis and phlegm;three most frequently appeared syndrome types in patients after intervention studied at six month were qi deficiency(110 casese,53.1%), blood stasis( 93 cases, 44.9%)and yin deficiency(76 cases, 36.7%), then followed by phlegm, qi stagnation, yang deficiency, cold stagnation respectively which indicates main syndrome types of patients after intervention studied at six month were qi deficiency, blood stasis and yin deficiency.2. For patients after operation studied at one week, three month, six month respectively, the proportion of syndrome type of blood stasis and phlegm decreased consistently with tendency of slow peace, qi deficiency, yang deficiency and yin deficiency risen consistently. Of all those syndrome types, there was significant change in yin deficiency, no obvious change in cold stagnation and qi stagnation besides main syndrome types in the observation period were blood stasis, qi deficiency and phlegm; there was tendency of decrease of sthenie and rise of asthenia.3.Most frequently appeared syndromes among patients with restenosis were blood stasis(59.5%), yin deficiency(57.1%) and qi deficiency(57.1%). The others are phlegm > qi stagnation > yang deficiency > cold stagnation. Sequence of syndromes among patients without restenosis were qi deficiency and blood stasis >yin deficiency > phlegm > qi stagnation > yang deficiency > cold stagnation. After comparison within two groups, there was statistical significance(P<0.05) between patients with restenosis which was higher and patients without restenosis in syndromes of blood stasis, phlegm and yin deficiency.4. Results of single factor analysis which took the patients as unit showed that there was significant difference(P<0.05) between male patients groups with restenosis and groups without restenosis in BMI and the distribution of smoking,hypertension and diabetes mellitus. To further verify this result, multivariate logistic regression is adopted with restenosis as dependent variable and male, smoking,hypertension, diabetes mellitus and BMI as variable. The results showed that smoking,hypertension and diabetes mellitus were individual risk factors of restenosis(P<0.05),the value of OR is as follows: 3.287, 2.955 and 4.476.Conclusion1.Main types of TCM syndrome among 207 patients after percutaneous coronary intervention in Kunming are blood stasis, qi deficiency and phlegm.2.From one week to six mouths after surgery,among 207 patients after percutaneous coronary intervention in Kunming, syndrome of blood stasis and phlegm has decreased gradually. However, syndrome of qi deficiency, yin deficiency and yang deficiency have improved gradually; syndrome after intervention tends to transform from sthenie to asthenia.3.Syndromes of blood stasis, phlegm and yin deficiency in patients group with restenosis after percutaneous coronary intervention are significantly higher than groups without restenosis which are related with the restenosis after percutaneous coronary intervention. This indicates more emphasis should be laid on resolving phlegm and removing blood stasis as well as nourshing yin and strengthening body resistance for patients after percutaneous coronary intervention.4.Smoking, hypertension and diabetes mellitus are the independent risk factors of restenosis which indicates more emphasis should be laid on the interventions of those factors in clinical to reduce the possibility of restenosis after intervention.