The Study Of The Correlation Between ACS And TCM Syndrome Elements And Type D Personality

Objective:To study the distribution of type D personality in patients with coronary heart disease(CHD),compary the clinical data and syndrome elements distribution between type D personality and non-type D personality in patients with acute coronary syndrome(ACS),to explore the correlation between traditional Chinese medicine(TCM)syndrome factors and type D personality and the pathogenesis of ACS,so as to provide new ideas for the prevention and treatment of ACS with integrated traditional Chinese and Western medicine.Methods:The patients who were diagnosed as CHD in Zhujiang Hospital in 2016.1-2017.6 were divided into ACS group and stable angina pectoris(SAP)group according to the relevant diagnostic criteria.The patients with normal coronary artery were selected as control group.According to the type D personality scale,the observed subjects were divided into type D personality group and non-type D personality group.Collect observation object of gender,age,past medical history,body mass index,blood lipid,blood pressure,rest heart rate,degree of coronary artery lesions,mood,psychology,four diagnostic informationand other general clinical data,improve the clinical questionnaire completed and data entry.T test andχ2 test were used to compare the clinical data of each group,and the correlation between type D personality and ACS was analyzed by using Pearson correlation analysis and logistic binary regression analysis.At the same time,the patient’s four diagnostic information was analyzed to explore the correlation between distribution of syndrome elements and type D personality in ACS patients.Results:203 cases of CHD were enrolled,including 135 cases in group ACS and 68 cases in group SAP and 61 cases in control group were enrolled.The proportion of the CHD patients with hypertension,systolic blood pressure(SBP)and rest heart rate(RHR),body mass index(BMI),total cholesterol(TC),triglyeeride(TG),low density lipoprotein cholesterol(LDL-C),fasting plasma glucose(FPG)and high-sensitive C-reactive protein(hs-CRP)levels were higher than control group,high density lipoprotein cholesterol(HDL-C)level is lower than the control group,and the differences were statistically significant(P<0.05).Compared with the SAP group,the RHR,SBP,TC,FPG and hs-CRP level of the ACS group were higher and the HDL-C level was lower,and the differences were statistically significant(P<0.05).The type D personality of ACS was 43.7%,significantly higher than that of SAP group(P<0.05).The NA scores of st-segment elevation myocardial infarction(STEMI)and non-st-segment elevation myocardial infarction(NSTEMI)in ACS was higher than that in patients with unstable angina(UA)(P<0.05).In patients with ACS the SBP,RHR,BMI,LDL-C,FPG and hs-CRP level of type D personality group were higher than those of non-type D personality group,the age,and HDL-C level is less than those of non-type D personality group,and the differences were statistically significant(P<0.05).The ACS patient anxiety scale(GAD-7)and depression scale(PHQ-9)scores were higher than those of the SAP group(P<0.05).GAD-7 scores,PHQ-9 scores,Gensini scores were positively correlated with NA scores and SI scores(P<0.05).The results of logistic binary regression analysis showed that type D personality,GAD-7,TC and hs-CRP were independent risk factors for ACS.The distribution of blood stasis,sputum and qi deficiency between ACS patients and SAP patients were statistically significant(P<0.05).In patients with ACS,blood stasis syndrome and sputum turbidity syndrome are more likely to occur.In SAP patients,there is a large probability of qi deficiency.In patients with CHD,the frequency of blood stasis syndrome and qi stagnation syndrome in patients with type D personality disorder was higher than that of non-type D personality group(P<0.05),while the frequency of sputum turbidity syndrome and qi stagnation syndrome in patients with type D personality disorder was higher than that of non-type D personality groups in patients with ACS(P<0.05).Conclusion:The proportion of type D personality increased significantly in ACS,and correlated with inflammatory factors,blood pressure,plasma glucose,blood lipids,anxiety and depression scores,which is maybe an independent risk factor for ACS.The NA scores and SI scores of type D personality were positively correlated with the Gensini scores of the degree of coronary artery disease,which indicated that type D personality was related to the severity of coronary artery disease.The common TCM syndromes of type D personality are blood stasis,qi stagnation and sputum turbidity syndrome.Therefore,early identification of TCM syndrome elements and type D personality characteristics of patients in the process of prevention and treatment of ACS will help to guide the intervention of integrated traditional Chinese and Western medicine.