| Objective:To analyse the relationship between TCM syndrome types of coronary atherosclerotic heart disease(CHD)with lipoprotein(a)and degree of coronary artery stenosis,and to research about the relationship between TCM syndrome types of CHD,chemical examination data and interventional image,so as to provide some ideas for the diagnosis and treatment of the disease with the thinking of integrated traditional Chinese and western medicine.Method:A total of 314 patients who diagnosed as coronary atherosclerotic heart disease and accord with the inclusion criteria were selected.The results of plasma lipoprotein(a)and coronary angiography were collected,results of coronary angiography are expressed by gensini score calculation,and the patients were differentiated according to the thinking of traditional Chinese medicine.Using spss24.0 to analyze the correlation.Results:1.Both of lipoprotein(a)and coronary angiography does not comply with the normal distribution.The result of rank sum test showed that Lp(a):H=171.983,P<0.001.Gensini score:H=122.823,P<0.001.There were significant differences.That is to say,there was a big difference in Lp(a)concentration and Gensini score among different syndrome types.2.Compared with heart blood stasis syndrome,plasma Lp(a)and Gensini score of type of qi stagnation and blood stasis,qi deficiency and blood stasis syndrome and deficiency of both qi and yin syndrome were lower.Among them,deficiency of both qi and yin syndrome was the lowest,0.224 times plasma Lp(a)and 0.028 times Gensini score of heart blood stasis syndrome,and genini score(P<0.05)showed significant difference.The plasma Lp(a)which type of qi stagnation and blood stasis was little bit higher than deficiency of both qi and yin syndrome,which was 0.39 times ofthat in control syndrome,but(P>0.05)had no significant difference.The Gensini score in type of qi stagnation and blood stasis was slightly higher than other two,which was 0.419 times of that of the control syndrome(P<0.05),which showed significant difference,while the plasma Lp(a)compared with the control syndrome had no significant difference(P>0.05).Meanwhile,the plasma Lp(a)of phlegm-accumulation syndrome was evidently 2.709 times higher than heart blood stasis syndrome(P<0.05).The Gensini score of phlegm-accumulation syndrome was 1.637 times more than the control syndrome without significant difference(P>0.05).The Gensini score of yin deficiency of heat-kidney syndrome was 0.132 times lower than that of heart blood stasis syndrome significantly(P<0.01),but the plasma Lp(a)was 1.829 times higher,unfortunately there was no significant difference(P>0.05).The plasma Lp(a)and Gensini score of yang-qi deficiency syndrome were the highest,the Gensini score was significant(P<0.01),but the other was not(P>0.05),and the sample size of yang-qi deficiency syndrome were too small,no discussion to avoid errors.3.The ROC curve of excess syndrome or deficiency syndrome,phlegm-accumulation syndrome or non-phlegm-accumulation syndrome,deficiency of both qi and yin syndrome or non-deficiency of both qi and yin syndrome were all statistically significant.For the ROC curve of excess syndrome or deficiency syndrome,areas under the ROC curve were0.821(>0.50)for Gensini score and 0.820(>0.50)for the combination,which approximately the same.Areas under the ROC curve for Lp(a)was0.705(>0.50).Among phlegm-accumulation syndrome or non-phlegm-accumulation syndrome,area under the ROC curve for the combination was 0.844>which for Gensini score 0.835>which for Lp(a)0.796(>0.50).As for deficiency of both qi and yin syndrome or non-deficiency of both qi and yin syndrome,area under the ROC curve for the combination was 0.894>which for Gensini score 0.882>which for Lp(a)0.765(>0.50).To sum up,the combination of Lp(a)and Gensini score can beused for distinguish phlegm-accumulation syndrome and deficiency of both qi and yin syndrome,and the combination is better than the single ones.Conclusion:1.The combination of plasma Lp(a)and Gensini score can be used for distinguish several TCM syndrome types of CHD.2.When plasma Lp(a)and Gensini score are both low,CHD type tends to be deficiency of both qi and yin syndrome,type of qi stagnation and blood stasis,qi deficiency and blood stasis syndrome;when plasma Lp(a)is high and Gensini score is not such high,CHD type tends to be yin deficiency of heat-kidney syndrome;when plasma Lp(a)and Gensini score are extremly higher than heart blood stasis syndrome that CHD type tends to be phlegm-accumulation syndrome.3.Plasma Lp(a)and Gensini score can be used to distinguish the excess or the deficiency syndrome of CHD,phlegm-accumulation syndrome or not,and deficiency of both qi and yin syndrome or not.The combination of both is better than single ones in distinguishing deficiency of both qi and yin syndrome and phlegm-accumulation syndrome. |
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