| Purpose:This subject collects and studies clinical data of female coronary heart disease patients through investigation,analyzes the characteristics of coronary artery disease,distribution of traditional Chinese medicine syndromes and related risk factors in female coronary heart disease patients,and attempts to explore their correlation,and then to provide clinical research and decision-making for female coronary heart disease Provide clues and basis,with a view to providing theoretical guidance for the standardization of TCM syndrome differentiation and TCM standard diagnosis and treatment,help to carry out a wide range of noninvasive screening of female coronary heart disease,and provide new ideas for the prevention and treatment of female coronary heart disease with integrated Chinese and Western medicine.Material and method:This study was conducted using a retrospective survey to collect medical records of patients undergoing coronary angiography from January 1,2016 to December 31,2018 in the Department of Cardiology of Tianjin Nankai Hospital.The final screening was based on inclusion and exclusion criteria.A total of 1086 effective medical records were published.829 patients with coronary heart disease diagnosed with coronary angiography were selected as the observation group,including 465 males as male CHD group(n=465)and 364 females as female CHD group(n=364);257 female patients with no obvious coronary artery stenosis served as a control group,that is,female non-CHD group(n=257).According to the complete medical record,the patient's general condition,characteristics of coronary artery disease,TCM syndrome type,and risk factors(blood routine,blood biochemistry,coagulation function and other laboratory test indicators)were statistically analyzed,and the data was statistically analyzed using SPSS 23.0 statistical software.Results:1.Female CHD group compared with female non-CHD group in age,hypertension,diabetes,dyslipidemia,and whether menopause was P<0.05.2.Compared with the male CHD group,the female CHD group had statistically significant differences in age,hypertension,diabetes,smoking,and traditional Chinese medicine P<0.05.Among them,age,hypertension and diabetes were in female CHD group> male CHD group,smoking: male CHD group> female CHD group.Among the two types of TCM syndromes:female CHD group: phlegm and turbidity obstruction syndrome> Qi and Yin deficiency syndrome> Xinshen Yin deficiency syndrome> Xinshen Yang deficiency syndrome> Heart and blood stasis syndrome> Qi stagnation and chest syndrome> Han Ning Xinmai syndrome.Male CHD group: Heart-blood stasis syndrome> Heart-kidney-yang deficiency syndrome>Heart-kidney-yin deficiency syndrome> Qi-yin deficiency syndrome> Phlegm turbidity obstruction syndrome> Qi stagnation syndrome> Cold coagulation heart pulse syndrome.Comparison of each syndrome type: Phlegm-turbidity obstruction syndrome and Qi-yin deficiency syndrome: female CHD group> male CHD group;heart blood stasis syndrome,heart and kidney yang deficiency syndrome: female CHD group <male CHD group;P <0.05.3.Number of coronary lesions: female CHD group: 158 cases(43.4%)with single branch>127 cases(34.9%)with three branches>79 cases(21.7%)with two branches>CHD group with males: 198 cases(42.6%)with three branches >140 cases with double branch(30.1%)>127 cases with single branch(27.3%).Between the two groups: single branch:female CHD group> male CHD group;double branch,three branches: female CHD group<male CHD group;both P <0.05.4.Among the two groups of coronary artery lesions: female CHD group: LAD 319 cases(87.6%)>RCA case 196(53.8%)>LCX case 176(48.4%)>LM case 16(4.4%);male CHD group: LAD Case 420(90.3%)> RCA case 291(62.6%)> LCX case 281(60.4%)> LM case35(7.5%).Among them,LCX: female CHD group <male CHD group;RCA: female CHD group <male CHD group,all P <0.05.5.Comparing the degree of coronary artery disease(Gensini score)between the two groups,women were lower than men,and the result P<0.05 was statistically significant.The comparison between female Gensini score and syndrome type was P<0.001,the difference was statistically significant.Among them: syndrome of phlegm-turbidity> syndrome of deficiency of heart-kidney-yin> syndrome of deficiency of heart-kidney-yang> syndrome of deficiency of both qi and yin> syndrome of heart-blood stasis> cold coagulation heart pulse>cardioplegia of qi stagnation,comparison of syndrome of phlegm-turbidity with other syndromes P<0.05.6.WBC,NEUT%,LYMPH%,MONO%,EO%,BASO%,RDW-CV,PDW,total bilirubin,alkaline phosphatase,urea,creatinine,uric acid,fasting blood glucose,blood potassium,aspartate aminotransferase,The indexes of LDH,PT,PT-INR,TG,HDL,LDL,and C-reactive protein were P<0.05 between female CHD and female non-CHD patients.7.The above indicators MONO%,EO%,RDW-CV,PDW,urea,creatinine,uric acid,fasting blood glucose,TG,C-reactive protein indicators exist simultaneously between female CHD and male CHD and female non-CHD patients.Learn the differences.8.Multivariate logistic regression analysis showed that age,hypertension,diabetes,menopause,PDW,creatinine,fasting blood glucose,TG,total cholesterol,C-reactive protein were positively correlated with female CHD patients,all P<0.05.9.Age,blood sugar,TG,total cholesterol are statistically different between female CHD group TCM syndromes.10.The age of female CHD group showed the syndrome of deficiency of heart-kidney yang>syndrome of phlegm obstruction> syndrome of heart-kidney yin deficiency> syndrome of heart-blood stasis> syndrome of deficiency of qi and yin> syndrome of qi stagnation and heart chest> syndrome of cold coagulation and heart pulse;Among them,the age-level syndrome of heart-kidney-yang deficiency is the highest,and the cold-condensation cardiology syndrome is the lowest.There is a statistical difference between the syndrome of cold coagulation and phlegm obstruction,the syndrome of deficiency of heart and kidney yang and the syndrome of stagnation of heart and chest,and the syndrome of coagulation of heart and blood circulation.11.The fasting blood glucose of female CHD group showed the deficiency syndrome of heart,kidney and yin in the index> the syndrome of obstruction of phlegm and turbidity> the syndrome of deficiency of both qi and yin> the deficiency of heart and kidney yang> the syndrome of stagnation of the heart and chest> the cardioplegia of cold coagulation> the syndrome of blood stasis Among them,the fasting blood glucose level has the highest heart-kidney-yin deficiency syndrome and the lowest heart-blood stasis syndrome.Phlegm-turbidity obstruction syndrome and heart-blood stasis syndrome,qi stagnation cardiothoracic syndrome,Qi-yin deficiency syndrome and heart-blood stasis syndrome, heart-kidney yin deficiency syndrome heart-blood stasis syndrome,qi stagnation cardiothoracic syndrome,cold coagulation heart pulse syndrome,heart-kidney syndrome There is a statistical difference between Yang deficiency syndrome and heart blood stasis syndrome.12.Female CHD group TG showed phlegm and turbidity obstruction syndrome on the index> Xin Shen Yang deficiency syndrome > Qi Yin deficiency syndrome > Qi stagnation cardiothoracic syndrome>Heart blood stasis syndrome>Xin Shen Yin deficiency syndrome>Han Ning Xinmai syndrome;Among them,the TG phlegm obstruction syndrome is the highest,and the Han Ning Xinmai syndrome is the lowest.Phlegm turbidity obstruction syndrome and heart blood stasis obstruction syndrome,cold coagulation heart pulse syndrome,heart kidney yin deficiency syndrome,there is a statistical difference between cold coagulation heart pulse syndrome and heart kidney yang deficiency syndrome.13.Total cholesterol in female CHD group showed phlegm and turbidity obstruction syndrome> Qi stagnation cardiothoracic syndrome> Qi and yin deficiency syndrome> Heart and kidney yang deficiency syndrome> Heart and blood stasis syndrome> Heart and kidney yin deficiency syndrome> Han Ning Xinmai Syndrome;the syndrome of phlegm turbidity and obstruction of total cholesterol is the highest,and the syndrome of cold coagulation and heart pulse is the lowest.There is a statistical difference between the syndrome of phlegm turbidity and obstruction and the syndrome of cold coagulation heart pulse and heart.Conclusion:1.Age,hypertension,diabetes,dyslipidemia,and whether menopause may be related risk factors for the incidence of coronary heart disease in women;there are gender differences in age,hypertension,diabetes,and smoking.Among them,age,hypertension and diabetes were in female CHD group> male CHD group,smoking: male CHD group> female CHD group.2.There are gender differences in the distribution of TCM syndromes: phlegm-turbidity obstruction syndrome and qi-yin deficiency syndrome: female CHD group> male CHD group;heart blood stasis syndrome,heart and kidney yang deficiency syndrome: female CHD group<male CHD group;3.There are differences in the number of coronary lesions between the two groups,including:female: single branch>three branches>double branch;male: three branches>double branch>single branch;both groups of coronary artery lesions have LAD>RCA>LCX>LM;The degree of coronary artery lesions(Gensini score)of female patients is generally lower than that of male patients.The Gensini score of female patients with different syndrome types:Phlegm-turbid internal obstruction syndrome> Heart and kidney yin deficiency syndrome>Heart and kidney yang deficiency syndrome> Qi and Yin deficiency syndrome> Heart blood Stagnation syndrome> Cold coagulation heart pulse> Qi stagnation cardiothoracic,phlegm internal resistance proved significantly higher than other groups.4.Age,high blood pressure,diabetes,menopause,PDW,creatinine,fasting blood glucose,TG,TC,C-reactive protein may be unique independent risk factors for the incidence of female coronary heart disease;age,fasting blood glucose,triglycerides,total cholesterol 3.The index may have an objective reference value for TCM syndrome differentiation of female patients with coronary heart disease.Female patients with coronary heart disease have the highest age-deficiency syndrome of heart-kidney yang,and the lowest syndrome of cold coagulation and heart-vessel syndrome,which may have objective reference significance for syndrome differentiation of traditional Chinese medicine and heart-kidney yang deficiency syndrome.Female patients with coronary heart disease have the highest fasting blood glucose level and the lowest syndrome of heart-kidney yin deficiency and the lowest syndrome of heart-blood stasis,which may have objective reference significance for syndrome differentiation of traditional Chinese medicine and heart-kidney-yin deficiency syndrome.Female patients with coronary heart disease had the highest TG and total cholesterol levels and the lowest phlegm-blocking syndrome,and the cold coagulation heart-pulse syndrome had the lowest,which may have an objective reference significance for TCM syndrome differentiation and phlegm-blocking syndrome. |
PDF Full Text Request