| Purpose:The coronary CTA information of 60 patients with angina caused by myocardial bridge was analyzed to explore the characteristics of angina caused by myocardial bridge.To study and analyze the TCM syndrome type of angina pectoris caused by myocardial bridge,and to explore the distribution law of syndrome type.This paper summarizes Professor Pang min’s academic experience and treatment thought in the treatment of myocardial bridge with traditional Chinese medicine,aiming to provide a broader idea and method for clinical diagnosis and treatment.Material and method:From January 2014 to January 2019,200 patients with angina pectoris as the main symptom were selected from Professor Pang min’s outpatient department of the Second Affiliated Hospital of Liaoning University of traditional Chinese medicine and underwent coronary CTA imaging examination.According to the diagnostic criteria,inclusion criteria and exclusion criteria,60 patients were selected to meet the requirements.The basic clinical information of 60 patients with myocardial bridge induced angina pectoris was collected by extracting CTA image data and questionnaire,including CTA image information,name,age,four diagnosis information,myocardial bridge with high risk factors,etc.a database was established,and the characteristics of myocardial bridge induced angina were analyzed by spss25.0 software.At the same time,using syndrome element integral system and syndrome element differentiation method,to determine syndrome element,clear syndrome type,calculate frequency,and explore the distribution characteristics of TCM syndrome element and syndrome type of angina caused by myocardial bridge.Results:1.General data analysis: in the 60 patients with angina caused by myocardial bridge in this study,the prevalence rate of women was higher than that of men.The age span is large,between 30-79 years old,50-59 years old and 60-69 years old are the most common patients.2.CTA image analysis of coronary artery: the most common myocardial bridge was located in the left anterior descending branch(45.6%),and the least was in the right coronary artery.According to the classification of patients with angina caused by myocardial bridge,single type(35 cases)was higher than multiple type(25 cases),deep type(43 cases)was higher than superficial type(17 cases),myocardial bridge with atherosclerosis in 31 cases(51.7%),no coronary atherosclerosis was found in the inferior wall coronary artery and the distal coronary artery of myocardial bridge.Among them,28 cases had proximal atherosclerosis(65.1%)in43 cases of deep myocardial bridge and 3 cases had proximal atherosclerosis(17.6%)in 17 cases of superficial myocardial bridge.Comparing the two groups,X2 = 10.993,P = 0.001(P< 0.05).The probability of atherosclerosis between the two groups was statistically significant.In 28 cases of deep atherosclerosis,19 cases had hypertension,17 cases had diabetes and 12 cases had dyslipidemia;in 3 cases of superficial atherosclerosis,2 cases had hypertension,1case had diabetes and 1 case had dyslipidemia.3.Analysis of syndrome types of TCM: the common syndrome types of 60 patients with angina pectoris caused by myocardial bridge in this study are: Blood Stasis(39.2%),Qi deficiency(29.2%),yin deficiency(14.6%),Qi Stagnation(10.0%),Yang deficiency(7.0%).The six common syndrome types are: Qi Yin deficiency and blood stasis syndrome(31.6%),Qi deficiency and blood stasis syndrome(26.7%),Yang deficiency and blood stasis syndrome(15.0%),qi stagnation and blood stasis syndrome(11.7%),qi stagnation syndrome(10.0%),Qi deficiency syndrome(5.0%).The most frequent syndrome type was Qi Yin deficiency and blood stasis syndrome.The first three syndrome types were all based on deficiency and excess syndrome.The analysis results were statistically significant(P = 0.000(P < 0.05)).4.Professor Pang min thinks that this disease is the syndrome of "deficiency of the original and excess of the standard".Deficiency of Qi and Yin and stagnation of blood vessels are the basic pathogenesis.In the treatment of traditional Chinese medicine,the concept of "Yu Tong Yu bu" is put forward.The core idea is to improve the "functional state" of blood vessels.The treatment principle is to invigorate Qi and nourish yin,promote blood circulation and remove blood stasis.The self-made Xinmai shuning formula is based on Shengmai San and Xuefu Zhuyu Decoction.It is flexible and has good clinical effect.Conclusion:1.Among the patients with angina pectoris caused by myocardial bridge,women are slightlyhigher than men,and the age of predilection is 50-69 years old.CTA imaging features of coronary artery: the most common location of myocardial bridge is in the left anterior descending branch,and single type and deep type are common.The proximal part of the wall coronary artery of the deep myocardial bridge is more likely to develop coronary atherosclerosis.The high risk factors of atherosclerosis,such as hypertension,diabetes and dyslipidemia,had no significant difference between the deep and superficial groups.2.The common syndrome elements of angina caused by myocardial bridge are blood stasis,Qi deficiency,yin deficiency,qi stagnation and yang deficiency.The common TCM syndromes are Qi Yin deficiency and blood stasis,Qi deficiency and blood stasis,Yang deficiency and blood stasis,qi stagnation and blood stasis,qi stagnation and Qi deficiency,among which Qi Yin deficiency and blood stasis are the most common in clinic.3.Professor Pang min thinks that the pathogenesis of angina caused by myocardial bridge is deficiency of Qi and Yin and stagnation of blood vessels.The theory of "Yu Tong Yu bu" is put forward.The core idea of traditional Chinese medicine treatment is to improve the "functional state" of blood vessels.Based on the principle of benefiting qi and nourishing Yin,promoting blood circulation and removing blood stasis,Xinmai shuning decoction is formulated by ourselves,which is based on Shengmai San and Xuefu Zhuyu Decoction.It is clinically effective. |
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