The Study On TCM Syndrome Type And Bilirubin Of Climacteric Carotidartery Disease

ObjectiveFrom the dialectical point of view of traditional Chinese medicine(TCM),this study analyzes the relationship between TCM Syndrome Types and bilirubin level in patients with climacteric carotid atherosclerosis,so as to deepen the TCM understanding of climacteric carotid atherosclerosis and bilirubin,and to open up new ideas for TCM treatment.In addition,the objective indicators can also strengthen the dialectical accuracy of clinical research and provide guidance for the evaluation of clinical efficacy to a certain extent.MethodsFrom March 1,2019 to January 1,2020,133 climacteric patients with carotid arteriosclerosis who were initially diagnosed in Shenzhen Hospital of traditional Chinese medicine were collected,and 60 normal climacteric patients with color Doppler ultrasound,whose average age of physical examination was 40-60,were randomly selected as the control group,and the corresponding diagnostic criteria,inclusion and exclusion criteria were formulated,and the medical records were sorted out Materials:general data such as name,age,BMI and four diagnostic information were collected,and the results of color Doppler ultrasound and biochemical data were recorded:total bilirubin(TBIL),indirect bilirubin(IBIL),direct bilirubin(DBIL).Spss20.0 statistical software was used to analyze the clinical data,and the test level was α＝0.05.To observe the difference between the two groups and the distribution of bilirubin in different TCM Syndromes of the disease.Results1.The levels of IBIL and TBIL in climacteric CAS patients were significantly lower than those in climacteric normal group(P<0.01).There was no significant difference in age,BMI and DBIL between the two groups(P>0.05).2.The levels of IBIL and TBIL in carotid plaque group(P＜0.01,P＜0.01)and carotid stenosis group(P<0.01,P<0.01)were significantly lower than those in carotid intimal thickening group,and there was no significant difference in DBIL between the groups(P>0.05).3.38 cases(28.57%)of qi stagnation and blood stasis syndrome,32 cases(24.06%)of liver and kidney yin deficiency+blood stasis syndrome,33 cases(24.81%)of spleen and kidney yang deficiency+phlegm and blood stasis syndrome,30 cases(22.56%)of stasis heat endogenous syndrome were included.4.The main symptoms of climacteric CAS patients were various,including sleep disorder(62.41%),dysphoria(43.61%),asthenia(39.10%),hyperhidrosis(27.07%),dizziness(12.03%),memory decline(5.26%).5.Climacteric CAS TCM syndrome types were related to bilirubin levels,and there was a significant difference in IBIL levels among the syndrome types(P<0.01).Compared with stasis heat endogenous syndrome,qi stagnation and blood stasis syndrome(P<0.01),liver and kidney yin deficiency+blood stasis syndrome(P<0.05),spleen kidney yang deficiency+phlegm blood stasis(P<0.01)all had significantly lower IBIL levels;compared with the syndrome of spleen kidney yang deficiency+phlegm blood stasis,IBIL levels of qi stagnation and blood stasis syndrome(P＜0.01),liver and kidney yin deficiency+blood stasis syndrome(P<0.01),stasis heat endogenous syndrome(P<0.01)were significantly increased.There was a significant difference in TBIL level among different syndromes(P<0.01).Compared with the syndrome of stasis heat endogenous,the level of TBIL in the syndrome of qi stagnation and blood stasis(P<0.05)、spleen kidney yang deficiency+phlegm blood stasis(P<0.01)were significantly lower;compared with the syndrome of spleen kidney yang deficiency+phlegm blood stasis,the level of TBIL in the syndrome of qi stagnation and blood stasis(P<0.01),the syndrome of liver kidney yin deficiency + blood stasis block(P<0.01)and the syndrome of stasis heat endogenous(P<0.01)were significantly higher.There was no significant difference in age,BMI and DBIL among the syndrome types(P＞0.05).Conclusion1.The level of bilirubin in climacteric CAS patients is abnormal,the important is IBIL and TBIL,which are significantly lower than that in the normal group.There is no significant difference in DBIL level,age and BMI between the two groups.2.The levels of IBIL and TBIL decreased with the progression of carotid atherosclerosis,and were negatively correlated with the severity of the disease.Sleep disorder is the most common symptom in climacteric CAS patients.The proportion of each syndrome type is approximately the same.There was significant difference between IBIL and TBIL,but no significant difference between DBIL groups.The results showed that the level of IBIL was significantly lower than the other three types.The lowest level of TBIL was spleen kidney yang deficiency+phlegm blood stasis syndrome,followed by qi stagnation and blood stasis syndrome,liver kidney yin deficiency+blood stasis stagnation syndrome and stasis heat endogenous syndrome.