| 1.Objective:To analyze and evaluate the current quality of life,cardiovascular events and sleep status of patients with coronary heart disease(CHD),explore the correlation between sleep quality and TCM syndromes of CHD patients,and summarize the distribution of TCM syndromes of CHD patients with sleep disorders and their correlation with recurrent cardiovascular events.In order to deepen the understanding of the pathogenesis of coronary heart disease with sleep disorders,improve the efficacy of traditional Chinese medicine,and improve the sleep of patients to reduce the possibility of recurrent cardiovascular events.2.Methods:Using the form of clinical epidemiological questionnaire,from September 2020 to December 2020,patients with coronary heart disease were included in the outpatient department of cardiovascular medicine of Dongzhimen Hospital,the general ward of cardiovascular medicine,the cardiovascular ward of Tongzhou District of Dongzhimen Hospital,and the cardiovascular ward of Guang' anmen Hospital.The general situation,quality of life,self-management and sleep of patients were investigated.The control of risk factors for coronary heart disease,medication of angina pectoris(increasing drug dose or increasing new drug treatment due to angina pectoris symptoms),hospitalization(hospitalization due to angina pectoris or other reasons),major cardiovascular adverse events(cardiac death,nonfatal myocardial infarction,revascularization of coronary artery,recurrent angina pectoris,nonfatal stroke and heart failure),TCM four diagnostic data and syndrome types were investigated.Excel was used to establish the database,and SPSS 20.0 statistical software was used for data analysis.3.Results:(1)A total of 203 patients were included in the study,including 102 males and 101 females.The average age of male patients was younger than that of female patients,and the incidence of coronary heart disease in males was younger than that in females(P<0.01).The average duration of 6.48 years,more than 6 years accounted for more than 1/3 patients;33%of the patients received revascularization treatment,of which 17.91%received more than once;Blood pressure control compliance rate was 73.40%,blood glucose control compliance rate was 64.04%,blood lipid control compliance rate was 36.95%,more than half of the population body mass index was not up to standard,21.67%of patients still smoking,18.23%of patients drinking,2.96%of patients with excessive drinking.(2)The self-management of female patients was better than that of male patients(P<0.01).The self-management of patients was positively correlated with the quality of life(correlation coefficient=0.15,P=0.032<0.05).The better the self-management of patients,the higher the quality of life.The total score of quality of life assessment(CQQC)was 154 points.The higher the score,the better the quality of life of patients.The median score of patients with coronary heart disease was 54 points.The older the patient was,the worse the quality of life was(P<0.01).The quality of life of patients with no complications of coronary heart disease was better(P<0.01).There was significant difference in CQQC score between less than 1 year and more than 6 years of disease duration(P<0.05).With the extension of disease duration,the quality of life of patients was gradually decreasing.Patients with coronary heart disease with low sleep quality score had poor quality of life(P<0.01).The length of sleep required was negatively correlated with quality of life(correlation coefficient=-0.16,P=0.023<0.05).The shorter the sleep time was,the higher the quality of life was.The total night sleep time was positively correlated with quality of life(correlation coefficient=0.185,P=0.008<0.01).The longer the total night sleep time was,the higher the quality of life was.(3)63%of patients with coronary heart disease have recurrent cardiovascular events(including acute myocardial infarction,revascularization and hospitalization of recurrent angina pectoris).About 29.6%of patients with coronary heart disease will have recurrent cardiovascular events within one year.Most patients with coronary heart disease who have a course of more than six years will be hospitalized due to recurrent angina pectoris,and revascularization or acute myocardial infarction will occur.With the prolongation of the course of disease,the possibility of cardiovascular events becomes higher,and there is a statistically significant difference between the course of disease less than one year and the other(P<0.05).It is not considered that age,gender and sleep quality have an impact on recurrent cardiovascular events(P>0.05).(4)82.27%of the patients with Pittsburgh Sleep Quality Index(PSQI)score greater than 5 points were prone to insufficient energy and sleepiness the daytime.Nearly half of the patients had less than 6 hours of total night sleep.More than one third of the patients needed more than half an hour to fall asleep.22.2%of the patients often used hypnotic drugs to help sleep.The PSQI score of elderly patients with coronary heart disease was higher(P<0.05),and the PSQI score of female patients with coronary heart disease was higher(P<0.05).The PSQI score of patients with coronary heart disease with complications was higher(P<0.01).The longer the course of coronary heart disease was,the more prone to sleep problems(P<0.05).It could not be considered that the frequency of revascularization and angina pectoris attack had an impact on the sleep quality of patients(P>0.05).Gender was correlated with the time required for sleeping.The time required for sleeping in female patients was longer than that in male patients(correlation coefficient=0.231,P=0.001<0.01).Age was positively correlated with the time required for sleeping.The older the patient was,the longer the time required for sleeping was(correlation coefficient=0.142,P=0.043<0.05).0.142,P=0.043<0.05).Palpitation was related to the time required to fall asleep.The higher the frequency of palpitation was,the longer the time required to fall asleep was(adjusted P=0.003).Patients with difficulty in defecation,dry stool,long time and long interval needed longer time to fall asleep than those with normal defecation(adjusted P=0.017).Nighttime sleep duration was associated with gender.Nighttime sleep duration in female patients was shorter than that in male patients(correlation coefficient=-0.17,P=0.016<0.05).Nighttime sleep duration in older patients was shorter than that in male patients(correlation coefficient=-0.153,P=0.029<0.05).Nighttime sleep duration in patients with acute coronary syndrome(unstable angina,ST-segment elevation myocardial infarction,non-ST-segment elevation myocardial infarction)was longer than that in patients with chronic coronary heart disease(stable angina,asymptomatic myocardial ischemia)(P<0.05).Nighttime sleep duration in patients with coronary heart disease without complications was longer than that in patients with complications(P<0.01).Nighttime sleep duration in patients with coronary heart disease was longer with lower frequency of palpitations(correlation coefficient=-0.144,P=0.04<0.05).(5)The distribution of TCM syndromes in patients with sleep disorders of coronary heart disease is qi deficiency and blood stasis>phlegm turbidity obstruction>heart blood stasis=qi stagnation and blood stasis>heart and kidney yin deficiency>qi and yin deficiency>heart and kidney yang deficiency>cold coagulation heart pulse.The PSQI score of patients with qi stagnation and blood stasis is the most serious.The PSQI score is correlated with TCM syndromes(correlation coefficient=0.391,P<0.0001),sleep time(correlation coefficient=0.449,P<0.0001)and night sleep time(correlation coefficient=0.343,P<0.0001)are also correlated with TCM syndromes.Compared with men,women are less likely to have empirical evidence,and are more likely to have deficiency-excess syndrome(P<0.05).Patients in the empirical group are younger than those in the deficiency-excess syndrome group(P<0.05),and patients without complications higher incidence of empirical evidence than those with complications(P<0.05).The application rate of traditional Chinese medicine prescriptions was 5.91%,and the total utilization rate of traditional Chinese medicine was 17.24%.The daytime energy of patients was correlated with the use of Chinese medicine,and Chinese medicine helped patients to improve the daytime symptoms caused by poor sleep(correlation coefficient=0.189,P=0.007<0.01).4.Conclusions:(1)At present,the sleep of patients with coronary heart disease is generally poor,which is related to age,gender,type of coronary heart disease,course of disease and complications,frequency of palpitations and defecation,and low quality of life.(2)The time required for sleeping,nighttime sleep duration and PSQI score were correlated with TCM syndrome types.The syndrome types of patients with sleep disorders of coronary heart disease were qi deficiency and blood stasis,with qi deficiency and blood stasis>phlegm turbidity obstruction>heart blood stasis=qi stagnation and blood stasis>heart kidney yin deficiency>qi and yin deficiency>heart kidney yang deficiency>cold coagulation heart,and the PSQI score of patients with qi stagnation and blood stasis was the highest.(3)There was no significant statistical correlation between sleep status of patients with coronary heart disease and recurrent cardiovascular events(hospitalization due to recurrent angina pectoris,acute myocardial infarction and revascularization).(4)Combination of traditional Chinese medicine in the treatment of coronary heart disease patients with sleep problems,or will achieve better results. |
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