Study On The Relationship Between Acute Coronary Syndrome TCM Syndromes And The Indexes Of Arteriosclerosis

Objective: To explore the distribution characteristics of TCM syndrome types of acute coronary syndrome(ACS)and the correlation of the ACS TCM syndrome types among the physical and chemical indicators such as atherogenic index of plasma(AIP),brachial-ankle pulse wave velocity(ba pulse wave)and ankle brachial index(ABI),analysing the distribution differences of physical and chemical indicators such as AIP,ba PWV,and ABI among different syndrome types,to excavate the objectified indicators conducive to ACS TCM syndrome differentiation and classification,which providing an objective basis for the integrated diagnosis and treatment of TCM and Western medicine in ACS.Methods:A retrospective analysis was conducted on 233 cases of newly diagnosed ACS hospitalized in the Department of Vascular Medicine,The First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2021 to December 2021.According to the diagnostic criteria of TCM syndromes,they were divided into 6 types: qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,Qi stagnation and blood stasis syndrome,qi deficiency and Yin deficiency syndrome,cold coagulation heart pulse syndrome and positive deficiency of Yang syndrome.Basic information,biochemical indicators,LVEF,BA PWV,ABI and other data of subjects with different syndrome types were collected,and AIP was calculated according to the data of five blood lipid tests.SPSS 24.0 statistical software was used to analyze the correlation between TCM syndrome types of ACS and physical and chemical indexes such as AIP,BA PWV and ABI.Result:1.A total of 233 ACS patients were included in this study,among which unstable angina was the most common in 154 patients,followed by ST elevation myocardial infarction in 52 patients and non-ST elevation myocardial infarction in 27 patients.The TCM syndromes of ACS were divided into 6 types,74 cases of qi deficiency and blood stasis syndrome(31.80%),63 cases of phlegm and blood stasis syndrome(27.00%),35 cases of qi stagnation and blood stasis syndrome(15.00%),30 cases of qi deficiency and Yin deficiency syndrome(12.90%),21 cases of cold coagulation and heart pulse syndrome(9.00%),10 cases of deficiency and Yang syndrome(4.30%).2.Among the ACS patients included,66.50% were male and 33.50% were female.There was significant difference in the composition of male and female among the syndrome types(P < 0.05).The age distribution of ACS syndrome types was significantly different(P < 0.05),among which the patients with phlegm and blood stasis syndrome had the smallest age,and the differences were statistically significant compared with qi deficiency and blood stasis syndrome,Qi stagnation and blood stasis syndrome,qi and Yin deficiency syndrome,and cold coagulation heart pulse syndrome(P < 0.05).There was no significant difference in the distribution of smoking,drinking and nationality among ACS syndromes(P > 0.05).3.There were significant differences in the incidence of hypertension among ACS syndrome types(P < 0.05),among which the incidence of cold coagulation heart pulse syndrome with hypertension was the highest at 90.48%.There was no significant difference in type 2 diabetes,chronic gastritis,fatty liver,hyperthyroidism and hypothyroidism(P > 0.05).4.The ACS of each card type of heart rate(P < 0.05),body mass index(P < 0.05),mean arterial pressure(P < 0.05)significant distribution differences,through comparing the two found that xu Yang to take off the card to the heart rate of the slowest,qi and Yin deficiency,qi deficiency and blood stasis syndrome,qi and blood stasis,phlegm and blood stasis and each certificate,card haemorrheological nature heart arteries and veins is significant difference(P < 0.05);Comparison is also found that xu Yang took the mean arterial pressure in patients with minimal,qi deficiency and blood stasis,phlegm and blood stasis syndrome,qi and blood stasis,qi and Yin deficiency syndrome,haemorrheological nature heart pulse compared difference was statistically significant(P < 0.05),qi deficiency and blood stasis syndrome and phlegm stasis mutual junction compared,haemorrheological nature heart arteries and veins,qi deficiency and blood stasis syndrome of mean arterial pressure,the smaller the significant difference(P < 0.05),There was no significant difference between the remaining syndrome types(P > 0.05).The comparison of body mass index among ACS syndromes showed that the syndrome of mutual accumulation of phlegm and stasis was the highest,followed by the syndrome of qi deficiency and blood stasis,the syndrome of qi deficiency and Yin deficiency,and the syndrome of cold coagulation and heart pulse(P < 0.05).5.In general physical and chemical indicators,there were significant differences in fasting blood glucose,glycosylated hemoglobin,uric acid,homocysteine,serum troponin T,creatine kinase isoenzyme and LVEF among different syndrome types of ACS,all P values were < 0.05,and the differences were statistically significant.There was no significant difference in creatinine level among ACS syndrome types(P > 0.05).Pairwise comparison is xu Yang took the highest fasting glucose,qi deficiency and blood stasis,qi and blood stasis,qi and Yin deficiency syndrome,haemorrheological nature heart pulse compared difference was statistically significant(P < 0.05),phlegm and blood stasis by fasting plasma glucose and qi and Yin deficiency syndrome,haemorrheological nature heart arteries and veins is higher,compared the difference was statistically significant(P < 0.05),There was no significant difference in pairwise comparison among other syndromes(P > 0.05).The pair-to-pair-comparison results of h BA1 c and URIC acid showed that patients with phlegm-stasis syndrome had the highest HBA1 C and uric acid,and the differences were statistically significant(P < 0.05)compared with q I-deficiency and blood-stasis syndrome,Qi-stagnation and blood-stasis syndrome,qi-Yin deficiency syndrome and cold coagulation heart pulse syndrome.The comparison of homocysteine levels among different syndrome types showed that the homocysteine level of qi stagnation and blood stasis syndrome was the highest,while that of qi and Yin deficiency syndrome was the lowest,and the differences were statistically significant with qi deficiency and blood stasis and phlegm stasis syndrome(P < 0.05).The CTNT and CKMB of positive deficiency Yang syndrome were the highest,while THE LVEF was the lowest.The CKMB of cold coagulation heart pulse syndrome was higher than that of qi stagnation and blood stasis syndrome,and the LVEF of phlegm-stasis syndrome was higher than that of cold coagulation heart pulse syndrome,the difference was statistically significant(P < 0.05).There were no significant differences in CTNT,CKMB and LVEF among other syndromes(P > 0.05).There were significant differences in the distribution of coronary lesions among different syndromes of ACS(P < 0.05),and the number of coronary lesions with positive deficiency Yang syndrome was more than that of other syndromes,with statistical significance(P < 0.05).6.The levels of AIP,TG and HDL-C of ACS syndrome types were significantly different(P < 0.05).Pair-to-pair-comparison showed that AIP was the highest in the syndrome of phlegm-stasis interaction,TG and HDL-C levels were the lowest,followed by qi-deficiency and blood-stasis syndrome,the difference was statistically significant(P < 0.05),hd L-C level in the syndrome of deficiency of Positive Yang was lower than that in the syndrome of deficiency of qi and Yin,the differences were statistically significant(P <0.05).Pairwise comparison of TG,HDL-C and AIP among other syndrome types showed no statistical significance.The P values of TC and LDL-C among ACS syndrome types were all > 0.05,and the difference was not statistically significant.7.There were significant differences in BA PWV and ABI levels among ACS syndrome types,with all P values < 0.05. Pair-to-paircomparison showed that BA PWV was the highest and ABI was the lowest in the syndrome of phlegm-stasis interaction,followed by qi-deficiency and blood-stasis syndrome,with statistically significant differences compared with other syndrome types(P < 0.05).Pairwise comparison of BA PWV and ABI of other syndromes showed no statistical significance.Conclusion:1.Unstable angina pectoris was the most common among ACS patients,and qi deficiency and blood stasis syndrome was a common TCM syndrome type of ACS.Age,smoking,drinking,hypertension and type 2diabetes are the influencing factors of ACS.2.The levels of blood glucose,uric acid and homocysteine in ACS patients with phlegm and blood stasis syndrome and Qi deficiency and blood stasis syndrome increased significantly.The level of homocysteine was the highest in qi stagnation and blood stasis syndrome,and the lowest in qi and Yin deficiency syndrome.The coronary artery lesions of patients with positive deficiency Yang syndrome were serious and the general condition was poor.Cold coagulation heart pulse syndrome is more common in female and ACS patients with hypertension.TG,AIP and BA PWV were the highest,HDL-C and ABI was the lowest in ACS patients with phlegm-stasis syndrome,followed by qi deficiency and blood stasis syndrome.3.AIP,ba PWV,ABI and other objective indicators can be used as the reference for TCM syndrome differentiation in ACS patients.