To Explore The Characteristics Of Acute Myocardial Infarction Based On The Meridian Flow Theory

Objective: By studying the time of rule of meridian flow in acute myocardial infarction(AMI),to further explore the correlation between the meridian flow time and syndrome types of TCM,to analyze the influence of meridian qi and blood flow and syndrome elements of TCM on the onset time of AMI,and to provide clinical reference for the prevention and treatment of AMI with meridian flow time medicine.Methods: The case data of 267 patients with AMI in the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from January2019 to December 2021 were collected.The patients’ onset time and TCM syndrome data were processed by circular distribution method,and the correlation between TCM syndrome types and onset time was analyzed.Binary Logistic regression analysis was used to analyze the correlation between syndrome elements of TCM and onset time,taking whether the onset of peak period as the dependent variable and syndrome elements of TCM as the independent variable.Results:1.Basic information of patients: a total of 267 patients with AMI were enrolled in this study,including 205 males(76.78%)and 62 females(23.22%).There were 211 cases(79.02%)of STEMI and 56 cases(20.97%)of NSTEMI.There were 9 cases of 20～39 years old,92 cases of 40～59 years old,132 cases of 60～79 years old,and 34 cases of≥80 years old.The average age of onset was 63.90 ± 13.27 years old.2.The distribution of TCM syndrome types and TCM syndrome elements in 267 AMI patients in this study:(1)The distribution of TCM syndromes from high to low was as follows:118 cases(44.19%)of phlegm and blood stasis syndrome,108 cases(40.44%)of qi deficiency and blood stasis syndrome,15 cases(5.61%)of chill coagulation of heart vessels syndrome,14 cases(5.24%)of qi stagnation and blood stasis syndrome,8 cases(2.99%)of qi and yin deficiency syndrome,and4 cases(1.49%)of zheng deficiency and yang removal syndrome.(2)The distribution of disease single location syndrome factors from high to low was as follows: 264 cases(29.59%)in heart,163 cases(18.27%)in spleen,88 cases(9.86%)in liver,43 cases(16.10%)in lung,and 24 cases(8.98%)in kidney.(3)The distribution of single syndromes from high to low was:There were187 cases of blood stasis(31.11%),148 cases of qi deficiency(24.62%),141 cases of phlegm turbidity(23.46%),35 cases of chill coagulation(5.82%),34 cases of qi stagnation(5.65%),25 cases of yang deficiency(4.19%),20 cases of yin deficiency(3.32%),11 cases of heat accumulation(1.83%).3.Circular distribution statistical analysis results:(1)According to the annual cycle,the overall peak of AMI incidence was February 2,and the peak period was from January 11 to February 24(r = 0.1778,P < 0.05).(2)According to the meridian flow and Na Jia method,the incidence of AMI had a peak trend in the value period of the sun bladder meridian(r = 0.089,P < 0.05).(3)According to the Circadian rhythm,the peak time of AMI incidence was 05:37,and the peak time of onset was concentrated 04:02 to 07:12(r =0.2059,P < 0.05).(4)According to the meridian flow and Na Zi method,the peak time of AMI incidence was Maoshi,and the peak period is from Yinshi to Chenshi.(5)In terms of the distribution of TCM syndromes,the peak of the onset of sputum and stasis is concentrated from Choushi to Maoshi(r=0.1937,P <0.05),but the central tendency was weak;There was no significant difference in the incidence of AMI qi deficiency and blood stasis syndrome,cold coagulation heart syndrome,qi stagnation and blood stasis syndrome,qi and yin deficiency syndrome,and zheng deficiency and yang removal syndrome among different time points(P > 0.05).4.According to binary Logistic regression analysis,the results showed that blood stasis was a related factor affecting the peak period of AMI(OR=2.328,95%CI: 1.326-4.087,P=0.003);Yang deficiency was a related factor affecting the peak incidence of AMI(OR=5.467,95%CI: 1.417-21.086,P=0.014);Chill coagulation was a related factor affecting the peak incidence of AMI(OR=9.567,95%CI: 1.117-81.928,P=0.039).Conclusions:1.According to the overall incidence characteristics of this study,AMI was sporadic throughout the year,with a small peak in winter,but the central trend was relatively weak.2.From the overall incidence characteristics of this study,the peak time of Maoshi,qi and blood flow into the large intestine meridian of hand yangming is easy to occur,and attention should be paid to the function of regulating the large intestine meridian of hand yangming and lung meridian of hand taiyin in the “preventive treatment”measures of AMI.The peak period is from Yinshi to Chenshi,and the lung meridian of hand taiyin,large intestine meridian of hand yangming,stomach meridian of foot yangming qi and blood flow through prosperity and decline affect the incidence of AMI;The daily period of bladder meridian of foot taiyang is the peak trend of AMI incidence,and attention should be paid to regulating the function of bladder meridian of foot taiyang and kidney meridian of foot shaoyin in AMI“preventive treatment”measures.3.From the distribution of TCM syndrome types in this study,the onset time of AMI with mutual accumulation of phlegm and blood stasis syndrome is different,but there is no significant difference in the onset time of qi deficiency and blood stasis syndrome,cold coagulation heart syndrome,qi stagnation and blood stasis syndrome,qi yin deficiency syndrome,and zheng deficiency and yang removal syndrome.4.The TCM syndrome elements of blood stasis,yang deficiency and chill coagulation are the related factors of AMI.