Study On Correlation Between Different Tcm Syndrome Types And Frailty And Nutritional Status In Elderly Patients With Stable Angina Pectoris Of Coronary Heart Disease

Objective:In this study,we regarded elderly patients with stable angina pectoris of coronary heart disease as study participants,frailty and nutritional status of patients were evaluated,and the relevance between different TCM syndrome types and the frailty and nutritional status of patients was explored,to provide objective evidence for the prevention and treatment of frailty and nutritional status of patients by combining Traditional Chinese and Western medicine.Methods:A total of 280 elderly outpatients and inpatients with stable angina pectoris of coronary heart disease admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from December 2021 to December 2022 were collected.Collecting patients’ general clinical data,information on the four diagnoses of Traditional Chinese Medicine,the frail scale score(FRAIL Scale),the nutritional status score(Mini-Nutritional Assessment Short Form(MNA-SF)),and nutrition-related indexes(hemoglobin(HGB),total protein(TP),albumin(ALB)).The frail status of patients was evaluated on FRAIL Scale and was divided into the non-frail group,pre-frail group,and frail group,the nutritional status of patients was evaluated based on MNA-SF and nutrition-related indexes,and TCM syndrome types were performed on the included patients.Excel database was established and SPSS25.0 software was used for statistical analysis to explore the correlation between different TCM syndrome types and frailty and nutritional status in elderly patients with stable angina pectoris of coronary heart disease.Results:1.Among 280 elderly patients with stable angina pectoris of coronary heart disease included in this study,70-79 years old patients accounted for the largest proportion with 52.14%.Male patients accounted for less proportion of 25%,female patients accounted for more proportion of 75%,and the ratio of males and females was 1:3.The number of patients with an educational level of junior high school or below was more,accounting for 66.79%.Patients with normal body weight were more,accounting for 64.29%.The majority of patients with a disease course of fewer than 15 years,accounting for 81.79%.More than half of patients with 3-5 kinds of drugs accounted for 53.57%.31.43% of patients had a family history of cardiovascular disease,23.57% of patients had a history of smoking and drinking,and 46.43% of patients had a normal diet with meat and vegetables.Patients who exercised 2-3 times and more than 3 times per week accounted for more than 34.64% and 34.29%.The number of children with more than 4 patients was large,accounting for 41.79%.Diseases associated with hypertension,cerebrovascular diseases,osteoarthropathy,and digestive system diseases were more common.2.According to FRAIL Scale to evaluate the frail status of patients,among 280 elderly patients with stable angina pectoris of coronary heart disease included in this study,122 patients(43.57%)in the non-frail group,88 patients(31.43%)in the pre-frail group,and 70 patients(25%)in the frail group.There were statistical significance in age,BMI,course of the disease,the number of medications,diet,exercise,the number of children,and educational level among the three groups(P<0.05).There were no significant differences in gender,family history of cardiovascular disease,and history of smoking and drinking among the three groups(P>0.05).There were statistical significance in hypertension,respiratory diseases,osteoarthropathy,and cerebrovascular diseases among the three groups(P<0.05).There were no significant difference in diabetes,digestive system diseases,rheumatism,and peripheral vascular disease(P>0.05).There were significant differences in MNA-SF,nutritional status,HGB,TP,and ALB nutrition-related indexes among the three groups(P<0.01).In addition,FRAIL Scale was negatively correlated with MNA-SF,HGB,TP,and ALB.Multivariate Logistic regression analysis showed that age,course of the disease,the number of medications,HGB,nutritional status,cerebrovascular diseases,and osteoarthropathy were factors affecting patients with frailty(P<0.05).3.According to TCM syndrome differentiation,among 280 elderly patients with stable angina pectoris of coronary heart disease included in this study,there were 77 cases(27.5%)of Qi deficiency and blood stasis syndrome,43 cases(15.36%)of Qi stagnation and blood stasis syndrome,38 cases(13.57%)of Qi Yin deficiency syndrome,65 cases(23.21%)of phlegm and blood stasis syndrome,23 cases(8.21%)of Yang Qi deficiency and decline syndrome,34 cases(12.14%)of heart-kidney Yin deficiency syndrome.Among them,patients with Qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,and Qi stagnation and blood stasis syndrome were the majority.4.According to FRAIL Scale,the differences between different TCM syndrome types on FRAIL Scale had significant statistical significance(P<0.01),FRAIL Scale of Qi deficiency and blood stasis syndrome and Yang Qi deficiency and decline syndrome were lower.According to the frail status assessed by FRAIL Scale,differences between the frail status of different TCM syndrome types had significant statistical significance(P<0.01),Qi deficiency and blood stasis syndrome and Yang Qi deficiency and decline syndrome were mostly combined with frailty accounting for 46.75% and 43.48% and combined with early frailty accounting for 37.66% and 34.78%.There was a moderate intensity correlation between different TCM syndrome types and the frail status.5.According to MNA-SF,the differences between different TCM syndrome types on MNA-SF had significant statistical significance(P<0.01),MNA-SF of Qi deficiency and blood stasis syndrome and Yang Qi deficiency and decline syndrome were lower.According to the nutritional status assessed by MNA-SF,differences between the nutritional status of different TCM syndrome types had significant statistical significance(P<0.01),Qi deficiency and blood stasis syndrome and Yang Qi deficiency and decline syndrome were mostly accompanied by malnutrition accounting for 55.84% and 47.83% and accompanied by malnutrition risk accounting for 29.87% and 30.43%.There was a weak intensity correlation between different TCM syndrome types and the nutritional status.6.According to nutrition-related indexes,there were significant differences in HGB,TP,and ALB levels among different TCM syndrome types(P<0.01).The HGB and ALB levels of Qi deficiency and blood stasis syndrome and Yang Qi deficiency and decline syndrome were lower,the TP level of Qi deficiency and blood stasis syndrome was lower.Conclusion:1.There is a high incidence of frailty in elderly patients with stable angina pectoris of coronary heart disease,age,course of the disease,the number of medications,HGB,nutritional status,cerebrovascular diseases,and osteoarthropathy were factors affecting patients with frailty.2.Compared with other syndrome types,patients with Qi deficiency and blood stasis syndrome and Yang Qi deficiency and decline syndrome have a higher incidence of frailty and have a higher incidence of malnutrition,they generally show complex pathological characteristics based on Qi deficiency and Yang deficiency and mixed with pathological products such as blood stasis.