Study on syndrome element characteristics and its correlation with coronary angiography in 324 patients with coronary heart disease.

OBJECTIVE: Recently, a new traditional Chinese medicine differentiation theory "Syndrome Element (SE)" has been raised. In this study, the main syndrome element types and their correlations with the results of coronary angiography (CAG) in patients with coronary heart disease (CHD) were investigated. METHODS: Epidemiology cross-sectional study method was employed and 324 patients with CHD were enrolled, and their syndrome element types as well as the CAG results were analyzed. The correlations among syndrome element types, Gensini score, and the number of abnormal branches were also analyzed based on the distribution characteristics of syndrome element and coronary angiography results in the 324 cases. RESULTS: According to their occurrence frequency in 324 CHD patients, the top eight major heart syndrome elements were Xin () blood stasis (85.8%), Xin qi deficiency (79.6%), Xin heat blockage (41.1%), Xin phlegm with turbid fluid (38.0%), Xin qi stagnation (24.7%), Xin yang deficiency (18.9%), Xin yin deficiency (17.5%) and Xin cold coagulation (4.4%), respectively, which suggested that Xin blood stasis and Xin qi deficiency were the two most common syndrome elements. Also, as coronary artery Gensini score increased, the changing trend of the syndrome element was "Xin yang deficiency with blood stasis" to "Xin phlegm obstruction with heat blockage" to "Xin yin deficiency with blood stasis" to "Xin qi deficiency with blood stasis" to "Xin cold coagulation with phlegm and turbid fluid, "Xin cold coagulation with blood stasis" to "Xin deficiency of qi, yin and yang". As the number of abnormal branches increased, the syndrome element changing trend was "simultaneous occurrence of cold and heat syndrome" to "Xin qi and yang deficiency with blood stasis" to "Xin retention of phlegm with turbid fluid" to "Xin cold coagulation in the heart meridian", "Xin deficiency of both qi and yin". The result of this study shows that Xin qi deficiency and Xin blood stasis were the major syndrome elements in patients with CHD. CONCLUSION: As the severity and extent of coronary artery lesion increased, there were some apparent correlations among syndrome elements, Gensini score and number of abnormal coronary artery branches.

[Clinical study on compatibility and dismantlement of Xuefu Zhuyu decoction].

OBJECTIVE: To investigate the regularity of traditional Chinese compound prescription by observing the clinical effect of the compatibility and dismantlement of Xuefu Zhuyu decoction on blood stasis and stagnation of qi syndrome of angina. METHOD: 123 outpatients were randomly divided into Xuefu Zhuyu group(XF), Jingzhi Xuefu Zhuyu group(JZ), Yaodui group(YD) and placebo group and treated. RESULT: The array of angina effect and blood stasis and qi stagnation of syndrome effect was XF group, JZ group, YD group, placebo group( P < 0.01). The levels of blood viscosity, platelet adhesiveness, RED transfigure were significantly different before and after treatment in XF group (P < 0.05). The levels of blood viscosity, platelet adhesiveness were significant different before and after treatment in JZ group ( P < 0.05). The levels of blood plasma viscosity, platelet adhesiveness were significantly different before and after treatment in YD group ( P < 0.05). The levels of platelet adhesiveness, RED transfigure were significantly different before and after treatment in placebo group (P < 0.05). There are no difference among levels of blood lipoprotein and ET of four groups ( P > 0.05). Significant difference was found among four groups in increase of NO and t-PA and decrease of IL-6 (P < 0.05). CONCLUSION: The clinical effect and indexes amelioration are correlated to the combination of prescription and the corresponding degree of prescription to syndrome. There are same material foundation in the series of Xuefu Zhuyu dismantle decoction, but the function degree and targets are different with the change of herbs. The method of conjugating disease and syndromes, and prescription to syndromes are a practical pattern to expound the relationship between disease and syndrome.

[Research on quantified diagnosis and combining diseases with syndrome of blood stasis].

OBJECTIVE: To explore the way of quantified diagnosis of blood stasis syndrome (BSS) and the essence of BSS. METHODS: Using t-test and logistic regression to analyze the symptoms, signs, and objective indexes of BSS in clinical test. RESULTS: (1) The levels of endothelin, nitric oxide, and t-PA between 182 patients with BSS and non-BSS had notable difference. (2) The stepwise regression analysis about hemoglobin, triglyceride, total cholesterol, endothelin, nitric oxide, and t-PA in 170 patients with BSS or non-BSS revealed that the order of these indexes considering their importance was: endothelin, hemoglobin, t-PA, nitric oxide. However, the triglyceride and total cholesterol could not enter the regression equations. (3) The stepwise regression analysis about 40 symptoms and signs in 601 patients with BSS or non-BSS revealed that the 18 items had the very contribution to diagnose the BSS when the F value was 6, and so a regression equation was available. The total coincidence ratio was 94.24% when the other quantified data about BSS were tested in the equation. CONCLUSION: The standardized TCM syndrome, which accorded with the criteria of combining diseases with syndrome, was made up of symptoms, signs, and objective indexes. The standard could be obtained by multi-center, prospective, random and controlled clinical epidemiological survey and clinical test.