Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China.
Chin J Integr Med. 2014 May;20(5):341-6. doi: 10.1007/s11655-014-1831-5. Epub 2014 Mar 6.
To analyze the correlation of Chinese medicine syndrome evolvement and cardiovascular: events in patients with stable coronary heart disease (CHD).
This prospective cohort study investigated and: collected the clinical information of patients with stable CHD and observed the syndrome type at the baseline and 6-month at follow-up, as well as the cardiovascular events during the 6-month and 12-month follow-up. The patients were divided into the event group and the non-event group. The interaction and the impact of syndrome evolvement on cardiovascular events were examined through multifactor dimensionality reduction (MDR) analysis and the results were verified by Chi-square test.
Totally 1,333 of 1,503 stable CHD patients enrolled met the inclusion criteria: of MDR analysis. Among them, 959 (71.9%) cases were males and 374 (28.1%) cases were females. Thirty seven cases had cardiovascular events during 6 to 12 months after the study began. The results of the MDR analysis and verification using Chi-square test showed that the development of cardiovascular events was positively correlated with interaction between blood stasis and toxic syndrome at the baseline, blood stasis at the baseline and qi deficiency at the 6-month follow-up, toxic syndrome at the baseline and qi deficiency at the 6-month follow-up, toxic syndrome at the base line and blood stasis at the 6-month follow-up, qi deficiency and blood stasis at the 6-month follow-up (P<0.05 for all).
Blood stasis, toxic syndrome and qi deficiency are important factors of stable CHD. There: are positive correlation between cardiovascular events and syndrome evolution from blood stasis to qi deficiency, from toxic syndrome to qi deficiency and from toxic syndrome to blood stasis, indicating the pathogenesis of toxin consuming qi, toxin leading to blood-stasis in stable CHD patients prone to recurrent cardiovascular events.
分析中医证候演变与稳定型冠心病（CHD）患者心血管事件的相关性。
本前瞻性队列研究调查并收集了稳定型 CHD 患者的临床信息，观察基线和随访 6 个月时的证候类型，以及随访 6 个月和 12 个月时的心血管事件。患者分为事件组和非事件组。通过多因素维度缩减（MDR）分析检查证候演变对心血管事件的相互作用和影响，并通过卡方检验验证结果。
1503 例稳定型 CHD 患者中，共有 1333 例符合 MDR 分析的纳入标准，其中男性 959 例（71.9%），女性 374 例（28.1%）。研究开始后 6 至 12 个月内，37 例发生心血管事件。MDR 分析和卡方检验验证的结果表明，心血管事件的发生与基线时血瘀与毒证的相互作用、基线时血瘀与随访 6 个月时气虚、基线时毒证与随访 6 个月时气虚、基线时毒证与随访 6 个月时血瘀、随访 6 个月时气虚与血瘀呈正相关（均 P<0.05）。
血瘀、毒证和气虚是稳定型 CHD 的重要因素。心血管事件与从血瘀到气虚、从毒证到气虚以及从毒证到血瘀的证候演变呈正相关，表明在稳定型 CHD 患者中，毒邪耗气、毒邪致血瘀的病机与复发性心血管事件相关。
