Objective

2

To explore the characteristics and evolution trend of modern traditional Chinese medicine （TCM） syndromes of coronary heart disease.

Methods

2

Data of the inpatients with the first diagnosis of coronary heart disease， angina pectoris， acute coronary syndrome， heart failure， arrhythmia， post-percutaneous coronary intervention， post-coronary artery bypass grafting， and old myocardial infarction by western medicine in the Department of Cardiology， The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 1st， 2015 to September 30th， 2021 were enrolled， and gender， age， clinical symptoms， tongue and pulse manifestations were retrospectively collected. Secondary proofreading judgment of the syndrome type was re-checked and judged， and the syndrome elements were extracted. Correlation analysis was performed for the syndrome elements.

Results

2

A total of 3374 patients with coronary heart disease were included. The top four symptoms were chest tightness （1791， 53.08%）， chest pain （1612， 47.78%）， breathlessness （1484， 43.98%）， and palpitations （1387， 41.11%）. The top four pulse manifestations were wiry pulse （2261， 67.01%）， thready pulse （1067， 31.62%）， slippery pulse （795， 23.56%）， and deep pulse （755， 22.38%）. The tongue color was mainly purple dusky （1703， 50.47%）， and white coating （2184， 64.73%）， thin coating （1321， 39.15%）， and greasy coating （1181， 35.00%） were mostly common seen. The top four TCM syndromes were

qi

deficiency and blood stasis （737， 21.84%），

qi

deficiency and phlegm stasis （432， 12.80%）， binding of phlegm and stasis （427， 12.66%）， and heart and blood stasis obstruction （393， 11.65%）. The syndromes were mostly deficiency-excess complex， and accompanied by blood stasis and phlegm turbidity. The top four syndrome elements were blood stasis （2814， 83.40%），

qi

deficiency （1928， 57.14%）， phlegm turbidity （1495， 44.31%）， and

yin

deficiency （560， 16.60%）. Syndrome elements association analysis showed that phlegm turbidity， blood stasis， and

qi

deficiency have the strongest correlation， among which the combination of phlegm turbidity and blood stasis is the strongest. The annual distribution of the syndrome elements between 2015 to 2020 showed that the proportions of the syndrome elements of

yin

deficiency， phlegm turbidity and blood stasis were statistically different （

P

＜0.05）， while the differences among other syndrome elements were not statistically significant （

P

＞0.05）.

Conclusion

2

The basic pathogenesis of modern coronary heart disease is still root deficiency and branch excess， and the syndromes are mainly deficiency-excess complex， accompanied with phlegm and stasis. The syndrome elements related to branch excess account for the largest proportion， especially manifested as phlegm and blood stasis.