Correlation between TCM Blood Stasis Pattern of Coronary Heart Disease and Coronary Angiography Result: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

ZHOU Xiaoqing ¹ ,  LIANG Hao ² , SUN Xiang ³ , ZHOU Hongtu ²

1. Diagnostics Institute of Traditional Chinese Medicine, Hunan University of Traditional Chinese Medicine, Changsha 410007, China; 2. Department of Geriatrics, The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha 410007, China; 3. Department of Cardiology, Changsha Hospital of Traditional Chinese Medicine, Changsha 410100, China;

Corresponding author：

LIANG Hao, Email: lianghao118@126.com

Keywords：

Traditional Chinese medicine; Coronary heart disease; Coronary angiography; Blood stasis pattern; Meta-analysis

DOI：

10.7507/1672-2531.20120227

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To explore the correlation between traditional Chinese medicine (TCM) blood stasis pattern of coronary heart disease (CHD) and coronary angiography result, so as to screen dangerous patterns and provide evidence for the objectification of TCM pattern differentiation.
Methods 　Literature on correlation between blood stasis pattern and coronary angiography results from January 1992 to May 2012 were searched in the following databases: China Academic Journal Network Publishing Database (CAJD), Chinese Biomedical Literature Database (CBM), China Doctor Dissertation Full-text Database (CDFD), Chinese Selected Master’s Theses Full-Text Databases (CMFD), PubMed and MEDLINE. According to the inclusion and exclusion criteria, literature screening, data extraction and methodological quality assessment of the included studies were conducted. Then meta-analysis was performed using RevMan 5.1 software.
Results 　A total of 28 studies involving 4 901 patients were included. The results of meta-analysis showed that, there is a significant significance between blood stasis pattern and the following coronary angiography result, namely, number of culprit vessels (OR=1.38, 95%CI 1.08 to 1.77, P lt;0.05), severity of stenosis (OR=1.79, 95%CI 1.04 to 3.08, P lt;0.05), and Gensini score (OR=7.74, 95%CI 3.99 to 11.49, P lt;0.05).
Conclusion 　Compared with other TCM patterns, CHD with blood stasis pattern easily tends to present multi-vessels lesions, more than 75% stenosis and higher Gensini score, indicating the condition of CHD with blood stasis pattern is more severe than with other patterns. Due to the discrepancy of pattern differentiation and the limited quality of original studies, this conclusion is insufficient to be fully applied into clinical practice, and more large scale and high quality clinical trials are required.

Citation： ZHOU Xiaoqing,LIANG Hao,SUN Xiang,ZHOU Hongtu. Correlation between TCM Blood Stasis Pattern of Coronary Heart Disease and Coronary Angiography Result: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2012, 12(12): 1470-1477. doi: 10.7507/1672-2531.20120227 Copy

1.	吴锡桂. 我国人群冠心病流行现况与趋势. 中国慢性病预防与控制, 2003, 8: 190-191.
2.	史载祥, 谷万里. 冠状动脉造影与冠心病中医辨证研究探讨. 中国中西医结合杂志, 2007, 27(1): 76-79.
3.	Porta M. A dictionary of epidemiology, Fifth Edition. New York: Oxford University Press, 2008: 154.
4.	Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol, 1983, 51(3): 606-607.
5.	Knottnerus JA, Muris JW. Assessment of the accuracy of diagnostic tests: the cross-sectional study. J Clin Epidemiol, 2003, 56(11): 1118-1128.
6.	Rutjes AW, Reitsma JB, Vandenbroucke JP, et al. Case-control and two-gate designs in diagnostic accuracy studies. Clin Chem, 2005, 51(8): 1335-1341.
7.	Wells G A, Shea B, O’Connell D, et al. The Newcastle Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in Meta-analysis. Avaliable at: http://www.ohri.ca/programs/clinical _epidemiology/oxford.asp.
8.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
9.	Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
10.	吴泰相, 刘关键, 李静. 影响系统评价质量的主要因素浅析. 中国循证医学杂志, 2005, 5(1): 51-58.
11.	曾明, 孙福成, 许锋, 等. 冠状动脉病变与中医辨证分型关系的初步研究. 中国心血管杂志, 1999, 4(4): 234-237.
12.	王东生, 袁肇凯, 魏经汉, 等. 冠心病痰癖辨证与冠状动脉造影的相关性研究. 中医杂志, 2003, 44(12): 937-938.
13.	张敏州, 丁邦晗, 张维东, 等. 375例胸痹心痛患者冠状动脉造影结果与中医证型的对比研究. 中国中西医结合急救杂志, 2004, 11(2): 115-117.
14.	苏倩. 冠心病中医证型及体质类型与客观指标相关性研究. 北京: 北京中医药大学, 2004: 38-47.
15.	刘永明, 蒋梅先. 259例冠心病患者中医辨证分型与冠脉造影结果的关系研究. 北京中医, 2005, 24(3): 131-133.
16.	王旭升. 冠心病中医证候与冠状动脉造影的相关性研究. 北京: 北京中医药大学, 2005: 40-50.
17.	薛增明. 冠心病中医证型与冠状动脉造影、HCY、hsCRP相关性的临床研究. 济南: 山东中医药大学, 2006: 12-15.
18.	李静, 张继东, 刘同涛. 冠心病中医证型与冠脉病变的相关性. 山东中医药大学学报, 2006, 30(2): 124-126.
19.	张广增, 贺福田, 吴范武, 等. 冠状动脉病变与415例胸痹心痛患者辨证分型关系的研究. 中华中医药杂志, 2006, 21(8): 498-499.
20.	刘红旭, 王振裕, 彭伟, 等. 113例冠状动脉造影患者中医证候与造影特点分析. 中日友好医院学报, 2006, 20(1): 35-37.
21.	王阶, 邢雁伟, 李志忠, 等. 102例冠心病心绞痛患者中医证候特征分析. 中医杂志, 2007, 48(2): 160-162.
22.	郭冬梅. 冠状动脉造影结果与胸痹心痛中医证型关系探讨. 乌鲁木齐: 新疆医科大学, 2007: 8-13.
23.	张鹏, 徐伟建. 中医证型与冠状动脉病变程度的相关性研究. 中西医结合心脑血管病杂志, 2007, 5(2): 101-103.
24.	潘宗奇, 陈伯钧, 冯靖禧, 等. 冠心病造影结果与中医证型的相关性研究. 陕西中医, 2008, 29(6): 649-651.
25.	Wang J, Chu FY, Li J, et al. Study on Syndrome Element Characteristics and lts Correlation with Coronary Angiography in 324 Patients with Coronary Heart Disease. Chin J Integr Med, 2008, 14(4): 274-280.
26.	王阶, 何庆勇, 马长生. 基于冠脉造影的冠心病冠脉病变与血瘀证的相关性研究. 中国中西医结合杂志, 2008, 28(12): 1074-1077.
27.	王子宽, 柳荫, 刘军, 等. 冠心病患者冠状动脉病变范围及狭窄程度与中医证型相关性分析. 陕西中医, 2009, 30(2): 134-135.
28.	王琳. 冠心病冠脉病变程度及血浆同型半胱氨酸与中医证型的关系. 福州: 福建中医学院, 2009: 12-15.
29.	廖坚. 冠心病冠脉病变程度及心率变异性与中医证型的相关性研究. 广州: 广州中医药大学, 2009: 17-19.
30.	王振裕, 时亮, 陈嘉兴, 等. 冠心病患者中医证候与冠状动脉造影相关性研究. 中华中医药杂志, 2009, 24(9): 1194-1197.
31.	郭凡, 魏红, 周鑫. 冠心病中医证型与冠脉造影及血脂的相关性研究. 辽宁中医药大学学报, 2010, 12(5): 114-115.
32.	张鹏, 刘鹏, 徐伟建, 等. 368例冠心病冠脉病变特点与中医证型的相关性研究. 中西结合心脑血管病杂志, 2010, 8(11): 1308-1311.
33.	杜健鹏. 益气活血法治疗介入后冠心病的临床研究. 北京: 中国中医科学院, 2010: 39-53.
34.	侯发琴. 冠心病患者冠状动脉病变与中医证型关系的探讨. 现代中西医结合杂志, 2010, 19(13): 1591-1592.
35.	任毅, 陈可冀, 张敏州, 等. 405例冠心病患者冠状动脉造影结果与中医证型的相关性. 中医杂志, 2010, 51(8): 725-728.
36.	童伟. 冠心病的中医证型与冠脉病变的相关性研究. 北京: 北京中医药大学, 2010: 22-23.
37.	徐莺, 杨俊艳, 杜景柏. 冠心病患者中医辨证分型与冠脉造影结果的关系研究. 西部中医药, 2011, 24(8): 69-70.
38.	周莹, 杜武勋, 朱明丹, 等. 冠心病辨证分型与冠脉造影、血脂、EF的相关性研究. 辽宁中医药大学学报, 2011, 13(6): 78-80.
39.	王俊, 李昌繁, 江时森, 等. 冠心病危险因素定量积分评估与冠状动脉病变的关系研究. 医研究生学报, 2009, 22(10): 1052-1055.
40.	陈良华, 李琳. 管腔狭窄程度与急性心肌梗死. 心血管病学进展, 2010, 31(6): 834-836.
41.	Leaman DM, Brower RW, Meester GT, et al. Coronary artery atherosclerosis: severity of the disease, severity of angina pectoris and compromised left ventricular function. Circulation, 1981, 63: 285.
42.	Sianos G, Morel MA, Kappetein AP, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention, 2005, 1(2): 219-227.
43.	Little WC, Downes TR, Applegate RJ. The underlying coronary lesion in myocardial infarction: implications for coronary angiography. Clin Cardiol, 1991, 14(11): 868-874.
44.	王显, 胡大一. 急性冠脉综合征“络风内动”假说临床研究. 中华中医药杂志, 2008, 23(3): 204-208.

1. 吴锡桂. 我国人群冠心病流行现况与趋势. 中国慢性病预防与控制, 2003, 8: 190-191.
2. 史载祥, 谷万里. 冠状动脉造影与冠心病中医辨证研究探讨. 中国中西医结合杂志, 2007, 27(1): 76-79.
3. Porta M. A dictionary of epidemiology, Fifth Edition. New York: Oxford University Press, 2008: 154.
4. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol, 1983, 51(3): 606-607.
5. Knottnerus JA, Muris JW. Assessment of the accuracy of diagnostic tests: the cross-sectional study. J Clin Epidemiol, 2003, 56(11): 1118-1128.
6. Rutjes AW, Reitsma JB, Vandenbroucke JP, et al. Case-control and two-gate designs in diagnostic accuracy studies. Clin Chem, 2005, 51(8): 1335-1341.
7. Wells G A, Shea B, O’Connell D, et al. The Newcastle Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in Meta-analysis. Avaliable at: http://www.ohri.ca/programs/clinical _epidemiology/oxford.asp.
8. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
9. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
10. 吴泰相, 刘关键, 李静. 影响系统评价质量的主要因素浅析. 中国循证医学杂志, 2005, 5(1): 51-58.
11. 曾明, 孙福成, 许锋, 等. 冠状动脉病变与中医辨证分型关系的初步研究. 中国心血管杂志, 1999, 4(4): 234-237.
12. 王东生, 袁肇凯, 魏经汉, 等. 冠心病痰癖辨证与冠状动脉造影的相关性研究. 中医杂志, 2003, 44(12): 937-938.
13. 张敏州, 丁邦晗, 张维东, 等. 375例胸痹心痛患者冠状动脉造影结果与中医证型的对比研究. 中国中西医结合急救杂志, 2004, 11(2): 115-117.
14. 苏倩. 冠心病中医证型及体质类型与客观指标相关性研究. 北京: 北京中医药大学, 2004: 38-47.
15. 刘永明, 蒋梅先. 259例冠心病患者中医辨证分型与冠脉造影结果的关系研究. 北京中医, 2005, 24(3): 131-133.
16. 王旭升. 冠心病中医证候与冠状动脉造影的相关性研究. 北京: 北京中医药大学, 2005: 40-50.
17. 薛增明. 冠心病中医证型与冠状动脉造影、HCY、hsCRP相关性的临床研究. 济南: 山东中医药大学, 2006: 12-15.
18. 李静, 张继东, 刘同涛. 冠心病中医证型与冠脉病变的相关性. 山东中医药大学学报, 2006, 30(2): 124-126.
19. 张广增, 贺福田, 吴范武, 等. 冠状动脉病变与415例胸痹心痛患者辨证分型关系的研究. 中华中医药杂志, 2006, 21(8): 498-499.
20. 刘红旭, 王振裕, 彭伟, 等. 113例冠状动脉造影患者中医证候与造影特点分析. 中日友好医院学报, 2006, 20(1): 35-37.
21. 王阶, 邢雁伟, 李志忠, 等. 102例冠心病心绞痛患者中医证候特征分析. 中医杂志, 2007, 48(2): 160-162.
22. 郭冬梅. 冠状动脉造影结果与胸痹心痛中医证型关系探讨. 乌鲁木齐: 新疆医科大学, 2007: 8-13.
23. 张鹏, 徐伟建. 中医证型与冠状动脉病变程度的相关性研究. 中西医结合心脑血管病杂志, 2007, 5(2): 101-103.
24. 潘宗奇, 陈伯钧, 冯靖禧, 等. 冠心病造影结果与中医证型的相关性研究. 陕西中医, 2008, 29(6): 649-651.
25. Wang J, Chu FY, Li J, et al. Study on Syndrome Element Characteristics and lts Correlation with Coronary Angiography in 324 Patients with Coronary Heart Disease. Chin J Integr Med, 2008, 14(4): 274-280.
26. 王阶, 何庆勇, 马长生. 基于冠脉造影的冠心病冠脉病变与血瘀证的相关性研究. 中国中西医结合杂志, 2008, 28(12): 1074-1077.
27. 王子宽, 柳荫, 刘军, 等. 冠心病患者冠状动脉病变范围及狭窄程度与中医证型相关性分析. 陕西中医, 2009, 30(2): 134-135.
28. 王琳. 冠心病冠脉病变程度及血浆同型半胱氨酸与中医证型的关系. 福州: 福建中医学院, 2009: 12-15.
29. 廖坚. 冠心病冠脉病变程度及心率变异性与中医证型的相关性研究. 广州: 广州中医药大学, 2009: 17-19.
30. 王振裕, 时亮, 陈嘉兴, 等. 冠心病患者中医证候与冠状动脉造影相关性研究. 中华中医药杂志, 2009, 24(9): 1194-1197.
31. 郭凡, 魏红, 周鑫. 冠心病中医证型与冠脉造影及血脂的相关性研究. 辽宁中医药大学学报, 2010, 12(5): 114-115.
32. 张鹏, 刘鹏, 徐伟建, 等. 368例冠心病冠脉病变特点与中医证型的相关性研究. 中西结合心脑血管病杂志, 2010, 8(11): 1308-1311.
33. 杜健鹏. 益气活血法治疗介入后冠心病的临床研究. 北京: 中国中医科学院, 2010: 39-53.
34. 侯发琴. 冠心病患者冠状动脉病变与中医证型关系的探讨. 现代中西医结合杂志, 2010, 19(13): 1591-1592.
35. 任毅, 陈可冀, 张敏州, 等. 405例冠心病患者冠状动脉造影结果与中医证型的相关性. 中医杂志, 2010, 51(8): 725-728.
36. 童伟. 冠心病的中医证型与冠脉病变的相关性研究. 北京: 北京中医药大学, 2010: 22-23.
37. 徐莺, 杨俊艳, 杜景柏. 冠心病患者中医辨证分型与冠脉造影结果的关系研究. 西部中医药, 2011, 24(8): 69-70.
38. 周莹, 杜武勋, 朱明丹, 等. 冠心病辨证分型与冠脉造影、血脂、EF的相关性研究. 辽宁中医药大学学报, 2011, 13(6): 78-80.
39. 王俊, 李昌繁, 江时森, 等. 冠心病危险因素定量积分评估与冠状动脉病变的关系研究. 医研究生学报, 2009, 22(10): 1052-1055.
40. 陈良华, 李琳. 管腔狭窄程度与急性心肌梗死. 心血管病学进展, 2010, 31(6): 834-836.
41. Leaman DM, Brower RW, Meester GT, et al. Coronary artery atherosclerosis: severity of the disease, severity of angina pectoris and compromised left ventricular function. Circulation, 1981, 63: 285.
42. Sianos G, Morel MA, Kappetein AP, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention, 2005, 1(2): 219-227.
43. Little WC, Downes TR, Applegate RJ. The underlying coronary lesion in myocardial infarction: implications for coronary angiography. Clin Cardiol, 1991, 14(11): 868-874.
44. 王显, 胡大一. 急性冠脉综合征“络风内动”假说临床研究. 中华中医药杂志, 2008, 23(3): 204-208.

Chinese Journal of Evidence-Based Medicine

Correlation between TCM Blood Stasis Pattern of Coronary Heart Disease and Coronary Angiography Result: A Meta-Analysis

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