Exploration and construction of a diagnostic model for traditional Chinese medicine deficiency syndrome in middle-aged and elderly patients with angina pectoris of coronary heart disease
Objective To construct a diagnostic prediction model of traditional Chinese medicine(TCM)deficiency syndrome of angina pectoris in middle-aged and elderly patients with coronary heart disease.Methods Clinical data of 160 middle-aged and elderly(50-85 years)patients with angina pectoris of coronary heart disease and who were hospitalized in Taizhou Hospital Affiliated to Nanjing University of Chinese Medicine from January 2021 to December 2022 were selected.Age,gender,body mass index,smoking,drinking,blood routine,blood lipids,liver and kidney function,degree of coronary artery disease,and hypertension,diabetes,gastrointestinal disease,chronic obstructive pulmonary cerebrovascular disease were counted as independent variables.Each patient was given the deficiency and excess syndrome differentiation,and the results were used as dependent variables.Univariate logistic regression was used to screen variables,and multivariate logistic regression analysis was used to establish a model.A nomogram was used to present the model.Receiver operating curve,calibration curve,and decision curve analysis were used to evaluate the model.Results Among 160 patients,83 cases were positive syndrome and 77 cases were deficiency syndrome.Multivariate regression analysis showed that age>67-85 years[OR=2.776,95%CI(1.219,6.321),P=0.015],diabetes mellitus[OR=2.230,95%CI(0.960,5.178),P=0.062],Genisi score 4.50-7.50[OR=10.126,95%CI(2.574,39.843),P=0.001],Genisi score 8.00-15.75[OR=13.510,95%CI(3.441,53.040),P<0.001],Genisi score 16.00-80.00[OR=53.032,95%CI(11.769,230.027),P<0.001]were predictors of angina pectoris deficiency syndrome.The model equation was as follows,Logit(deficiency probability)=-4.231+1.021 × age(>67-85 years)+0.802 × diabetes+2.315 × Gensini level(4.50-7.50)+2.603 × Gensini level(8.00-15.75)+3.952 × Gensini level(16.00-80.00).The area under the curve was 0.852(95%CI:0.795-0.910).Calibration curve showed good accuracy,and decision curve analysis showed that the predictor variable showed a good positive rate of return in the broad risk range of 6%-85%.Conclusion In this study,a diagnostic prediction model for angina pectoris deficiency syndrome in middle-aged and elderly patients with angina pectoris of coronary heart disease is constructed,which has good clinical prediction ability.
Angina pectorisTraditional Chinese medicine syndrome typesDeficiency syndromeLogistic regression analysisPrediction modelNomogram