Abstract： Objective To explore the relationship between traditional Chinese medicine (TCM) syndrome and coronary lesion and the effect on prognosis in patients with acute coronary syndrome (ACS).Methods A total of 225 patients were divided into four clinical types of traditional Chinese medicine syndrome:heart blood stasis syndrome group(178 cases),dual deficiency of qi and yin syndrome group(50 cases),yin deficiency of heart and kidney syndrome group(14 cases) and phlegm blocking heart vessel syndrome group(10 cases).The effect of TCM syndrome on in-hospital and half a year clinical follow-up outcomes,including all-cause mortality,major adverse cardiac event(MACE),stroke and other major bleeding were collected and analyzed.Results Of the 225 patients,182 cases (72.2％) were three and two vessel lesion; 214 cases(85.0％) were type B and C lesion; 44 cases (17.5％) were left main coronary artery disease.According to SYNTAX score,phlegm blocking heart vessel syndrome group [(33.2 ± 2.0) scores] was higher than dual deficiency of qi and yin syndrome group,yin deficiency of heart and kidney syndrome group [(27.6 ± 1.9),(28.5 ± 2.5) scores,respectively,P ＜ 0.05].Phlegm blocking heart vessel syndrome group had a higher rate of left main lesion (5/10),chronic obstructive lesion (4/10),type C lesion (9/10] than the other three groups (P ＜0.05).All the patients had no in-hospital MACE;However,at 6 months,phlegm blocking heart vessel syndrome group had a higher MACE rate than the other groups (3/10 vs 7/178,2/50,0).Conclusions The main type of ACS is heart blood stasis syndrome.Although the phlegm blocking heart vessel syndrome is less,the patients had higher SYNTAX score and severe lesion.We should pay attention to this type patients and take the coronary examination in time to evaluate lesion in order to improve the short term prognosis.