Study On The Rule Of Syndrome And Treatment Of Event Chain Of “Angina Pectoris Of Coronary Heart Disease-After Interventional Therapy Of Myocardial Infarction-Heart Failure After Myocardial Infarction” Guided By The Yingwei Theory Of Vessel-Collateral Th

Previous studies have put forward the core theory of Vessel-collateral Theory—Yingwei Theory,“ Ying is in the vein,Wei is outside the vein”(《 Ling Shu 》),“ Yingwei is obstructed,the blood does not flow”(《Shang Han Lun》),“Blood transmission,shove,blocking and impassability”(《Jin Gui Yao Lue》),“Damaged heart,adjust its Yingwei”(《Nan Jing》),It reveals the core connotation of vascular disease prevention and treatment from different aspects of physiology,pathology,transmutation and treatment,guided by the Yingwei Theory of Vessel-collateral Theory,Based on the “blood transmission,shove,blocking and impassability”embodies the “shove” →“blocking” → “impassability” transmission law,and It’s correlation with coronary heart disease,angina pectoris,myocardial infarction and heart failure after myocardial infarction in the cardiovascular event chain,to study the rule of the syndrome and treatment of the event chain of “angina pectoris of coronary heart disease→myocardial infarction after intervention→heart failure after infarction”.It is helpful to reveal the regularity of pathogenesis transmission of cardiovascular diseases at this stage from a new perspective,and provide important support for systemic intervention in the event chain of“angina pectoris of coronary heart disease→ after intervention of myocardial infarction→heart failure after infarction”.Objective: Guided of Yingwei Theory of Vessel-collateral Theory,Ancient and modern medical records related to angina pectoris of coronary heart disease,after interventional therapy of myocardial infarction and heart failure after myocardial infarction were systematically collected,using data mining method,to study the rule of syndrome and treatment of event chain of“angina pectoris of coronary heart disease-after interventional therapy of myocardial infarction-heart failure after myocardial infarction”.Methods: Ancient chest pain and heartache,xinji related medical cases were obtained through the Chinese Medical Canon.Modern angina pectoris of coronary heart disease,after interventional therapy of myocardial infarction and heart failure after myocardial infarction related medical cases were retrieved from Pub Med,CNKI,Wanfang,VIP and Sinomed database.The medical cases that meet the inclusion and exclusion criteria were screened and the core database was established,then the symptoms and drug data were cleaned and normalized respectively.Frequency analysis,association rule,cluster analysis and other data mining methods were used to explore rule of syndrome and treatment of event chain of “angina pectoris of coronary heart disease-after interventional therapy of myocardial infarction-heart failure after myocardial infarction”.Results:Part Ⅰ Study on the Rule of Syndrome and Treatment of Ancient and Modern Medical Cases of Angina Pectoris of Coronary Heart Disease Guided by the Yingwei Theory of Vessel-collateral Theory1 Study on the rule of syndrome and treatment of ancient medical cases of chest pain and heartache.1.1 Study on the medical symptoms of chest pain and heartacheThe main symptoms of chest pain and heartache is chest pain,and the top five high-frequency symptoms are chest pain,chest pain through the back,poor tolerance,chest tightness,and palpitation;The first three high frequency tongue images are greasy moss,white moss and pale tongue;The first three high frequency pulses are string pulse,smooth pulse and fine pulse.Symptom association rules showed that the main symptoms of chest pain were highly associated with sputum,tiredness,shortness of breath,palpitation,vomiting,fatigue,abdominal distention,abdominal pain,belching and other symptoms.Symptoms were divided into four categories by clustering analysis,S1:belching,shortness of breath,vomiting,sputum and salivation,dizziness,etc.S2: chest tightness,lukewarm hands and feet,loose stool,etc.S3: sweating,tiredness,fatigue,poor performance,abdominal distension,etc.S4:expectoration,vomiting,pain on the back and shoulder,epigastric pain,body pain,sleep,palpitation,dry mouth and lips,bad urine,poor stool,etc.1.2 Research on the medical syndrome of chest pain and heartacheBased on the medical case syndrome differentiation standard of the Yingwei theory of Vessel-collateral Theory,the main syndromes of chest pain and heartache are Wei Qi stagnation,phlegm and turbidities obstruction,and Wei Yang deficiency,The association rules of syndrome showed that there were high correlations between Wei Qi stagnation and phlegm and turbidities blocking collaterals,blood stasis blocking collaterals and phlegm and turbidities blocking collaterals.1.3 Drug study in medical cases of chest pain and heartacheThe top ten high-frequency drugs of chest pain and heartache were Pinellia pinellia,Tangerine peel,Poria cocos,Trichosanthis trichosanthis,Allium stemon,ginger,licorice,cassia twine,peony;Classified statistical results of the efficacy of regulating Wei Qi Ying blood showed that the high-frequency drugs were Flow Qi and collateral-dredging drugs,Phlegm-reducing and collateral-dredging drugs and beneficial to Wei and warming Yang drugs.First-order and second-order full frequency drug association rules showed strong correlation among Trichosanthis trichosanthis,Allium macrostemon,Pinellia tuber,Cinmanthus tuber,Citrus aurantii,Poria cocos.The association rules of first-order de-high-frequency drugs showed that there were strong correlations between Allium macrostemon with cassia twig,ginger,hawthorn,turmeric,convoluted flower and cassia twig with peony.Second-order high-frequency drug association rule display that there were strong correlations among Citrus aurantii-cassia twig-Allium macrostemon,Magnolia officinalis-cassia twig-Allium macrostemon,Peony-cassia twig-licorice.Four core cluster combinations were obtained by drug cluster analysis.D1:flower,green onion,madder,bamboo shavings,tangerine peel,chinaberry seed,magnolia officinalis,Perilla,turmeric,etc.D2: Citrus aurantii,Allium macrostemon,Cassia twigs,Trichosanthis trichosanthis,Pinellia pinellia,Alpinia officinalis,Fructus Corni,Poria cocos,Ginger,etc.D3: Aconite,Astragalus membranaceus,Atractylodes atractylodes,White Liquor,Prickly Ash,Frankincense,Myrrh,Ligusticum chuanxiong,Atractylodes membranaceus,Fructus aurantii,Fructus grandiflorum,Atractylodes grandiflorum,etc.D4: Angelica,Peach kernel,Yanhusuo,Areca nut,Aconia,Fritillaria,Aloes,etc.2 Study on the rule of syndrome and treatment of modern medical cases of angina pectoris of coronary heart disease2.1 Research on general information of angina pectoris of coronary heart disease medical caseMale patients with angina pectoris of coronary heart disease significantly more than female patients,and the age of high incidence of angina pectoris of coronary heart disease is 60-69 years old.2.2 Symptoms research of angina pectoris of coronary heart disease medical caseThe main symptoms are chest pain,and the top five high-frequency symptoms are chest pain,shortness of breath,chest tightness,fatigue,and poor sleep.The first three high frequency tongue are white moss,purple dark tongue,greasy moss;The first three high frequency pulses are fine pulse,String pulse,deep pulse.Symptom association rule analysis showed that chest tightness,chest pain,fatigue,shortness of breath and tiredness were highly correlated.Seven symptom clusters were obtained by symptom cluster analysis,S1:chest tightness,chest pain,shortness of breath,fatigue,palpitation,poor sleep,etc.S2: chest pain,abdominal distention,belching,lack of gas,lazy speech,poor tolerance,etc.S3: Thoracic pain,pain in a fixed place,etc.S4: greasy mouth,fat body,phlegm,etc.S5: Sour and soft waist and knees,heat in five irritations,red zygomatic glands,night sweats and other symptoms of Yin deficiency;S6: red face,bitter mouth,irritability,belching,mouth thirst,etc.S7:chills,cold limbs,pale complexion,etc.2.3 Study on the syndrome of angina pectoris of coronary heart disease medical caseBased on the medical case syndrome differentiation standard of the Yingwei theory of Vessel-collateral Theory,the first four high-frequency syndromes were Wei Qi deficiency stagnation,blood stasis blocking collusion,Wei Qi stagnation and phlegm turbidity blocking collusion.The analysis of association rules of syndrome showed that high association rules were mainly concentrated in the relationship between Wei Qi deficiency stagnation,Wei Qi stagnation,blood stasis blocking collaterals and phlegm turbidity blocking collaterals.2.4 Drug study of angina pectoris of coronary heart disease medical caseThe top 10 drugs of angina pectoris of coronary heart disease were salviae miltiorrhiza,licorice,chuanxiong,astragalus membranaceus,pinellia tuber,poria cocos,angelica sinensis,trichosanthis,Allium macrostemon and safflower.Classified statistical results of the efficacy of regulating Wei Qi Ying blood showed that the high-frequency drugs were removing blood stasis and clearing collaterals drugs,enhancing Qi and solid Wei drugs,Flow Qi and collateral-dredging drugs,Phlegm-reducing and collateral-dredging drugs.First order drug association rule results show that the association rules of Ligusticum chuanxiong-salvia miltiorrhiza,salvia miltiorrhiza-astragalus membranaceus,astragalus membranaceus-ligusticum chuanxiong-trichosanthis,trichosanthis-pinellia ternata,ligusticum chuanxiong-angelica were highly correlated;Second-order drug association rule results show that the association rules of Astragalus membranaceus-Ligusticum chuanxiong-Salvia miltiorrhiza,Allium macrostemon-Trichosanthis tuber pinellia were highly correlated.Four core drug clusters were obtained by drug cluster analysis: D1:Bupleurum,Radix Dendrosum,Sandalwood,Amarum,Turmeric,Radix Corydalis,etc.D2: Astragalus membranaceus,Dangshen Radix,Atractylodes macrocephala,Ligusticum chuanxiong,red peony root,safflower,peach kernel,angelica,etc.D3: Trichosanthis,Pinellia tuber,Platycodon grandiflorum,Allium macrostemon,Citrus tangerine peel,Panax notoginseng,Leech,Dichosanthus,etc.D4: Aconite,cassia twig,keel,oyster,ginseng,Radix Ophiopogonis,Schisandra fruit,American ginseng,jujube seed and so on.Part Ⅱ Study on the Rule of Syndrome and Treatment of Medical Cases of After Interventional Therapy of Myocardial Infarction Guided by the Yingwei Theory of Vessel-collateral Theory1 Research on general information of After Interventional Therapy of Myocardial Infarction medical caseMale patients with After Interventional Therapy of Myocardial Infarction were significantly more than female patients,and the age of high incidence of this disease was 60-69 years old.2 Symptoms research of After Interventional Therapy of Myocardial Infarction medicalThe main symptoms of After Interventional Therapy of Myocardial Infarction were chest pain,and the top five high-frequency symptoms were chest pain,chest tightness,bluish lips,cold limbs and palpitations.The first three high frequency tongue images are dark purple tongue,white moss and greasy moss.The first three high frequency pulses are fine pulses,String pulse and jiedai pulse.The results of the association rules of symptoms showed that the main symptoms,chest pain and chest tightness,were highly correlated with fatigue,shortness of breath,bluish lips,chills,cold limbs,cold sweating and other symptoms.Three symptom cluster combinations were obtained by symptom cluster analysis.S1: Shortness of breath,tiredness,fatigue,poor appetite,tingling pain in chest,constant pain,sputum,dizziness,etc.S2: less breath and lazy speech,spontaneous sweating,cold sweating,cold limbs,pale face,chest pain,asthma,etc.S3: Chest tightness,bluish lips,palpitations,etc.3 Study on the syndrome of After Interventional Therapy of Myocardial Infarction medical caseBased on the medical case syndrome differentiation standard of the Yingwei theory of Vessel-collateral Theory,the first four high-frequency syndromes were,The first four high-frequency syndromes were blood stasis blocking collusion,Wei Qi deficiency stagnation,Wei Yang deficiency and phlegm turbidity blocking collusion.The analysis of association rules of syndrome showed that Wei Qi deficiency stagnation is associated with blood stasis blocking collusion.4 Drug study of After Interventional Therapy of Myocardial Infarction medical caseIn myocardial infarction after interventional therapy medical case,the top five high-frequency drugs were licorice,salvia miltiorrhiza,ginseng,pinellia ternata and trichosanthis;Classified statistical results of the efficacy of regulating Wei Qi Ying blood showed that the high-frequency drugs were removing blood stasis and clearing collaterals drugs,enhancing Qi and solid Wei drugs,Flow Qi and collateral-dredging drugs,beneficial to Wei and warming Yang drugs.The first-order and second-order drug association rules showed that the second-order drugs of Safflower,Angelica sinensis,Ligusticum chuanxiong,Salviorrhiza miltiorrhiza,Peach kerm and Astragalus membranaceus were highly correlated.Ginseng,astragalus and licorice had higher correlation.High correlation among aconite,ginseng and cassia twig;High correlation among trichosanthis,pinellia ternata,Allium macrostemon and fructus aurantii.Five significant drug combinations were formed by drug cluster analysis:D1: Astragalus membranaceus,Ligusticum chuanxiong,Radix Paeoniae Radix,Wulingzhi,Puhuang,Dilong,Guizhi,etc.D2: Trichosanthis,Pinellia ternata,Allium macrostemon,Acorus gramineus,Trionyx aurantii,Trifoliate aurantii,etc.D3: Aconite,dried ginger,ginseng,licorice,dogwood,whitepeony root,etc.D4: Bupleurum,Platycodon grandiflorum,Fructus Aurantii,Aurantii,Angelica sinensis,Peach kernel,Salviae miltiorrhiza,Safflower,Yanhuo,Panax notoginseng,Radix Achyranthes,etc.D5: Chinese and Western ophiopogon,Schisandra fruit,Dangshen,Atractylodes macrocephala,Chinese jujube and so on.Part Ⅲ Study on the Rule of Syndrome and Treatment of Ancient and Modern Medical Cases of Heart Failure after Myocardial Infarction Guided by the Yingwei Theory of Vessel-collateral Theory1 Study on the rule of syndrome and treatment of ancient medical cases of xinji.1.1 Study on the medical symptoms of xinjiThe main symptoms of xinji is chest pain,and the top five high-frequency symptoms are asthma,edema,cough,inability to lie down and urination;The first three high frequency tongue images are white moss,greasy moss and red tongue;The first three high frequency pulses are deep pulse,String pulse,fine pulse.The results of symptom association rules showed that high association rules mainly focused on symptoms such as edema,asthma,cough,and can not lie down,among which edema-asthma,cough-asthma,and wheezy-can not lie down were highly correlated.Symptoms were classified into three categories by cluster analysis: S1:fatigue,palpitation,cold body and limb,aversion to cold,poor appetite,chest pain,loose stool,yellow complexion and sweating.S2: chest tightness,edema,poor urination,unable to lie down,etc.S3: Shortness of breath,dark complexion,body pain,hypochondriac pain,cough,expectoration,etc.1.2 Research on the medical syndrome of xinjiBased on the medical case syndrome differentiation standard of the Yingwei theory of Vessel-collateral Theory,the main syndromes of xinji are Water blocking collusion and Wei Yang deficiency,The association rules of syndrome showed that there were high correlations between Wei Qi stagnation and Water blocking collusion.1.3 Drug study in medical cases of xinjiThe top ten high-frequency drugs of xinji were Poria cocos,tangerine peel,atractylodes atractylodes,pinellia tuber,almond,alisma,licorice,cassia twine,ginger,aconite;Classified statistical results of the efficacy of regulating Wei Qi Ying blood showed that the high-frequency drugs were water-Clearing and collateral-dredging drugs,enhancing Qi and solid Wei drugs,and beneficial to Wei and warming Yang drugs.The results of first-order drug association rules showed that poria cocos as the center was strongly correlated with tangerine peel,pinellia pinellia,atractylodes atractylodes,aconite,cassia twine and alisma orientalis.Second-order drug association rule results showed that there was strong correlation among yam,poria cocos,rehmannia glutinosa,alisma alisma,bark of tree peony,dogwood and aconite.Five core drug cluster combinations were obtained by drug cluster analysis: D1: poria cocos,cassia twood,ginger,pinellia tuber,aconite,cinnamon,alisma alisma,bark peony,dogwood and so on.D2: Astragalus membranaceus,Angelica sinensis,Atractylodes macrocephala,Dangshen,Licorice,Porcine cocos,Poria cocos bark,Magnolia officinalis bark,Fangji bark,Magnolia officinalis,etc.D3: mulberry bark,almond,gypsum,aster,Perilla seed,radish seed,coix seed,plantain seed,winter gourd seed,aloes,etc.D4:Ginseng,Radix Ophiopogonis Radix,Schisandra Fruit,Yam,Rehmannia glutinosa,Radix Achyranthes Radix,etc.D5: Draba nemorosa,Chinese jujube.2.Study on the rule of syndrome and treatment of modern medical cases of Heart failure after myocardial infarction2.1 Research on general information of heart failure after myocardial infarction medical caseMale patients with heart failure after myocardial infarction were significantly more than female patients,and the age of high incidence was 70-79 years old.2.2 Symptoms research of heart failure after myocardial infarction medical caseThe main symptoms are Chest tightness and asthma,The frequent symptoms were chest tightness,asthma,fatigue,palpitation,shortness of breath,Lower extremity edema.High frequency tongue image for moss white,dark purple tongue,thin moss;The high frequency pulse is deep pulse,fine pulse and weak pulse.The association rules of symptoms showed that the frequent symptoms of this disease were chest tightness and asthma,which were highly associated with shortness of breath,cold limbs,bluish lips and edema of lower limbs.Four symptom clusters were obtained by symptom cluster analysis,S1:spontaneous sweating,tiredness,poor appetite,chills,oliguria,bluish lips,asthma,sleeplessness,chest pain,etc.S2: red zygomatic,heat in five irritable areas,thirst,fatigue,shortness of breath,palpitation,etc.S3: lack of breath and lazy speech,pale complexion,loose stools,excessive phlegm,cough,etc.S4:lower limb edema,pale complexion,chest tightness,etc.2.3 Study on the syndrome of heart failure after myocardial infarction medical caseBased on the medical case syndrome differentiation standard of the Yingwei theory of Vessel-collateral Theory,the first four high-frequency syndromes were Wei Qi deficiency stagnation,Wei Yang deficiency,Water blocking collusion and blood stasis blocking collusion;The association rules of syndrome showed the associations between Water blocking collusion-Wei Yang deficiency,Wei Qi deficiency stagnation-blood stasis blocking collusion,blood stasis blocking collusion-Water blocking collusion were high correlation.2.4 Drug study of angina pectoris of coronary heart disease medical caseHigh-frequency drugs for heart failure after myocardial infarction include astragalus membranaceus,poria cocos,salvia miltiorrhiza,tractylodonis asparagus,semen aconite,licorice,semen leiocarpa,ginseng,semen opogonis,semen schisandrae,etc.Classified statistical results of the efficacy of regulating Wei Qi Ying blood showed that the high-frequency drugs were enhancing Qi and solid Wei drugs,ater-clearing and collateral-dredging drugs,removing blood stasis and clearing collaterals and beneficial to Wei and warming Yang drugs.First-order and second-order drug association rules results both showed that poria cocos,astragalus membranus,aconite,cassia twigg,Atractylodes ractylodes and Salvia miltiorrhiza had high association.Four drug clusters were formed by drug cluster analysis: D1: aconite,Cassia twig,astragalus membranaceus,red peony root,peach kernel,leonurus,zelan,zhuling,poria,Semen lepidii,etc.D2: Ginseng,Safflower,Panax notoginseng,Salvia miltiorrhiza,Ligusticum chuanxiong,Alisma alismatis,Mulberry bark,etc.D3: Curcuma zedoariae,Rhizoma triangularis,Rhizoma grandiflorum,Plantago seed,Bupleurum bupleurum,Cohenma,Platycodon grandiflorum,etc.D4: Cinnamon,Xianling Spleen,Radix Pseudostellariae Radix,American ginseng,Dragon bone,Oyster,Dangshen Radix,Radix Ophiopogonis Radix,Schisandra Fruit,Jujube Seed,Longan Meat,Angelica,etc.Conclusions:1 The basic pathogenesis of ancient medical cases of chest pain and heartache were Wei Qi deficiency stagnation,Wei Yang deficiency and phlegm and turbidities obstruction.The basic treatment method is flow qi and dredging collaterals,Wen Tong Weiyang,expelling phlegm and dredging collaterals.The basic pathogenesis of Modern medical cases of angina pectoris of coronary heart disease were Wei Qi deficiency or stagnation,Phlegm and blood stasis blocking collaterals.The basic treatment method is enhancing Qi and chang Wei,dispel phlegm,remove blood stasis and dredging collaterals.2 The basic pathogenesis of ancient medical cases of after interventional therapy of myocardial infarction were Qi deficiency and blood stasis,collaterals obstructed.The basic treatment method is enhancing Qi and solid Wei,removing blood stasis and dredging collaterals.3 The basic pathogenesis of ancient medical cases of xinji were Qi Yang deficiency,water block collaterals.The basic treatment method is enhancing qi and warming Yang,dispelling water and dredging collaterals.The basic pathogenesis of Modern medical cases of heart failure after myocardial infarction were enhancing qi and warming Yang,removing blood stasis and dredging collaterals,dispelling water and removing edema.4 The event chain of “angina pectoris of coronary heart disease-after interventional therapy of myocardial infarction-heart failure after myocardial infarction”reflects the evolution process of key pathogenesis of “Abnormal qi moving(qi)→blood stasis in veins(blood)→blood stasis in collates and water appear(water)”.Based on the pathogenesis evolution process of the event chain and guided by Yingwei Theory of Vessel-collateral Theory,systematically prevent and cure the event chain of “angina pectoris of coronary heart disease-after interventional therapy of myocardial infarctionheart failure after myocardial infarction”,combine prevention with treatment and give full play to the clinical advantages of TCM of "treating present disease and preventing future disease".Control the upstream factors,treat the current disease,prevent the downstream transmission,systematically intervene in the chain of cardiovascular events.