Investigation Of The Syndrome Factors In Perioperative Period Of Coronary Artery Diseaseand The Experience Of Professor Zhong Jingbai Using Medicine After The Treatment Of Stenting

The paper consists of three parts:literature review,syndrome factor research and medical experience summary.The literature review comprehensively introduced the etiology and pathogenesis,syndrome characteristics,TCM treatment and clinical research of TCM in the perioperative period of coronary heart disease stent implantation;By means of the investigation of the status of syndrome factors,the evolution rule of the syndrome elements in perioperative period of coronary stenting is explored;Physicians experience is to use data mining approach to summarize professor Zhong Jingbai modulation coronary stenting in patients with clinical application experience.Objective:1.To study the evolution of coronary artery bypass surgery;2.To summarize the experience of professor Zhong Jingbaiin the treatment of coronary heart disease after coronary heart disease.Method:From October 2017 to February 2018,a total of 628 patients were screened before coronary surgery,215 hospitalized patients with coronary stent implantation in the emergency ward of Anzhenhospital of Beijing affiliated to capital medical university were selected,The general information and symptoms of the patient were recorded by field investigation,According to the collected patient data,the patient was diagnosed,SPSS 16.0 software was applied to analyze these data;With a retrospective study,Collected and sorted out the 69 cases and 191 prescriptions for the clinical treatment of coronary heart disease in the outpatient department of the professor Zhong Jingbaiin June,2008 and June,2016,and In this paper,there are no supervised data mining methods,such as apriori algorithm and complex system entropy clustering,which are used in the software of "TCM inheritance auxiliary system(V2.5)" to analyze these prescriptions.Result:1.Study on the evolution of TCM syndrome elements in perioperative period after coronary stent implantation:(1)General information:A total of 215 patients with coronary stent implantation were enrolled,There were 164 males and 51 females.34-76 years old,with an average age of 60±9 years old.There were 2 patients with stable angina,157 patients with unstable angina,26 patients with acute st-segment elevation myocardial infarction,and 30 patients with acute non-st-segment elevation.There were 138 patients with hyperlipidemia,127 patients with hypertension,79 patients with diabetes mellitus,20 patients with old myocardial infarction,and 18 patients with old cerebral infarction,25 patients were interviewed by telephone for 48h after surgery,215 cases were followed by telephone follow-up 7 days and 28 days after surgery.(2)The evolution rule of syndrome elements:The Preoperative identification of 190 patients was arranged in sequence:heat accumulation(174 cases),qi deficiency(158 cases),phlegm(157cases)，Yang deficiency(154cases),qi stagnation(133cases),Yin deficiency(123 cases),cold setting(112cases),blood stasis(96 cases);In the 8 hours after the operation,The number of syndromes detected from high to low order is:Heat accumulation(167 cases),qi deficiency(125 cases),Yin deficiency(116 cases),phlegm(95 cases),Yang deficiency(50 cases),blood stasis(48 cases),cold coagulation(30 cases),qi stagnation(15 cases);In the 24 hours after the operation,The number of syndromes detected from high to low order is:Heat accumulation(152 cases),qi deficiency(114 cases),Yin deficiency(82 cases),phlegm(72 cases),blood stasis(33 cases),Yang deficiency(30 cases),cold setting(19 cases),qi stagnation(4 cases);In the 48 hours after the operation,The number of syndromes detected from high to low order is:Heat accumulation(115 cases),qi deficiency(85 cases),Yin deficiency(66 cases),sputum(44 cases),Yang deficiency(20 cases),blood stasis(17 cases),cold coagulation(10 cases),qi stagnation(1 cases).(3)Main symptoms detected:Preoperative:the first five were chest tightness(135 cases),irritability(110 cases),dry mouth(110 cases),chest pain(101 cases),and fatigue(101 cases);8 hours after operation:the first five were found to be weak(101 cases),dry(60 cases),poor sleep(59 cases),and shortness of breath(52 cases);24 hours after operation；the first five were found to be weak(90 cases),shortness of breath(36 cases),poor sleep(45 cases),dry mouth(32 cases),chest pain(20 cases);48 hours after operation:The first five were found to be anemic(56 cases),shortness of breath(22 cases),palpitations(17 cases),poor sleep(15 cases),dry mouth(14 cases);7 days after operation:The first five were the lack of fatigue(35 cases),chest pain(24 cases),chest tightness(16 cases),shortness of breath(15 cases),and wan PI(8 cases);28 after operation:the first five were lack of fatigue(30 cases)，chest pain(20 cases),shortness of breath(12 cases),chest tightness(8 cases),and wan PI(4 cases).2.Experience of the professor Zhong Jingbaiin the treatment of coronary heart disease after coronary heart disease:(1)General information:collect Zhong Jingbaiprofessor in May 2008-June 2016 outpatient treatment,a total of 69 cases of coronary heart disease after the stent,a total of 191 prescription,47 men,22 women,aged 38-98,the average age of 64 ±12 years old.(2)Symptoms curative effect:in the diagnosis and treatment of 191 times,chest tightness to reduce or reduce 70,53 times chest pain to reduce or alleviate the palpitation and reduce 21 times,improve sleep of 14 times,reduce or mitigate the nine,reduce the nine fatigue,diet improved seven times,shortness of breath to improve two times.(3)Frequency of drugs:2662 times of total drug use in 191 prescriptions,The occurrence frequency of Chinese traditional Chinese medicine is from high to low in the top five order:Salvia miltiorrhiza(149times).Astragalus(130times)、fructus amomi(97tiemes),safflower(91times)、Ligusticum wallichii(89times).The other drugs with a frequency greater than 20%are:Forsythia suspense.liquorice.Chicken’s Gizzard-membrane、Viola mandshurica、fructus aurantii、the root of kudzu vine、radix paeoniae rubrathe、Poria cocos、cassia twig、Allium macrostenon、Trichosanthes kirilowi.(4)Four gas and five flavor distribution:The frequency of four gas is ranged from high to low:Temperature(1181 times),cold(795 times),flat(516 times),cool(95times),heat(9 times);The frequency of five tastes is ranged from high to low:Flavor(1265 times),bitter taste(1192 times),spicy(1087times),sour(207times),salty(92tiemes)and astringent(84times).(5)Distribution of meridians:The number of returnees from high to low in the top 6 isLiver meridian(1221 times),spleen meridian(1173 times),heart meridian(968 times),lung meridian(932 times),stomach meridian(918 times),kidney meridian(530 times).(6)The distribution of the drug and the Angle medicine:The number of drugs in the top 5 of frequency range from high to low is:Salvia miltiorrhiza and Astragalus(103times).Salvia miltiorrhizaandfructus amomi(89times)、safflowerand Salvia miltiorrhiza(87times)、Salvia miltiorrhiza andLigusticum wallichii(77times)、Astragalusandfructus amomi(76times),The remaining frequencies are higher:Astragalus andLigusticum wallichii.safflowerand Astragalus、Forsythia suspense and Salvia miltiorrhiza、Astragalus andLigusticum wallichii;The high frequency Angle drugs are：Salvia miltiorrhiza and Astragalus andfructus amomi(70times)、Salvia miltiorrhiza and Astragalus andsafflower(56times)、Salvia miltiorrhiza and Astragalus andLigusticum wallichii(55times).Conclusion:Patients with coronary artery stents were mainly middle-aged and elderly,and the proportion of males was higher than that of females,the risk factors such as hyperlipidemia,were correlated with the coronary stent;the pathogenesis of this deficiency is throughout the perioperative period,this deficiency is dominated by qi deficiency and Yang deficiency,Qi deficiency detection is the highestreal evil is dominated by heat and phlegm,the heat accumulation syndrome is the most frequent,it is suggested that the treatment of patients with coronary artery disease should pay attention to the benefit and heat,before and after the operation,all the factors of the syndromes were reduced,especially in the case of qi stagnation,condensation,Yang deficiency and phlegm,and the decrease of heat accumulation,qi deficiency and Yin deficiency was relatively slow,the efficacy of coronary stenting in alleviating the factors of the syndrome was suggested,coronary stent in patients with qi deficiency syndromes mainly by,thermal aggregates,phlegm turbidity,Yin deficiency and Yang deficiency syndrome elements,prompt clinical treatment should with yiqi,clear heat,phlegm,nourish Yin,this treatment in combination with the application.After stenting,the lack of anaphylaxis was slower,and it’s a huge percentage,the postoperative period of perioperative period will continue to be unsatisfactory,during the perioperative period of mid-and late sleep,the prions checked out more,attention should be paid to the patient’s sleep condition and the care of the spleen and stomach,Coronary artery disease has a great influence on syndrome and symptoms;In the course of clinical treatment of coronary heart disease after coronary artery bypass surgery,The professorZhong Jingbai attached great importance to Invigorate qi and blood circulation,regulate spleen and stomach,and value qi deficiency blood stasis this core pathogenesis.The Salvia miltiorrhiza、Astragalus.fructus amomi safflower、Ligusticum wallichii are commonly used;The commonly useddistribution of the drug are Salvia miltiorrhiza and Astragalus、Salvia miltiorrhiza andfructus amomi、Forsythia suspenseand Salvia miltiorrhiza、Astragalus andfructus amomi,etc;The commonly usedAngle medicine areSalvia miltiorrhiza and Astragalus andfructus amomi、Salvia miltiorrhiza and Astragalus andsafflower、Salvia miltiorrhiza and Astragalus andForsythia suspense、Salvia miltiorrhiza andfructus amomiandsafflower.On the basis of invigorating qi and activating blood drugs,it is used to treat drugs such as nourishing Yin and clearing heat,detoxifying and removing phlegm,etc.