| Objective:To explore the correlation between TCM Syndrome Types and risk factors,the law of traditional Chinese medicine and its action mechanism in patients with acute ischemic stroke（AIS）in the Department of encephalology of Hubei Hospital of traditional Chinese medicine,in order to provide some reference for the clinical standardized treatment of AIS with traditional Chinese medicine.Methods:To screen AIS patients hospitalized in huayuanshan hospital,Department of encephalopathy,Hubei Hospital of traditional Chinese medicine from November 2019 to November 2021,collect and record their hospitalization data,extract the required data,establish a database,and conduct a statistical study on the relationship between TCM Syndrome Types and risk factors by logistic regression analysis;Excel 2019,SPSS statistics 28.0,SPSS mold 14.1,R and other software were used to carry out frequency statistics,association rules,cluster analysis and network pharmacology analysis on the standardized traditional Chinese medicine.Results:1.A total of 146 patients were included,including 89 males and57 females,with a male to female ratio of 1.5614:1.The patients’ ages are mainly 60-69 years old and 70-79 years old,accounting for67.8% of the total study population.AIS patients are often complicated with hypertension,dyslipidemia,diabetes and other diseases.2.75cases（51.37%）of TCM syndrome types were wind phlegm blocking collaterals,followed by 28 cases（19.18%）of qi deficiency and blood stasis syndrome,19 cases（13.01%）of disturbance of wind Yang,16 cases（10.96%）of yin deficiency and wind movement syndrome,5 cases（3.42%）of phlegm heat viscera syndrome and 3 cases（2.05%）of others;3.The risk factors of wind phlegm Blocking Collaterals syndrome were gender and hyperhomocysteinemia（P < 0.05）;The risk factors of qi deficiency and blood stasis syndrome were gender（P <0.05）;The risk factors of wind Yang disturbance syndrome were age and hypertension（P < 0.05）;The risk factor of yin deficiency and wind movement syndrome was hypertension（P < 0.05）;The risk factors included in this study have no significant correlation with phlegm heat Fu syndrome.4.A total of 222 prescriptions of traditional Chinese medicine were obtained,involving 219 flavors of traditional Chinese medicine,with a total frequency of 3170 times.The ones with a frequency of use of traditional Chinese medicine ≥ 100 times were Ligusticum chuanxiong,Angelica sinensis,Poria cocos,licorice,Pinellia ternata,Astragalus membranaceus and Atractylodes macrocephala;According to the classification of drug efficacy,the top five categories of frequency are tonifying deficiency drugs,promoting blood circulation and removing blood stasis drugs,resolving phlegm,relieving cough and asthma drugs,calming liver and calming wind drugs and clearing heat drugs;The medicinal properties are mainly "warm and flat",the five flavors are mainly "sweet,pungent and bitter",and the meridians are mainly "liver,spleen and lung".5.Four new candidates were obtained by cluster analysis;The correlation network diagram shows that Angelica sinensis,Ligusticum chuanxiong,Pinellia ternata,astragalus,tangerine peel,Poria cocos,Atractylodes macrocephala and licorice are closely related;The drug combinations with high support and confidence include tangerine peel Zhuru,Astragalus Atractylodes macrocephala,Uncaria multiflorus,Rehmannia glutinosa and Ophiopogon japonicus.6.Select the strongly linked drugs in the association network diagram,i.e.Angelica sinensis,Ligusticum chuanxiong,Pinellia ternata,Astragalus membranaceus,tangerine peel,Poria cocos and Atractylodes macrocephala for network pharmacological analysis.The main effective active ingredients are 69 and 212 potential targets（after weight removal）,4031 potential targets of AIs are screened,and the intersection targets of drugs and diseases are 182.The visual network diagram of active ingredients and targets shows quercetin,kaempferol,naringin Kaempferin is the core active ingredient.PPI network diagram shows Jun,TP53,mapk3,myc and HIF1 A are the core targets.Go enrichment is mainly concentrated in the response to hypoxia and oxidative stress.KEGG is mainly related to fluid shear stress and atherosclerosis,IL-17 signal pathway,TNF signal pathway and other signal pathways.Conclusion:1.The sex ratio of men and women is 1.5614:1,which has obvious difference.The age of patients is mainly concentrated in the age groups of 60-69 and 70-79,suggesting that elderly patients,especially men,should pay more attention to the prevention of AIS.2.AIS disease is mixed with deficiency and excess.The syndrome of wind phlegm blocking collaterals is the most common in clinic.The risk factors of AIs have a certain correlation with TCM syndrome types.The risk factors of wind phlegm stasis syndrome are gender and hyperhomocysteinemia;The risk factor of qi deficiency and blood stasis syndrome is gender;The risk factors of wind Yang disturbance syndrome are age and hypertension;The risk factor of yin deficiency wind movement syndrome is hypertension.It can provide a theoretical basis for the systematic prevention and treatment of AIS.3.Combined with syndrome type,high-frequency single drug use,high-frequency drug category,four Qi,five flavors and meridian analysis,this study believes that tonifying qi and blood,resolving phlegm and removing blood stasis are the main treatment direction of AIS.4.The core drug pairs and new prescription groups selected by association rules and cluster analysis meet the requirements of TCM syndrome differentiation,and various analyses based on association rules have internal identity,which also shows that this analysis has high credibility and can provide reference for clinical medication and better treat AIS.5.In the network pharmacological analysis,it is concluded that the core traditional Chinese medicine components（Angelica sinensis,Ligusticum chuanxiong,Pinellia ternata,Astragalus membranaceus,tangerine peel,red peony root,Poria cocos,Atractylodes macrocephala）regulate the fluid shear stress and atherosclerosis pathway,AGERAGE signal pathway,IL-17,TNF and other signal pathways in diabetes complications through mapk3,Jun,TP53,AKT1,H1F1 A and other targets,and play a role in inhibiting cell apoptosis,antiinflammatory,anti-oxidation,promoting angiogenesis,reducing lipid,etc. |
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