| Objective: Based on the related research of zongqi theory,combined with the physiological and pathological functions of zongqi and the etiology and pathogenesis of angina pectoris of coronary heart disease,this study preliminarily explored the feasibility of using zongqi theory to guide the diagnosis and treatment of angina pectoris of coronary heart disease.Through a retrospective study,the distribution characteristics and evolution of TCM symptoms of coronary angina pectoris were discussed.Finally,data mining was conducted based on the traditional Chinese medicine inheritance auxiliary platform to summarize the medication rule and academic experience of Professor Xu Zongpei in the clinical treatment of coronary heart disease angina pectoris,providing new ideas and clinical reference for the clinical treatment of the disease and the inheritance of academic experience.Research methods: 1 Theoretical study: Based on the retrieval and reading of TCM classics related to the theory of zongqi and the related discussion of CHD angina pectoris,the origin of zongqi theory is sorted out,the physiological and pathological functions of zongqi and the etiology and pathogenesis of CHD angina pectoris are summarized,and the feasibility of using zongqi theory to guide the diagnosis and treatment of coronary angina is preliminarily explored.2 Clinical study: In this study,we used retrospective research method to collect the basic data of patients with coronary angina pectoris,developed a clinical questionnaire of TCM syndromes,performed descriptive analysis and frequency analysis on the general data and four diagnostic information of patients,factor analysis was used to explore the main syndromes,and the distribution rules of TCM syndromes were summarized by factor analysis and cluster analysis.3 Study on law of drug use: According to inclusion and exclusion criteria,the case prescriptions of patients with angina pectoris of CHD diagnosed and treated by Professor Xu Zongpei’s clinic were collected to analyze the four qi,five tastes,meridian,the frequency of commonly used drugs and drug classes,and the dose of drugs to explore the pattern of prescription formation and then to explore potential new prescriptions.Research results: 1 Theoretical study: The theory of zongqi originated from Huangdi Neijing,developed in Atmospheric Theory in Ming and Qing Dynasties,matured in Shenxilu in Medical Center,and further studied in modern times.Zongqi is mainly composed of the inhaled air and the subtle qi of water and grain.It has the physiological functions of “breathing” and “penetrating the heart and veins”.The instructor believes that most patients with angina pectoris of CHD in modern clinical practice are mixed with deficiency and reality,and this deficiency is mostly due to lack of zongqi,and standard reality is mostly due to stagnation of zongqi.2 Clinical study:(1)General data statistical results: 610 patients with angina pectoris of coronary heart disease were included in this study,256 patients(41.97%)were male and 354 patients(58.03%)were female,and there were significantly more females than males;The oldest age was 92 years old and the youngest was 22 years old,mainly concentrated between 51 and 70 years old,accounting for 59.01%;(2)Results of the distribution of the four diagnostic information: The frequency statistics of the four diagnostic information of 610 patients showed that there were 38 four diagnostic information with frequency > 10%,among which chest tightness,breath-holding,and panic ranked the top three,accounting for 68.36%,66.89% and 54.43% respectively;In tongue image,purple dark tongue,white moss and greasy moss were more frequent.In pulse image,chord veins,sliver veins and fine veins were more common;(3)Factor analysis results showed that the pathological elements mainly included blood stasis,qi stagnation,phlegm and heat,and the pathological elements mainly related to liver,spleen,heart,lung and stomach;(4)Cluster analysis results: It was found that the distribution of symptoms was more reasonable when the symptoms were clustered into 4 categories,in which 24.59% of the syndrome of qi stagnation and blood stasis,23.77% of the syndrome of qi deficiency and blood stasis,35.90% of the syndrome of phlegm stagnation and blood stasis,and 15.74% of the syndrome of phlegm obstruction and heat accumulation.3 Study on medication rule:(1)The statistical results of the four gases,five tastes,and the attributive meridians of drugs: 570 prescriptions for angina pectoris in CHD were included in this study,involving 187 tastes of drugs.The four qi drugs were used most frequently with warm drugs,followed by cold drugs,flat drugs as auxiliary,and heat drugs least;Bitterness drugs were the most frequently used,followed by spicy drugs,sweet drugs as the auxiliary,and astringency drugs the least.The frequency of liver meridian was the highest,followed by spleen meridian,heart meridian,lung meridian and stomach meridian,and sanjiao meridian was the least;(2)Statistical results of frequency of drugs: There were 38 kinds of traditional Chinese medicines with the frequency of more than 50 times,and the top 10 drugs were yanhusuo,yujin,danshen,chishao,zhiqiao,jiegeng,wulingzhi,jiangxiang,zhigancao and guizhi;(3)Statistical results of frequency of drug classes:According to the classification of 38 commonly used drugs whose frequency of use was more than 50 times in the previous step,and it was found that drugs for promoting blood circulation and removing blood stasis were the most frequently used,accounting for 31.40%,followed by drugs for relieving phlegm,cough and asthma,relieving surface,clearing heat,tonifying deficiency and regulating qi,accounting for 15.45%,12.92%,11.03%,10.99%and 10.89% respectively.And dehumidifying drugs were the least,accounting for 0.81%;(4)Results of dose analysis of commonly used drugs: The top 10 commonly used drugs were selected for dose analysis,and the commonly used dose of yanhusuo,yujin,jiegeng,wulingzhi,jiangxiang and guizhi was 10 g,danshen was 20 g,chishao was 12 g,zhiqiao was15 g,zhigancao was 5g;(5)The results of the association rule analysis: There were 40 dosage patterns of 2 drugs used ≥ 454 times,and the top five dosage patterns were yanhusuo-yujin,yanhusuo-danshen,yujin-danshen,yanhusuo-chishao,chishao-yujin.There were 33 association rules with confidence of 1,and 10 core drugs were finally obtained by improving the support level;(6)The results of entropy cluster analysis: There were 19 drug pairs with association coefficients ≥ 0.016195 in the prescription,which in turn 22 core combinations were evolved,and 11 potential new prescriptions were mined.Conclusion: Professor Xu Zongpei held that the pathological changes of zongqi are always present in the development of coronary artery disease,and most of the clinical cases are characterized by deficiency and mixed deficiency,and this deficiency is mostly due to lack of zongqi,and standard reality is mostly due to stagnation of zongqi.Clinical studies have also shown that the syndrome of this disease is mostly deficiency and solid,single syndrome is rare.So we should pay more attention to the prevention and treatment of phlegm turbidity,blood stasis and other standard cases while giving consideration to specimens.The clinical use of herbal medicines are mostly cold and warm,pungent,open and bitter,and the core drugs are yanhusuo,yujin,danshen,chishao,zhiqiao,jiegeng,wulingzhi,jiangxiang,zhigancao and guizhi,which mainly promote blood circulation,resolve blood stasis,regulate qi,relieve pain and regulate qi flow,providing medication reference for clinical treatment. |
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