Study On The Correlation Between Syndrome Characteristics And Cardiopulmonary Function In Patients With Coronary Heart Disease After PC

Study 1Objective:To explore the clinical medication rule and core pathogenesis of patients with coronary heart disease after PCI,and to provide evidence for clinical medication.Method:The prescription information of patients with coronary heart disease after PCI from Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 2020 to December 2020 was screened according to the sodium standard,and an EXCEL database was established to strictly standardize the data.Through data mining software,statistical analysis,association rule analysis and cluster analysis were carried out on drug frequency,four qi and five flavor,normalization and drug category of traditional Chinese medicine prescriptions,so as to summarize medication rules of patients with coronary heart disease after PCI,and explore the core pathogenesis.Results:204 prescriptions were collected in this study,among which 198 drugs were included.The high frequency drugs were Chuanxiong rhizoma,salviorrhiza miltiorrhiza,Red peony root,Astragalus,Radix Pinella francium,Trichosanthes fructus,Tangerine peel,Golden tulip,Angelica sinensis and Codonopsis.The drugs with high frequency were classified as activating blood circulation and removing blood stasis,tonifying deficiency,regulating qi,reducing phlegm and relieving cough and asthma,and improving water and dampness.Warm drugs were the main drugs,followed by cold,calm,heat and cool drugs.Bitter drugs were the main drugs,followed by occinative drugs,sweet drugs,sour drugs,salty drugs,light drugs,astringent drugs appeared less frequently,and most of the channels were into liver,lung,spleen and heart channels.The commonly used drugs were drugs for promoting blood circulation and removing blood stasis,followed by drugs for tonifying deficiency,clearing heat,reducing phlegm,relieving cough and antiasthmatic,regulating qi and regulating water and dampness.The commonly used drugs are Trichosanthes,Allium macrostemon-Pinellia,Pinellia farinae,Allium macrostemon-Trichosanthis,Pinellia farinae,Trichosanthis-Allium macrostemon,Salvia miltiorrhiza,Trichosanthis-pinellia,Allium macrostemon-Pinellia ternata,Salvia miltiorrhiza,Allium stemon-Trichosanthes,Salvia miltiorrhiza,Allium macrostemon-Pinellia Trichosanthis-Pinellia farinae,Drug cluster analysis showed that the first class was Ligusticum chuanxiong,Salvia miltiorrhiza,red peony root,Astragalus membranaceus,Tangerine peel,fried licorice root.The second category is Ligusticum chuanxiong,Salvia miltiorrhiza,red peony root,Safflower,Pinellia farinae,Tulips;The third class was Pinellia farinae,Astragalus membranaceus,Rhizoma coptidis,Salvia miltiorrhiza,citrus peel,Trichosanthis fructus;The fourth category is salvia miltiorrhiza,Chuanxiong Rhizoma,red peony root,Codonopsis rhizoma,Atractylodes rhizoma,citrus peel;The fifth category is red Peony root,salvia miltiorrhiza,Astragalus,Chuanxiong,Poria,Tangerine peel.Conclusion:The basic etiology and pathogenesis of patients with coronary heart disease after PCI are deficiency and deficiency,and the core pathogenesis is Qi deficiency and blood stasis.In addition to supplementing deficiency,drugs should also be used to remove pathogenic factors.The treatment methods mainly include supplementing Qi and promoting blood circulation,regulating qi and promoting blood circulation,clearing heat and promoting blood circulation,removing phlegm and promoting blood circulation,and promoting water and blood circulation.Study 2Objective:To observe the correlation between syndrome elements and cardiopulmonary function indexes of patients with coronary heart disease after PCI through retrospective study,and to provide objective basis for clinical diagnosis of patients with coronary heart disease after PCI.Method:Patients with coronary heart disease from Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 1,2022 to December 31,2022 were collected according to the natrol standard.The syndrome elements were extracted according to the four diagnosis information,and the differences of cardiopulmonary exercise test indexes between patients with coronary heart disease and those after PCI were analyzed.Moreover,by analyzing the differences between the syndrome elements of patients with coronary heart disease and the syndrome elements of patients with coronary heart disease after PCI and the cardiopulmonary exercise test indexes,binary logistics regression analysis of the indexes with differences was conducted to analyze the correlation between the syndrome elements and cardiopulmonary exercise test indexes.Results:A total of 94 patients with coronary heart disease were included,including 39 patients after PCI(41.5%),more males than females after non-PCI.No significant difference was found in age and co-morbidities between the two groups,and there was no difference in CPET index between patients with coronary heart disease and patients after PCI.MAX HR in patients with coronary heart disease was negatively correlated with phlegm turbiditin(OR=0.926,P=0.025<0.05),and the index associated with blood stasis syndrome after PCI was peakV02%pred(OR=1.055,P=0.045<0.05),the index related to sputum turbiditin after PCI was initial RER(OR=1.101,P=0.031<0.05).Conclusion:In the coronary heart disease group and the coronary heart disease group after PCI,the distribution of blood stasis syndrome was the most,followed by phlegm turbidification syndrome,indicating that patients with coronary heart disease mostly present the symptoms of phlegm and blood stasis,in line with the basic pathogenesis of chest obstruction and heart pain.Secondly,there is no significant difference in the CPET indexes between patients with coronary heart disease and patients after PCI,It may be due to the small sample size.Through mutual verification of CPET parameters and TCM syndrome elements,the accuracy of myocardial oxygen supply capacity and exercise endurance of patients after PCI can be improved.Combined with clinical biochemical index test results and ECG changes of patients,it is conducive to early screening of patients at risk after PCI,and TCM diagnosis,treatment and intervention.Thus,clinical symptoms and quality of life of patients can be improved more effectively,mortality and re-hospitalization rates can be reduced,and the occurrence of postoperative restenosis can be reduced,so as to give full play to the application value of CPET in the field of traditional Chinese medicine.