| Purpose:This paper aims to explore the characteristics and evolution of TCM syndromes of angina pectoris of coronary heart disease in different years in order to provide reference for TCM clinical prevention and treatment of angina pectoris of coronary heart disease in the future.Methods:1.Literature research:By comprehensively searching literatures related to TCM syndrome of coronary heart disease and angina pectoris from CNKI,Wanfang Database,VIP Information Resource System,and China Biomedical Literature Database from the establishment of the database to August 2022,the final included literatures were obtained after strict screening according to the exclusion criteria,and the TCM syndrome type and syndrome element information of patients were extracted to establish an Excel database.Through statistical analysis,the characteristics and evolution of TCM syndrome of angina pectoris of coronary heart disease in different years were obtained.2.Clinical research:A cross-sectional study was conducted on inpatients and outpatients diagnosed with angina pectoris of coronary heart disease in the Department of Cardiology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January2020 to January 2023.The symptoms,signs,tongue and pulse of the patients were extracted and the relevant data were statistically analyzed.To explore the distribution characteristics of TCM syndrome types and syndrome elements during this period.Results:1.Literature research:Finally 113 literatures were included,a total of 26928 patients with angina pectoris of coronary heart disease.The statistics were carried out from three aspects of syndrome type,syndrome element and evolution law,and the contents included in each aspect were ranked from high to low according to the composition ratio.(1)Syndrome type: 74 TCM syndrome types were sorted out in the included literature,among which empirical(42.54%),deficiency(35.25%),and mixed syndrome(22.21%).The main diseases were Qi deficiency and blood stasis(15.30%),blood blood stasis(9.53%),deficiency of heart qi(9.26%),phlegm obstruction of heart pulse(9.11%),deficiency of Qi stagnation and blood stasis(8.63%),deficiency of heart Yin(8.40%),deficiency of heart Yin(7.74%),interjunction of phlegm and blood stasis(5.73%)and deficiency of heart Yang(3.73%).(2)Syndrome elements: Eighteen kinds of TCM syndrome elements and 13 kinds of disease syndrome elements were extracted,among which solid syndrome elements(53.88%),deficiency syndrome elements(46.12%),Blood stasis(29.40%),Qi deficiency(24.80%),Yin deficiency(15.50%),phlegm(12.20%),qi stagnation(6.30%),Yang deficiency(4.90%),cold(3.60%);There were 5 kinds of syndrome elements,including heart(87.40%),kidney(9.20%),spleen(1.95%),liver(1.34%)and lung(0.11%).(3)Evolution law:The cases in the literature involved five decades: 1980 s,1990s,early 21 st century,2010 s,and 2020 s.In the 1980 s,deficiency of heart qi(46.79%)and deficiency of heart Yin(45.84%)were the main syndromic types,which basically showed a decreasing trend since the 1990 s.The deficiency of qi and Yin(1.48%→2.84%→11.82%→11.98%→6.48%),the phlegm-obstructed heart pulse(1.53%→4.11%→11.01%→12.57%→15.76%)increased year by year.The proportion of Qi-deficiency and yin-deficiency syndrome elements in 1980 s was significantly higher than that in other years,and the Sputum(2.40% → 9.03% → 13.00% → 13.90% → 13.40%),the kidney(0.35%→6.4%→17.48%→12.46%→19.61%)showed an upward trend year by year,while the other syndrome elements showed no obvious change regularity in different years.2.Clinical research:A total of 189 patients with angina pectoris of coronary heart disease were included.(1)General information: Among the 189 patients,105 were males and 84 were females,with more males than females.The patients were mainly aged 50-79 years old,and hypertension,diabetes and dyslipidemia accounted for a large proportion of complications.(2)Syndrome type: the majority of syndrome were mixed with deficiency and reality,accounting for 70.37%.Specific syndrome types were interjunction of phlegm and blood stasis(9.00%),deficiency of Qi and blood stasis with phlegm and blood stasis(9.00%),deficiency of Qi and Yin with interjunction of phlegm and blood stasis(7.41%),deficiency of qi and blood stasis with blood stasis of Qi and Yin(4.23%),stagnation of Qi and blood stasis with blood stasis of Qi and Yin(3.70%).(3)syndrome-elements: A total of 18 syndrome-elements were extracted,including 11 pathologic syndrome-elements,among which 65.79% were solid syndrome-elements and 34.21% were deficiency syndrome-elements,mainly blood stasis(26.77%),phlegm(22.52%),qi deficiency(17.02%),Yin deficiency(14.89%)and qi stagnation(8.87%).There were 7 kinds of syndrome elements,mainly heart(36.77%),spleen(25.68%),kidney(25.15%)and liver(9.15%).The statistical results of syndrome elements distribution in clinical and literature showed that the syndrome elements in phlegm,spleen,kidney and liver were increased compared with those in literature,while the syndrome elements in heart were decreased compared with those in literature,with statistical difference(p<0.05),while the changes of remaining syndrome elements were not statistically different(p>0.05).Conclusions:1.The TCM syndrom of angina pectoris of coronary heart disease in different ages are roughly in line with the characteristics of deficiency and solid.The main TCM syndrom types and syndrom elements are basically the same,but their composition ratio changes with the ages.2.The solid syndrome of angina pectoris of coronary heart disease is mainly composed of blood stasis,phlegm turbidness and qi stagnation,while the deficiency syndrome is mainly composed of qi deficiency,Yin deficiency and Yang deficiency.Compared with syndrome elements of different ages,syndrome elements of phlegm turbidity showed an increasing trend with age,while syndrome elements of qi deficiency and Yin deficiency were reduced year by year.3.The pathogenesis of angina pectoris of coronary heart disease is mainly heart,involving spleen,liver,kidney and other viscera.Compared with the disease location syndrome elements of different ages,the kidney syndrome elements showed an increasing trend,while the spleen and liver syndrome elements increased in the 2020 s. |
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