| ObjectiveReveal the Cum-phase and Conversion of pathogenesis of phlegm,phlegm,sputum,heat and deficiency in chest cramps(CHD),and explore the methods of ancient and modern physicians treating thoracic cramps(CHD).To provide the study of chest cramps(CHD)pathogenesis with reference,guide and improve the clinical diagnosis and treatment.Methods 1.Methods of collecting medical recordsThe method of combining computer search and manual search was used to collect the medical records of ancient medical records and the five contemporary Chinese medicine doctors.The collected medical records were strictly screened and arranged in according to the inclusion and exclusion criteria.2.Establishment of the databaseAfter the terminology was standardized for the medical case,a data entry pool was formed,and the data entry pool was used as the basis for the entry of medical records.3.Statistical methodsThe medical record database was imported into SPSS 21.0 software.The frequency analysis method was used to analyze the frequency of symptoms,the frequency of drug use,the drug's four characteristics,five flavors,and the classics and types of drugs.The frequency of medical records was screened.High-frequency drugs,statistical drugs four sex,five flavors,return,type,according to this rough inference chest(CHD)pathogenesis elements,while providing initial data for follow-up other data analysis methods for reference.In the factor analysis process,correlations between high-frequency drugs and high-frequency symptom variables were analyzed to determine whether the data meet the requirements of factor analysis,and principal component analysis was used as a factor analysis method to extract common factors.Factor analysis was used to extract high-frequency symptoms and common factors in high-frequency drugs,summarize the potential symptom combinations and potential drug combinations in the medical case,and derive the combination of potential pathogenesis and potential pathogenesis with potential symptom combinations and potential drug combinations.Cluster analysis of high-frequency symptoms and high-frequency drugs,according to the results of cluster analysis,the combination of the symptoms in the medical case and drug combination,and based on the combination of symptoms and drug combinations to derive the combination of pathogenesis and pathogenesis of medical records.ResultsThe data analysis results of 108 ancient medical cases,38 medical works,201 medical records of Chinese medical masters,and 41 books and literature obtained from the data analysis of ancient medical records and medical records of Chinese medical masters are as follows: 1.Research of Ancient medical cases 1.1 Symptom StudyThrough the frequency analysis of the symptoms of ancient medical records,the high-frequency symptoms and high-frequency pulse in ancient medical records were obtained.The analysis of high-frequency symptoms and high-frequency pulse results in the diagnosis of chest disease and heart-phase organs,details as follows:Phase and organs:(1)Spleen and stomach: stomach cramps,poor appetite,epigastric pain,poor diet,vomiting(2)lungs: belching,coughing,wheezing,shortness of breath According to the ancient medical records of high-frequency symptoms,pulse rough derivation of the chest pathogenesis,as follows:High-frequency symptoms: chest pain,belching,back pain,chest pain,thorough shoulders,cold limbs,vomiting,stomach cramps,poor diet,stomach cramps,palpitations,wheezing,poor appetite,shortness of breath,and cold back.High frequency pulse: pulse string,pulse fine,pulse number,pulse astringent,pulse sinkPhase and organs:(1)Spleen and stomach: stomach cramps,poor appetite,epigastric pain,poor diet,vomiting(2)lungs: belching,coughing,wheezing,shortness of breath.According to the ancient medical records of high-frequency symptoms,pulse rough derivation of the chest pathogenesis,as follows:(1)Yang deficiency-cold limbs,back cold,thin pulse.(2)hot evil-pulse number.(3)blood stasis-pulse astringent.(4)Qi stagnation-stomach cramps,belching,pulse string.(5)qi deficiency: heart palpitations,shortness of breath,wheezing,poor appetite,pulse.According to the results of cluster analysis of high-frequency symptoms and pulse conditions in ancient medical records,the deduced pathogenesis and pathogenesis combination are as follows:(1)lack of energy,chest and Yang deficiency,drinking water within the stop,lung gas upside down-shortness of breath,pulse Shen,palpitations,wheezing,cough,back cold,belching;(2)spleen and stomach qi stagnation,stomach supine-stomach suffocation,diet Poorly pharyngeal,vomiting,poor appetite,pulse string;(3)Yang or Yang Yu-chest pain thorough back,back pain,chest pain,cold limbs;(4)heat and phlegm-pulse number,pulse astringent.By correlating the high-frequency symptoms of ancient medical records,KMO test and Bartlett's sphere test,the data of high-frequency symptoms in ancient medical records could not meet the requirements of factor analysis,and the underlying diseases in the high-frequency symptoms of ancient medical records could not be analyzed.machine.1.2 Drug ResearchThrough the analysis of the frequency of drugs in ancient medical records,the high-frequency drugs in ancient medical records are as follows:Phlegm drugs: Pinellia,Gualou,melon peel,inula,almonds,ginger;Qi drugs: Poria white,dried tangerine peel,Citrus aurantium;Huoxue Huayu drugs: turmeric,peach kernel;Qi drugs: Ginseng,Atractylodes,Licorice,Poria;Wenyang medicine: dried ginger,cassia twig;blood medicine: white peony.Based on the frequency analysis of the nature,types of drugs,and drug categories contained in the ancient medical records,we obtained:Taste: Xin Wen Yao drugs up,followed by cold,bitter,sweet,flat nature.Guijing: After the lung,spleen,stomach,heart,followed by the liver and kidney.Drug categories: phlegm drugs,Qi drugs,qi drugs,warm Yang drugs,blood circulation drugs are used more often.Through the factor analysis of the ancient medical records of high-frequency drugs,the potential drug combination was derived,and the combination of the underlying pathogenesis and pathogenesis in the ancient medical case was derived as follows:(1)qi stagnation and blood stagnation-Gualou,white turmeric,turmeric,Citrus aurantium;(2)Yangxu Shuiyin-cassia twig,ginger;(3)Yangde cold stagnation Qi stagnation-Citrus,ginger,melon skin;(4)Spleen(qi)deficiency-Atractylodes;(5)blood deficiency blood stasis-Angelica;(6)liver and spleen does not,blood deficiency and Tianjin-white peony root,licorice;(7)blood stasis-peach kernel;(8)stomach upside down-invert.Based on the results of cluster analysis of ancient medical records of high-frequency drugs,the categories of pathogenesis and pathogenesis combination in ancient medical records are derived as follows:(1)ginseng Tangfang: spleen and stomach yang deficiency,cold sputum upside down;(2)orange sputum ginger decoction: stagnation of drinking stagnation,gas stagnation in the middle;(3)wolfberry almond licorice: drinking stop stagnation,water drinking emphasis;(4)four Reverse scattered or Bupleurum Shugansanhuanzhi-Yang Yu or qi stagnation;(5)Taohong Siwu Tang Fang: blood stasis;(6)Xuanfu Daibantang class: heart and stomach with the disease,stomach Qi reverse;(7)Zhuo Gancao Decoction : Water drink;(8)Guizhi ginger Gorgon soup: cold drink qi stagnation;(9)Gualou white agent: Yang deficiency,phlegm drink,qi stagnation;(10)Er Chen Tang: CD dampness.2.Research of Chinese Medicine Master Medical Cases 2.1 Symptom StudyThrough the analysis of the symptoms of contemporary Chinese medicine doctors' medical cases,the high-frequency symptoms,high-frequency pulse and high-frequency tongue images in the medical records of the doctors of the national medical department were obtained,and the high-frequency symptoms,high-frequency pulse and high-frequency tongue images were adopted.Analyzes the internal organs of the coronary heart disease and the heart,as follows:High-frequency symptoms: belching,chest pain,heart palpitations,shortness of breath,dizziness,fatigue,loss of appetite,poor appetite,upset,sweating,dry mouth.High-frequency pulse: pulse string,pulse Shen,pulse fine,pulse number,pulse delay,pulse knot,pulse astringent.High frequency tongue image: tongue licking,red tongue,pale tongue,white fur,slippery moss,greasy moss,thin fur,less moss,yellow fur.Phase and organs:(1)spleen and stomach: poor appetite(2)lung: hernia,shortness of breath.According to the high-frequency symptoms,high-frequency pulse and high-frequency tongue image of the national medical doctors' medical records,the chest pathogenesis is roughly deduced as follows:(1)Qi deficiency-palpitation,shortness of breath,dizziness,fatigue,poor appetite,pale tongue,and fine pulse.(2)yin deficiency-upset,insomnia,less moss,thready pulse.(3)blood stasis-dark tongue,pulse astringent.(4)sip,qi stagnation-moss slippery,greasy,pulse sinking,pulse string.(5)cold drink stopped-dry mouth,pulse late.(6)hot-upset,pulse count.(7)Qi and blood deficiency-chest pain,belching,heart palpitations,pale tongue,pulse.A cluster analysis of the high-frequency symptoms,pulse and tongue images in the Chinese medicine master coronary artery disease medical case,according to the cluster analysis results,the high-frequency symptom combination of the Chinese medical master coronary artery disease medical case was derived,and the pathogenesis derived therefrom was derived.The pathogenesis is as follows:(1)Heat-yellow moss,greasy moss,poor appetite,belching,dry mouth,pulse delay;(2)enthusiasm-upset,insomnia,tongue spasm,pulse string;(3)qi and yin deficiency,both hot-tongue Red,pulse,slippery pulse,palpitation,dizziness,and lack of moss;(4)Qi and blood deficiency-pale tongue,white coating,shortness of breath,fatigue,thin coating,fine pulse;(5)blood stasis or blood deficiency-pulse,pulse,pulse Shen,sweat out.The factor analysis of the high-frequency symptoms,pulse,and tongue in the medical doctor's case of coronary artery disease was performed.Based on the results of factor analysis,the underlying pathogenesis of coronary heart disease was as follows:(1)Damp heat-yellow moss,greasy moss,red tongue;(2)lack of blood-shortness of breath,fatigue,dizziness,sweating,pale tongue;(3)yin deficiency heat-less moss and upset,insomnia;(4)cold drink stopped-Dry mouth and pulse are late.2.2 Drug ResearchThrough the analysis of the frequency of the medicines of the doctors in the Chinese medicine doctor's case,the high-frequency medicines in the medical doctors' case are as follows:High-frequency drugs: tonic: wolfberry,licorice,Atractylodes,Codonopsis,Angelica,Astragalus,Angelica,Schisandra,Ophiopogon japonicus,ginseng,heterophylla;phlegm drugs: Pinellia,Gualou,Shichangpu,white,Zhuru Bile Nanxing;Blood circulation and phlegm medicine: Salvia miltiorrhiza,Chuanxiong,red peony,Puhuang,peach kernel,safflower,turmeric,Corydalis yanhusuo;Wenyang medicine: Guizhi,Fuzi,ginger,Asarum;qi medicine: tamping,Citrus aurantium,orange peel.An God medicine: Raw oysters;heat medicine: Coptis.The frequency analysis of the taste,the classics,and the drug category of all the medicines in the Chinese medicine doctor's case was as follows:Taste: Gan,warm,bitter and pungent drugs are used more often than cold drugs.Qualifications: There are more drugs for the spleen,heart meridians,liver meridians,lung meridians,stomach meridians and kidney meridians.Drug categories: The use rate of blood circulation and phlegm drugs,qi drugs,phlegm drugs,qi drugs,heat-clearing drugs is high.A cluster analysis was performed on the high-frequency medicines of the doctors of the Chinese medicine doctors for coronary heart disease.Based on the analysis results,the classifiers with the same pathogenesis or pathogenesis combination in the medical case were obtained.The results are as follows:(1)Guizhi plus Aconite Angelica Asarum Ginseng Dried Ginger Decoction and Shixiaosan(formerly to go Wulingzhi)in the category of Fang-Yangxu,Hanning,Qixue Deficiency and Blood Stasis;(2)Taohong Siwu Tang or Xuefu Zhuyu Soup and Jinlingzi Powder-qi stagnation and blood stasis;(3)Shengmaisan or Huangpi Shengmai Powder-Qi and Yin Deficiency;(4)Melon Whitening Agent-Qiyin;(5)Huanglian Wendan Decoction-Tangre fever;(6)Sijunzi Decoction-Qi deficiency;(7)Salvia,Pinellia-blood stasis,dampness.Through factor analysis of the high-frequency medicines of the Chinese medicine master coronary disease medical record,the potential drug combination in the medical case was drawn,and its potential pathogenesis and pathogenesis combination was deduced as follows:(1)Yang Deficiency Han Ning-Fuzi,Guizhi,Zingiber,Asarum;(2)Blood Sputum-Radix Paeoniae Rubra,Rhizoma Chuanxiong,Peach Kernel,Saffron,Corydalis,Salvia miltiorrhiza;(3)Qi stagnation-resistance-Citrus aurantium,Shichangpu,Bile Nan Xing,Gualou,wolfberry white;(4)Spleen Qi-wolfberry,Atractylodes;(5)yin-Ophiopogon,Schisandra;(6)qi deficiency-Codonopsis,Astragalus;(7)yin deficiency Yangshuo-Baiji,raw oysters.3.Compare and analyze ancient and modern medical cases 3.1 Comparison and analysis of symptomsComparing the statistical analysis results of the high-frequency symptoms between the ancient medical case and the contemporary five national medical doctors' medical cases,it can be concluded that in ancient and modern medical cases,hernia and chest pain are the two highest percentages of symptoms.These two symptoms are also the main symptoms of coronary heart disease(CHD).In addition,palpitations,shortness of breath,and poor appetite are common symptoms that occur in addition to the main symptoms in the high-frequency symptoms of ancient and modern medical records.These three symptoms are heart and spleen.The common clinical manifestations of the two deficiency syndromes reflect the consensus of ancient physicians and masters of modern Chinese medicine on the understanding of chest(coronary heart disease): In addition to the heart,chest(heart disease)is also related to the spleen,caused by deficiency of heart and spleen.The clinical manifestations were mainly qi deficiency.Comparing the pathogenesis derived from the high-frequency symptom clustering analysis results of the ancient medical case and the master medical doctor's case,we can see that in the pathogenesis analysis of the ancient and modern medical cases,the sputum,wetness,heat,phlegm,and deficiency are common to both.Pathogenesis.In the virtual pathogenesis,the ancient medical case was dominated by yang deficiency,and the national medical doctor's medical case was more concentrated on "deficiency of blood and blood" and "deficiency of both qi and yin." In addition to the heart,the spleen and stomach are the common points of the ancient and modern doctors' understanding of the disease location of the chest.3.2 Comparison and analysis of drugComparing the four ancient and modern medicines,the four drugs,five flavors,and the menstrual flow,we can conclude that the ancient and modern doctors use the drugs in warm,cold,and flat areas,and that they are sympathetic,bitter and sweet.Hand Taiyin lung,Foot Taiyin spleen,foot Yangming stomach meridian,foot yin yin liver through the majority of drugs.Xin Gan Hua Yang,Gan Han Yin,bitter temperature can dampness,drug test can be speculated that ancient and modern physicians believe that the pathogenesis of chest(coronary heart disease)when there is yang,yin deficiency,dampness,chest(CHD The disease position does not stop at the heart and is related to more dirty.Through comparative analysis of ancient and modern drug categories,it can be concluded that the proportions of phlegm-resolving drugs,qi drugs,qi-invigorating drugs,and blood circulation and phlegm-removing drugs accounted for a relatively high proportion in ancient medical cases and national medical doctors' medical cases,reflecting the ancient and modern medical families from dampness,Qi lag,qi deficiency,blood stasis angle understanding of chest pathogenesis consensus.In ancient and modern medical records of high-frequency drugs,both used phlegm drugs: Pinellia,Gualou;qi drugs: Chinese wolfberry,licorice,Atractylodes,ginseng;qi drugs: white peony,orange peel,Citrus aurantium;Guizhi,dry ginger;Yin and blood medicine: Angelica,Angelica;blood circulation drugs: turmeric,peach kernel.With drug testing,it can be seen that ancient and modern physicians have a consensus on chest(coronary heart disease)phlegm,qi deficiency,qi stagnation,yang deficiency,yin deficiency(blood deficiency),and blood stasis pathogenesis.It reflects the ideas of supplementing qi,eliminating phlegm,promoting blood circulation,and regulating qi in the process of treating the chest(chiral heart disease).Conclusion 1.Literature research1.1 The historical changes of the chest disease position: The book described in the ancient medical book covers a wide range of areas.It can be summarized by non-contemporary medicine or by a disease.Therefore,when the coronary heart disease is studied through the ancient chest medical case,it is necessary to use the chest card according to the ancient medical thesis.The contemporary research on the treatment of coronary heart disease was conducted in detail and the medical records belonging to coronary heart disease in the medical treatment of ancient chest were delineated as research objects.1.2 Research on the theory of pathogenesis The essence of the theory of pathogenesis is to explore the relationship between different pathogenesis of diseases,and to sum up the mutual coexistence and mutual transformation between the pathogenesis of the disease by "concurrent" and "transformation," which is to connect the various pathogenesis of the disease.Elements,the formation of diseases and disease mechanisms,elaborated the theory of the internal network of complex pathogenesis.The theory of pathogenesis and integration includes the integration of disease and evil,the sandwich and change of disease,and the compound and transmission of disease location.In the process of pathogenesis,the main factors affecting the pathogenesis of diseases are the rise and decline of evil spirits,physical factors,the pathogenic characteristics of the disease,external regions,climatic factors,and life factors.1.3 Cognition of pathogenesis of coronary heart disease(CHD)The pathogenesis of coronary heart disease(chest)involves two aspects: the deficiency of qi,the deficiency of yang,the deficiency of yin deficiency(deficiency of blood),and the loss of viscera.The pathogenesis of corporal pathogenesis is qi stagnation,cold coagulation,and dampness.Mainly bloody and hot Yu.1.4 Coronary heart disease pathogenesis theory research In the process of occurrence,development,change and outcome of coronary heart disease,imaginary and factual are the two key elements of the pathogenesis and transformation of the pathogenesis.Among these,the functional changes of the organs,blood,blood,fluid,and essence,and actual conditions.The amount,transmission and transshipment as well as their inter-relationships constitute the basis for the occurrence of concurrent pathogenesis of coronary heart disease.The serious loss of air,blood,fluid,fluid,and fineness in the body,severely destroys the relationship between interoperability and mutualization,and constitutes the pathological basis of the pathogenesis of coronary heart disease “ virtual deficiency”.On the basis of the “virtual” pathogenesis,Qi,The functions of blood,fluid,fluid,and essence are severely limited and cannot function normally.If the transmission and transport are blocked,then the wet,phlegm,and oysters are born.These pathological products can become new pathogenic factors.In turn,the “virtual” is aggravated,and on the other hand,these new pathogenic factors are accumulated in the human body for a long period of time and they can produce heat.The heat can also cause poison and rot,damage the heart muscle,aggravate “virtual”,and various “ben The "virtual" and "compounding" pathogenesis transformed into suffering in such a cycle,supporting the entire pathogenesis of coronary heart disease.2.Medical case studythe Understanding of chest pathogenesis which is Summarized by ancient medical doctors and national doctors contains two aspects:deficiency and excess.The deficiency is due to deficiency of qi,deficiency of yin(blood),and deficiency of yang.The excess causes by qi stagnation,cold condensate,heat turbidity,ampness,blood stasis.disease locations of chest are lungs,spleen and stomach as well as heart,which prompted the chest(coronary heart disease)in the treatment follow the clinical trial direction of "inseparable,not only the heart".As a result,In terms of treatment,we should take into account both deficiency and excess.3.The methods of treating chest obstruction(coronary heart disease)by ancient and modern doctors can be summed up as grasping the main disease,recognizing the pathogenesis,emphasizing phlegm and blood stasis,regulating qi,caring for spleen and stomach,not forgetting deficiency.4.The pathogenesis of coronary heart disease is summarized as follows: deficiency is the basic pathogenesis that runs through the whole course of coronary heart disease,and it is also the starting factor of the whole course of the disease.The pathogenesis of phlegm and blood stasis is the key to the progress and change of the course of coronary heart disease.However,in different stages of development,they have their own main pathogenesis.Early coronary heart disease patients are often complicated with metabolic syndrome,and dampness and evil are the main contradictions of the pathogenesis.The attack period is often the acute or unstable period of coronary heart disease.The symptoms were acute coronary syndrome,heat evil was the main pathogenesis.The remission stage was mainly after PCI or CABG treatment or drug control of patients with relatively stable condition,at this time,the deficiency of venereal disease was the main clinical contradiction.Especially,the pathogenesis of deficiency of Qi and Yin is more,and the end stage is mainly of heart failure,with both yin and yang damage as the main clinical pathogenesis. |
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