Systematic Evaluation Of Vertigo Treated By Chinese Medicine And Research On The Law Of "pulse Syndrome Treatment"

Objective: This study comprehensively collected the randomized controlled literature(RCT)of Chinese medicine in treating vertigo at home and abroad,systematically evaluated the clinical efficacy and safety of Chinese medicine in treating vertigo through evidencebased medicine methods,deeply explored the rule of syndrome and treatment of vertigo,explored the relationship between "pulse and syndrome" and provided decision-making evidence and diagnosis and treatment experience for clinical diagnosis and treatment of vertigo in Chinese medicine.Methods: 1.formulate retrieval strategies,search databases such as CNKI,CBM,wanfang and PubMed databases,establish criteria for inclusion and exclusion of documents,evaluate the quality of the included documents using the modified jadad scale score,extract general information of documents,research design types,basic information of patients,intervention measures,outcome indicators,and follow-up information,and establish a database.Meta-analysis of similar studies using revman 5.2 software and descriptive analysis of studies that cannot be combined to evaluate the clinical efficacy and safety of traditional Chinese medicine in the treatment of vertigo.2.select the randomized controlled literature of traditional Chinese medicine as the main treatment for vertigo,extract the name,author,source,published year,pulse condition,syndrome type,traditional Chinese medicine and other data of included study,input them into Microsoft office excel 2003 form to establish the original database,and convert them into standard database,use SPSS 20.0 statistical software to carry out frequency,frequency analysis,clustering analysis on sex,age,course of disease,syndrome element,pulse condition,syndrome type,traditional Chinese medicine and so on,and use the average addition and subtraction standard deviation to carry out statistical description on the measurement data,and use frequency and frequency description for the counting data;The SPSS modeler 18.0 statistical software is used to establish a model,apriori algorithm is used to carry out statistical analysis of association rules,the best confidence and support values are found by repeatedly setting corresponding confidence and support values,association rules of pulse condition,Chinese medicine itself and association rules between pulse condition,syndrome type and Chinese medicine are mined,and network association diagrams are made.Results: 1.evaluation of the efficacy and safety of traditional Chinese medicine in treating vertigo.(1)traditional Chinese medicine treatment alone: it is superior to western medicine control group in overall curative effect,vertigo disorder rating scale(dhi),TCM syndrome score,vertebral-basilar artery transcranial Doppler(TCD)average blood flow velocity,vertigo recurrence rate,and human health status(health status questionnaire SF-36);The adverse reactions of the traditional Chinese medicine group were slight,and there was no obvious difference between the traditional Chinese medicine group and the western medicine control group.the clinical use was safe.(2)traditional Chinese medicine combined with western medicine treatment: it is superior to western medicine control group in overall curative effect,TCM syndrome score,transcranial Doppler(TCD)average blood flow velocity,plasma viscosity,vertigo disorder score scale(dhi),European vertigo evaluation scale,and plasma no level.The adverse reactions of the traditional Chinese medicine combined with western medicine group were slight,and there was no obvious difference compared with the western medicine control group,so it could be used safely.2.the rule of vertigo syndrome treatment and the relationship between " pulse syndrome treatment".(1)rule of syndrome and treatment:(1)etiology and pathogenesis: the ratio of vertigo to vertigo is basically the same for men and women.the main age of onset is between 45 and 65 years old.the course of disease ranges from several minutes to several years.common past diseases include hypertension,vertebrobasilar artery insufficiency,posterior circulation ischemia,cervical vertigo,Meniere's disease,etc.Vertigo is closely related to liver,spleen and kidney.Phlegm,blood stasis,inverse qi,yin deficiency and yang hyperactivity are the main syndrome elements,while phlegm and blood stasis are the main pathogenic factors.(2)distribution of syndrome type: common pulse conditions in traditional Chinese medicine include string pulse,slippery pulse,thin pulse,astringent pulse,weak pulse,etc.common pulse conditions include string pulse,moist slippery pulse,real string pulse,slow weak pulse,weak thin pulse,etc.Phlegm and turbid upper Mongolia type,liver yang upper hyperactivity type,phlegm and blood stasis blocking collaterals type,liver and kidney yin deficiency type,qi and blood deficiency type are common TCM syndromes of vertigo in modern literature.(3)medication rule: common traditional Chinese medicines are astragalus membranaceus,oriental waterplantain rhizome,kudzuvine root,etc.Commonly used drugs include deficiency-tonifying drugs,liver-calming and wind-calming drugs,blood-activating and stasis-removing drugs,etc.Through cluster analysis,the drugs were grouped into 13 categories,namely,strengthening spleen,invigorating qi,eliminating phlegm,calming liver,subduing yang,promoting blood circulation,removing blood stasis,dredging collaterals,etc.Common compatibility rules of traditional Chinese medicines: Eucommia ulmoides and Achyranthes bidentata,Eucommia ulmoides and Uncaria bidentata can be used to treat dizziness caused by yin deficiency of liver and kidney.Ramulus uncariae cum uncis and Rhizoma gastrodiae,concha haliotidis and ramulus uncariae cum uncis,Herba taxilli and Rhizoma gastrodiae and radix achyranthis bidentatae can be used to treat dizziness due to hyperactivity of liver yang.Ginger,white atractylodes rhizome,dried orange peel and tuckahoe can be used to treat spleen failure and dizziness caused by turbid phlegm.(2)association of vertigo with " pulse syndrome and treatment" :(1)analysis of association between pulse condition and syndrome type: combination with high degree of association: syndrome of hyperactivity of liver yang,syndrome of moist and slippery pulse and syndrome of turbid phlegm,syndrome of weak astringent pulse and syndrome of qi deficiency and blood stasis,etc.(2)correlation analysis between syndrome type and traditional Chinese medicine: combinations with high correlation degree: tangerine peel,Pinellia tuber,atractylodes rhizome,tuckahoe and gastrodia tuber are commonly used for phlegm and turbid upper Mongolia syndrome;The syndrome of hyperactivity of liver yang is usually manifested by Uncaria rhynchophylla,Achyranthes bidentata and gastrodia elata.The syndrome of phlegm and blood stasis blocking collaterals is commonly used by Ligusticum wallichii,Pinellia tuber,tuckahoe,gastrodia tuber,etc.(3)correlation analysis between pulse condition and traditional Chinese medicine: combination with high correlation degree: Rhizoma gastrodiae,ramulus uncariae cum uncis,achyranthis radix,eucommiae cortex,concha haliotidis are commonly used in string pulse;Pericarpium citri tangerinae,Rhizoma atractylodis macrocephalae,Rhizoma Pinelliae,poria,and Rhizoma gastrodiae are commonly used for pulse skating.Weak arteries and veins are commonly used as astragalus membranaceus,codonopsis pilosula,atractylodes macrocephala,Cimicifuga foetida,angelica sinensis,etc.3.through in-depth excavation and analysis of the modern syndrome and treatment rules of vertigo,it is found that vertigo is located in the clear orifices.the main causes and pathogenesis are qi movement disorders caused by exogenous six evils,emotional internal injuries,food stagnation,chronic physical deficiency,fatigue and blood loss and other factors,resulting in qi deficiency or qi movement disorders.Disorders of qi movement include movement changes of qi such as inverse qi,qi stagnation,qi depression,qi closure,and qi withdrawal.they further evolve into changes of fire,phlegm generation,cessation of drinking,blood stasis,and so on.they form evolutionary pathogenesis and produce pathological changes such as wind,fire,phlegm,blood stasis,and deficiency,which disturb the clear orifices,prevent the clear yang from rising,or cause dizziness due to loss of vital essence and blood and loss of nourishment in the brain orifices.It is suggested that the movement disorder of qi is the basic pathogenesis of vertigo.Clinical syndrome differentiation is divided into deficiency syndrome,empirical syndrome and deficiencyexcess syndrome.To treat dizziness,the first thing is to regulate qi.regulating qi includes invigorating qi and regulating qi movement.The clinical diagnosis should pay attention to the application of pulse diagnosis,give full play to the objective diagnosis advantages of pulse diagnosis,adopt the integrated diagnosis and treatment mode of " pulse diagnosis and treatment" and combine other three diagnosis methods to differentiate and treat vertigo and improve the curative effect.Conclusions: 1.traditional Chinese medicine has a good clinical effect in treating vertigo,which is superior to western medicine group in improving TCM syndrome score,vertigo score scale,clinical biochemical indicators,etc.The adverse reactions caused by the drug were slight,and there was no obvious difference between the two groups.the clinical application was safe.2.relationship between vertigo syndrome and " pulse syndrome" treatment:(1)syndrome treatment rule: vertigo occurs in middle-aged and elderly people,and both men and women can be ill without obvious gender difference.Vertigo is closely related to liver,spleen and kidney.the main pathogenic factors are phlegm,blood stasis,inverse qi,yin deficiency,yang hyperactivity,qi deficiency,etc.The main causes and pathogenesis of vertigo are phlegm and turbid upper Mongolia,hyperactivity of liver yang,obstruction of collaterals by phlegm and blood,yin deficiency of liver and kidney and deficiency of qi and blood.phlegm and turbid upper Mongolia is the most common disease,followed by hyperactivity of liver yang and obstruction of collaterals by phlegm and blood stasis.it is again yin deficiency of liver and kidney and deficiency of qi and blood.it is believed that vertigo is closely related to phlegm,wind,blood stasis and deficiency.(2)"pulse-syndrome-treatment" correlation: pulse-syndrome,syndrome-medicine,pulse-medicine correlation is carried out on pulse condition,syndrome type,and traditional Chinese medicine.it is found that there are corresponding pulse-syndrome,syndrome-medicine,and pulse-medicine.the " pulse-syndrome-treatment" three are closely related,have consistency,and have their inherent association rules.3.the system summarizes and proposes that vertigo is a dynamically changing disease process.the movement disorder of qi is the basic pathogenesis of vertigo," phlegm and blood stasis" is the basic pathogenic factor of vertigo.vertigo is mixed with deficiency and excess.clinical symptoms should be treated from " qi and phlegm and blood stasis".treatment should be based on regulating qi,including invigorating qi and regulating qi movement.The clinical diagnosis should focus on giving full play to the objective diagnosis advantages of pulse diagnosis.through the integrated diagnosis and treatment mode of " pulse diagnosis and treatment" and the combination of other three diagnoses,the diagnosis and treatment of vertigo can provide new ideas for clinical diagnosis and treatment of vertigo.