The Extraction Of Syndrome Factor From Ischemic Cardiomyopathy And Related Research About Insidious Pathogen Of Phlegm And Blood Stasis

Purpose:Explore the disease location factors and disease character factors in the course of disease of ischemic cardiomyopathy and further clarify the position and role of the insidious pathogen of phlegm and blood stasis .MethodsDocument research :By computer search and manual search methods combined, retrieval of medical knowledge database Qinghua University CNKI domestic literature, which range from January 1980 to December 2009. Extracted from relevant syndrome factor in accord with the requirement syndromes , and make use of a statistics method to extract disease location factors and disease character factors and analyzes the data.Retrospective research:The 263 CHD patient's diagnosis and treatment information come from Affiliated hospital of Changchun University of Traditional Chinese Medicine,from January 2001 to December 2009. Diagnosis and treatment of this information consistent with the diagnosis and the inclusion criteria. Symptoms collected using the《retrospective studies questionnaires of TCM symptoms of ICM》,and make use of a statistics method to extract disease location factors and disease character factors and analyzes the data.Prospective cross-sectional research:115 clinical observation data of CHD comes from the hospital patient which are receivied treatment in Affiliated hospital of Changchun University of Traditional Chinese Medicine,range from December 2009 to December 2010. These patients's information consistent with the diagnosis and the inclusion criteria. We adopt prospective cross-sectional way to investigate the syndrome and construct the information database of TCM symptoms. Finally take a descriptive analysis, cluster analysis and principal component analysis to extract the relative disease location factors and disease character factors. Result :Document research:1.The distribution of syndrome factors of ICM: The major disease character factors were Yang deficiency, blood stasis and phlegm, Qi deficiency, excessive fluid ,Yin deficiency, stagnation of Qi, hemopenia.In the disease character factors ,the deficiency of Yang accounted for the largest proportion (52.62%).The secondary one was blood stasis(45.31%)and Phlegm syndrome(41.96%)。In the solid syndrome factors,phlegm syndrome(45.31%) and blood stasis(41.96%) accounted for the largest proportion. In the deficiency syndrome factors, deficiency of Yang and deficiency of Qi have the highest frequency.2.There are four categories of syndrome factor combination: single-factor symptom, two-factor symptom, three factors symptom and four factors symptom. In the four combinations, there are 18 types at most seeing. In the single-factor symptom ,Yang deficiency syndrome of the single factor symptom have the highest frequency. In the two-factor symptom, phlegm + blood stasis accounted for the largest proportion. In the three factors symptom, deficiency of Yang+phlegm + blood stasis have the highest frequency. In the four factors symptom, deficiency of Yang +phlegm + blood stasis+ deficiency of Qi and deficiency of Yin + deficiency of Yang +phlegm + blood stasis holds certainly great proportion. The total proportion of the combination which phlegm + blood stasis exist in reached 30.44%.3. In the combination of Yang deficiency,Including the condition which both other syndrome factors also exist in , The proportion of deficiency of Yang +phlegm + blood stasis reached 36.94% . In the combination of blood stasis,Including the condition which both other syndrome factors also exist in , phlegm + blood stasis reached 76.46%。In the combination of Qi deficiency,Including the condition which both other syndrome factors also exist in , deficiency of Qi+ phlegm + blood stasis reached 31.08%;In the combination of phlegm, Including the condition which both other syndrome factors also exist in , phlegm + blood stasis reached 76.95%.Retrospective research:1.The major disease character factors were Yang deficiency, blood stasis and phlegm, Qi deficiency, excessive fluid ,Yin deficiency, stagnation of Qi, hemopenia and turbidity, and the deficiency of Yang accounted for the largest proportion(58.94%), The secondary one was blood stasis(56.27%)and phlegm syndrome(51.71%).2. In the process of retrospective research,we found that there are four categories of syndrome factor combination and there are 17 types at most seeing. In the single-factor symptom, Qi deficiency have the highest frequency. In the two-factor symptom, phlegm + blood stasis accounted for the largest proportion. In the hree factors symptom, deficiency of Yang +phlegm + blood stasis have the highest frequency. In the four factors symptom, deficiency of Yang +phlegm + blood stasis+ deficiency of Qi and deficiency of Yin + deficiency of Yang +phlegm + blood stasis holds the major proportion. The total proportion of the combination which phlegm + blood stasis exist in reached 41.07%.3. In the combination of Yang deficiency, Including the condition which both other syndrome factors also exist in ,the proportion of deficiency of Yang +phlegm + blood stasis reached 44.27% . In the combination of blood stasis,Including the condition which both other syndrome factors also exist in , phlegm + blood stasis reached 78.26%。In the combination of Qi deficiency,Including the condition which both other syndrome factors also exist in , deficiency of Ql+ phlegm + blood stasis reached 45.34%;In the combination of phlegm, Including the condition which both other syndrome factors also exist in , phlegm + blood stasis reached 79.42%.4. Qi deficiency and Yang deficiency mostly concentrated in cardiac functionⅡlevel ,but in cardiac functionⅢlevel and cardiac functionⅣits distribution was less. With the deterioration of heart function, the number of the three combination (deficiency of Yang +phlegm + blood stasis, deficiency of Yang +phlegm + blood stasis+ deficiency of Qi, deficiency of Yin + deficiency of Yang +phlegm + blood stasis )showing the number of cases focused on a growing trend.AtⅡ,Ⅲ,Ⅳlevels of cardiac function ,including the condition which both other syndrome factors also exist in, the proportion of phlegm + blood stasis respectively reached 31.08%,44.1%, 51%.5. In the complication of ischemic cardiomyopathy hypertensive,diabetes, cardiac arrhythmia , AP ,dyslipidemia ,including the condition which both other syndrome factors also exist in, the proportion of phlegm+blood stasis respectively reached 53.9%, 52.7%, 50.4%, 54.4%, 47.4%。 Prospective cross-sectional research:1. Adopting principal components analysis,there are 14 factor eigenvalues greater than 1%, the cumulative contribution rate reached 83.653% .We conducted a comparative analysis for the factor loading matrix, then extracted the typical 36 symptoms from the most important 14 factors.2.The above 36 symptoms are divided into two categories .One category includes the particular symptoms in ICM,the other category are the concomitant symptoms of ischemic cardiomyopathy. In the former category, the symptoms of heart palpitation , edema, oliguria clustered together then the symptoms of woke up choking, vein exposed on the neek, rapid respiration also clustered together .The latter category cluster can be seen as follows: spontaneous perspiratio and fatigue ,lose one's appetite, distinclination to talk, loose stool ,tender tongue, short breath clustered together. cold limb ,chilly sensation, distress in the loins clustered together. Dry mouth, burning sensation of five centres , dry stool, emaciation ,pale tongue with very little fur ,rapid pulse reddened tongue clustered together. Dark purple lips, dark tongue quality,stickiness in the mouth, slippery pulse, thick libngual fur, enlarged tongue ,vein be circuit and purple under tongue, darkish complexion clustered together. Greasy fur,cough with phlegm, white phlegm, tongue一coating white, chest distress ,stringy pulse clustered together. In the fourth and fifth clusters, the symptoms of phlegm Intricately clustering with the symptoms of blood stasis. Finally come together with deficiency syndrome.3.The 115 ICM patients can be cluster into four groups , then we extract the combination of disease location factors and disease character factors .There are 14 cases in the first group which accounted for 12.17% of the total number of patients .The disease location factors are hesrt and lung,.The disease character factors are phlegm + blood stasis. There are 45 cases in the second group which accounted for 39.13% of the total number of patients.The disease location factors are hesrt , kidney , spleen.The disease character factors are deficiency of Yang+ phlegm + blood stasis. There are 35 cases in the third group which accounted for 30.43% of the total number of patients.The disease location factors are hesrt , lung, kidney , spleen.The disease character factors are deficiency of Yang + phlegm + blood stasis+ deficiency of Qi .There are 21 cases in the fourth group which accounted for 18.26% of the total number of patients. The disease location factors are hesrt , lung, spleen, kidney .The disease character factors are deficiency of Yang + phlegm + blood stasis+ deficiency of Yin.4.The symptom distribution of ischemic cardiomyopathy in cardiac function grading exhibit that with the deterioration of heart function, the symptoms of Yang deficiency, Cold limb ,chilly sensation, distress in the loins ,oliguria and the symptoms of Yin deficiency, dry mouth, burning sensation of five centres , dry stool, emaciation ,focused on a growing trend .The weight of typical symptoms of accumulation of phlegm and blood stasis still keeps at relatively high levelConclusion:1.The findings suggest that the major excess syndrome of disease location factors are phlegm and blood stasis,and the major deficiency syndrome are deficiency of Yang,deficiency of Yin,deficiency of Qi. In the combinations of syndrome factors, phlegm + blood stasis has the largest distribution in ischemic cardiomyopathy. In the combinations of syndrome factors, phlegm + blood stasis has the closest relationship with deficiency of Qi, deficiency of Yin , deficiency of Yang. Accumulation of phlegm and blood stasis has the largest distribution in the complications of ischemic cardiomyopathy.2. The clinical manifestations of accumulation of phlegm and blood stasis is the most importantly component factor of the typical symptom which belong to ischemic cardiomyopathy. The result of cluster analysis indicate that accumulation of phlegm and blood stasis widely exist in the combined symptom of the disease location factors and disease character factors of ischemic cardiomyopathy .The weight of accumulation of phlegm and blood stasis always keeps at relatively high level. With the deterioration of heart function, the relative deficiency syndrome focused on a growing trend and the clinical symptoms are more obvious. The aggravation of syndrome of ischemic cardiomyopathy is the consequences of the effect of insidious pathogen and the deterioration of heart function.3. The evolvement rules of syndrome factors of ischemic cardiomyopathy can be revealed as follows: The insidious pathogen of phlegm and blood stasis,always hide in the deep place , in the early times, it induced the symptoms of Qi deficiency. Along with the disease aggravated,the healthy energy is sinking into a decline ,then it could not conquer pathogen . The insidious pathogen of phlegm and blood stasis, takes this opportunity to attack human body,and the different condition of individuals' bodies will produce different effect- deficiency of Qi ,deficiency of Yin ,deficiency of Yang, even all of them exist at present. With the deterioration of healthy energy, the symptom of accumulation of phlegm and blood stasis focused on a growing trend and the patient's mobility gradually declining. In the final phase, the clinical symptom of imbalance of Yin and Yang will be more and more serious.4. The elementary locations of ischemic cardiomyopathy are heart, kidney, spleen, liver, kidney, and among all of them, heart is the most important disease location .Besides , spleen and kidney are also important. the relationships between blood stasis and heart,phlegm and spleen, Yang deficiency and kidney,Qi deficiency and heart ,spleen, kidney, Yin deficiency and kidney are most closely.5. According to the academic thoughts of professor Dengyue, and combining the research with clinical practice, the pathogenic characteristics of ischemic cardiomyopathy can be summarized as"interconnections between five viscera, accumulation of phlegm and blood stasis, insidious pathogen pathopoiesia", this rule will ,from the point of activating the stagnant and activating the blood, provide the theoretical principle for intervention disease.