The Analysis About Traditional Chinese Medicine Syndrome And Treatment In Coronary Heart Disease Combine With Non-valvular Atrial Fibrillation

Objective:This research applied the methods of data mining to analyze the symptoms, traditional Chinese medicine (TCM) syndrome factors, herbals and other aspects in coronary heart disease (CHD) combine with non-valvular atrial fibrillation (non-valvular AF). And trying to analyze the relationship among syndrome factors, CHA2DS2-VASc and HAS-BLED Scores; as well as the analysis of new herbal formulas.Method:Information engineer screened 228 patients included in the standard from our unified clinical and research information platform. These medical record information which included in the standard from were entered into Inheritance of traditional Chinese medicine inheritance support platform software V2.5. The software integration data mining method was used to distribute prescriptions according to four properties, five flavors and meridians tropism in the database and achieve frequency statistics, syndrome distribution, prescription regularity and new prescription analysis. All the cases need to calculated CHA2DS2-VASc and HAS-BLED scores. The relationship among TCM syndrome factors were analyzed by SPSS 17.0.Result:1. The symptoms of the patients with CHD combine non-valvular AF mainly include chest distress (159,69.74%), palpitation (130,57.02%), poor sleep (112,49.12%), cough (107, 46.93%), thirst (79,34.65%), hypodynamia (76,33.33%), dizziness (76,33.33%), shortness of breath (75,32.89%) and other symptoms. In this research, involving 23 kinds of tongue images,12 kinds of fur images,15 kinds of pulses; among them dark red tongue, thin and white fur, wiry pulse are significant high.2. The frequency distribution of TCM syndrome factors in the patients with CHD combine non-valvular AF from high to low are blood stasis, qi deficiency, turbid phlegm, yin deficiency, yang deficiency, heat deposition, dampness, excessive fluid, qi stagnation, blood deficiency, cold coagulation. The TCM syndrome mainly composed by two to four TCM syndrome factors, single syndrome factor is less. The TCM syndrome factors combinations which appeared more than 10 times from high to low were qi deficiency+yin deficiency+ blood stasis+turbid phlegm, qi deficiency+blood stasis, qi deficiency+yin deficiency, blood stasis+turbid phlegm, qi deficiency+yin deficiency+blood stasis. The distribution of TCM syndrome factors are no significant difference in paroxysmal AF, persistent AF and permanent AF (P> 0.05). The result show that yin deficiency and CHA2DS2-VASc scores have correlation (r= 0.149, P= 0.024< 0.05), blood deficiency and HAS-BLED scores have correlation (r= 0.134, P= 0.043< 0.05). There is no statistical significance between other TCM syndrome factors and the CHA2DS2-VASc and HAS-BLED scores (P> 0.05).3. The herbals commonly used by Guang’anmen Hospital department of cardiology to treat CHD combine with non-valvular AF mainly include Poria (Fuling), Milkvetch Root (Huangqi), Dwarf Lilyturf Tuber (Maidong), Prepared Liquorice Root (Zhigancao), Tangshen (Dangshen), Cassia Twig (Guizhi), Rehmannia Root (Shengdihuang), Salvia Root (Danshen), Chinese Magnoliavine Fruit (Wuweizi), Chinese Angelica (Danggui), Heterophylly Falsestarwort Root (Taizishen), Snakegourd Fruit (Gualou) and other herbals. The distribution of four properties is given priority to warm, cold, flat. The distribution of five flavors is given priority to sweet, bitter and pungent. The frequency distribution of meridians tropism from high to low is spleen meridian, lung meridian, stomach meridian, heart meridian, liver meridian, kidney meridian, large intestine meridian, gallbladder meridian, bladder meridian, pericardium meridian, small intestine meridian, triple energizer meridian. The frequency distribution of pathological zang-fu organs from hing to low is heart, spleen, kidney, lung, liver, cerebrum, stomach, gallbladder, bladder.4. We can got 24 kinds of herbal combinations and 13 kinds of association rules when setting support as 61 and confidence as 0.6. The herbal combinations mainly included ①Mikvetch Root (Hangqi), Poria (Fuling), ② Prepared Liquorice Root (Zhigancao), Poria (Fuling), ③Tangshen (Dangshen), Poria (Fuling) and other herbal combinations. The association rules mainly included ①Oriental Waterplantain Rhizome (Zexie)-> Poria (Fuling); ②Roasted Rhite Atractylodes Rhizome (Chaobaizhu)-> Poria (Fuling), ③Chinese Magnoliavine Fruit (Wuweizi)-> Dwarf Lilyturf Tuber (Maidong) and other association rules. There are 38 kinds of complex network entropy clustering core combinations when setting relevance degree as 8 and punishment degree as 4. These core combinations mainly include ①Bamboo Shavings (Zhuru)_Bile Arisaema (Dannanxing) Abalone Shell (Shijueming), ②Fermented Soybean (Dandouchi) India Madder Root (Qiancao) Fructus Gardeniae Praeparatus (Jiaozhizi), ③Dwarf Lilyturf Tuber (Maidong)_Chinese Magnoliavine Fruit (Wuweizi) Oyster Shell (Muli)_Heterophylly Falsestarwort Root (Taizishen) and other core combinations. Summarizing 19 new prescriptions based on entropy clustering analysis. The new prescriptions mainly included ①Bamboo Shavings (Zhuru)_Dried Tangerine Peel (Chenpi)_Immature Orange Fruit (Zhishi)_Bile Arisaema (Dannanxing) Abalone Shell (Shijueming), ②Fermented Soybean (Dandouchi) Cape Jasmine Fruit (Zhizi) Germinated Barley (Maiya)_India Madder Root (Qiancao)_Fructus Gardeniae Praeparatus (Jiaozhizi), ③Dwarf Lilyturf Tuber (Maidong) _Prepared Common Monkshood Daughter Root (Fuzi)_Heterophylly Falsestarwort Root (Taizishen) Chinese Magnoliavine Fruit (Wuweizi) Oyster Shell (Muli) and other prescriptions.Conclusions:1. TCM syndrome factors in patients with CHD combine non-valvular AF mainly include blood stasis, qi deficiency, turbid phlegm, yin deficiency and deficiency complicated with excess syndrome was significantly high. The distribution of TCM syndrome factors are no significant difference in paroxysmal AF, persistent AF and permanent AF. The patients with yin deficiency have higher thrombus risk.2. Doctors in Guang’anmen Hospital department of cardiology treat CHD combine with non-valvular AF mainly through supplementing qi and nourishing yin, assisted by activating blood and resolving stasis, invigorating spleen to remove dampness. Based on it, we concluded 19 new herbal formulas through complex network entropy clustering analysis. These new herbal formulas remains to be further clinical test and verify.