| This study is divided into two parts:literature review and clinical research.In the literature review part,firstly,the TCM(TCM)knowledge of Ventricular premature beat(VPB)is combed,including the TCM disease name,etiology and pathogenesis,traditional knowledge and modrn research of syndrome differentiation and treatment.Secondly,it summarizes the academic thoughts of eight national medical masters in the treatment of palpitation,analyzes the experience characteristics of national medical masters from the aspects of etiology,pathogenesis and treatment methods,so as to provide reference for clinical diagnosis and treatment of ventricular premature beats.In Study 1,we compared the difference between the two groups,and explored the characteristics of the two groups according to the efficacy standard of VPB,so as to provide ideas for improving the efficacy of TCM.In the second part of the study,the medical cases of the first part of the study population which were judged as effective and markedly effective were taken as the research objects.Professor Xu Hao's medication rules in the treatment of ventricular premature beats were analyzed by modern data mining technology.Study 1:Analysis of the characteristics of the excellent effect group of Professor Xu Hao in the treatment of VPBObjective:To explore the characteristics of the excellent and ineffective people in the treatment of VPB by TCM,and to provide ideas for improving the therapeutic effect of TCM on VPB.Methods:This study is a retrospective study collecting 144 cases of diagnosed VPB and treated with TCM in the cardiovascular outpatient department of Xiyuan Hospital from January 1,2015 to December 31,2019.According to the 24-hour ambulatory ECG ventricular premature beats before and after the treatment of TCM,the reduction of the number of premature beats?90%is significant,?50%is effective,and<50%is invalid.31 patients with significant therapeutic effect were selected as the excellent group and 27 patients with ineffective treatment were selected as the ineffective group.The general data,comorbidities,disease characteristics and treatment characteristics of 58 patients in the two groups were analyzed.Results:1.Demographic data and comorbidities:There was no significant difference in gender and age between the effective group and the ineffective group(P>0.05).There was no significant difference in hypertension,diabetes and hyperlipidemia(P>0.05),but only in coronary heart disease(P<0.05).The proportion of patients with coronary heart disease in the excellent effect group was higher than that in the ineffective group(35.5%vs 11.1%),However,logistic multivariate regression analysis did not find that it was an effective factor in the treatment of VPB.2.Main symptoms of TCM:The main symptoms were palpitation,precordial constriction,chest distress,chest pain,shortness of breath,fatigue and dizziness.After comparison,only shortness of breath was statistically significant(P<0.05).The proportion of shortness of breath was higher in the excellent group than that in the ineffective group(64.5%vs 37%),However,logistic multivariate regression analysis did not find that it was an effective factor in the treatment of VPB.3.Treatment information:There was no statistical difference between the excellent group and the ineffective group in whether to accept western medicine or surgical treatment(P>0.05),but there was statistical difference in the time of taking TCM.The average time and median time of taking TCM in the excellent group were higher than those in the ineffective group(P<0.05).In the logistic regression analysis model,the time of taking TCM was an independent factor of the group with excellent effect of TCM in the treatment of premature ventricular beats.The possibility of excellent effect of TCM increased by 73.8%(P<0.05)every month when the time of taking TCM increased.4.Disease data:According to the comparison of the last 24-hour dynamic ECG results before the treatment with TCM,there was no significant difference in Myerburg classification and 24-hour mean heart rate between the excellent group and the ineffective group(P>0.05),but there was significant difference in Yanaga classification(P<0.05).The proportion of day type patients was higher in the excellent group than in the ineffective group(54.8%vs 29.6%),and the proportion of night type patients was higher in the ineffective group than in the excellent group(29.6%vs 6.5%).However,logistic multiple factor regression analysis did not find the influencing factors of TCM treatment of ventricular premature beats.5.Characteristics of VPB attackAlthough there was no significant difference in course classification,inducement(emotional change,tiredness,insomnia)and characteristics(attack time,emotion)between the two groups(P>0.05),but because the p value of attack time characteristics=0.058<0.1,it was found that the attack time characteristics were independent factors influencing the TCM treatment efficiency of ventricular premature beat,and the frequency of premature beat in the afternoon The optimal treatment effect was 4.91 times of that of.patients with untimely attack(P<0.05).Conclusion:This study indicate that the time of onset and the time of medication are independent factors influencing the effectiveness of traditional Chinese medicine in the treatment of ventricular premature beats.According to the characteristics of the time of ventricular premature beats,those who frequently occur in the afternoon are more likely to have better results than those who occur frequently in the morning,frequently at night,and those who have irregular attacks throughout the day.For patients with premature ventricular contractions treated with Chinese medicine,the longer they take the medicine,the greater the possibility of superior treatment of Chinese medicine.In addition,the combination of coronary heart disease,Yanaga's daytime premature beats,shortness of breath as the main symptom,etc.may be the characteristics of the TCM predominant effect of ventricular premature beats.Related,it is worth further study.Study ?:Research on professor xu hao's experience in the treatment of premature ventricular beats in traditional Chinese medicine based on data mining techniquesObjective:To collect the medical cases of VPB patients whose diagnosis and treatment effect is judged to be significant and effective by Professor Xu Hao,analyze them with modern data mining technology,explore and summarize clinical medication experience,provide reference for TCM syndrome differentiation and treatment of VPB,and provide ideas and methods for modern data mining technology to summarize and inherit clinical experience.Methods:This study collected the medical cases of patients with VPB(meet the inclusion and exclusion criteria)who were treated by Professor Xu Hao and whose curative effect was judged to be significant and effective from January 1,2015 to December 31,2019 in the cardiovascular outpatient department of Xiyuan Hospital.After standardizing the medical case data(four diagnosis information,name of Chinese medicine,etc.),verify the modification and confirm the correctness,and then import them in batches The ancient and modern medical case cloud platform(v2.2.2)is locked,and the data mining module of the platform is used for analysis.Based on frequency statistics,correlation analysis,cluster analysis,complex network and other methods,combined with the experience of teachers,Professor Xu Hao's thinking and experience in the treatment of VPB were summarized.Results:In this study,31 patients and 86 patients who were judged to be effective in the treatment of VPB by Professor Xu Hao were included,with 406 times of effective medical records.Through data mining and analysis,the top 10 symptoms were as follows:panic,poor sleep,fatigue,shortness of breath,dry mouth,chills,chest tightness,precordial contraction,dizziness and spontaneous sweating.The most common tongue features are fat,dark and white fur.The pulse features are fine,stringy and complex.TCM syndrome is mainly characterized by deficiency of Qi and Yin,and the top 10 single herbs in the frequency of TCM use are:Roasted licorice,dangshen,mulberry parasite,Yujin,bupleurum,Yuanzhi,Fructus aurantii,Fushen,Astragalus and Ramulus Cinnamomi.Among the four drugs,the most common drugs were mild cold drugs and warm drugs;among the five drugs,the most sweet drugs were 799,followed by bitter drugs;among the drugs,the most common drugs were heart channel drugs,liver channel drugs and lung channel drugs.According to the association rule analysis and cluster analysis,the commonly used drug combinations are:radix codonopsis pilosula-processed licorice,radix turpentine-mulberry parasitism,astragalus-processed licorice,yuanzhi-processed licorice,fructus aurantii-chaihu,fructus aurantii-processed licorice,radix astragali-radix codonopsis pilosula,cassia twig?processed licorice,radix radix codonopsis,oyster-processed licorice,radix paeoniae-mulberry parasitism,radix ophiopogonis-processed licorice,radix tuber-root root-processed radix.The core prescription drugs are Yujin,Huangqi,Guizhi,Yuanzhi,dangshen,Fushen,roasted liquorice,oyster,trifoliate,mulberry parasitism,white peony,Maidong and Bupleurum.Conclusion:This study included 31 significantly effective patients and 86 effective patients by Professor Xu Hao's traditional Chinese medicine treatment of ventricular premature beats.A total of 406 medical records of effective medical records were used,and data were analyzed using various analysis methods of the ancient and modern medical case cloud platform.,Provides objective data support for summarizing its medication experience,and comprehensively draws the following conclusions:1.Ventricular premature beats are mostly evidences of deficiency and standardization.Deficiency is deficiency of qi,blood,yin and yang,and standardization is more common with stasis,heat,phlegm and depression.Professor Xu Hao believes that,according to the main symptoms and signs of patients,combined with the characteristics of ventricular premature beats,the key pathogens should be extracted,the main and secondary specimens should be distinguished,and the virtual and real should be considered.Ningxin Anshen is often used as the basic treatment.Fushen and Yuanzhi are commonly used.On this basis,Dangshen,Astragalus,Atractylodes macrocephalae,parasitism to nourish qi and spleen,and liver and kidney are used for the deficiency syndrome;Nourishing yin and nourishing blood;Guizhi,Zhigancao Tongyang complex pulse;empirical commonly used methods Pinellia,orange peel expectorant;Bupleurum,Citrus aurantium and soothing liver and regulating qi;turmeric heat blood cooling serum fever.2.Through complex network analysis,it is concluded that Professor Xu Hao's core prescriptions for the treatment of ventricular premature beats are astragalus,turmeric,twig,oysters,fushen,codonopsis,Polygala,Citrus aurantium,Zhigancao,mulberry,white peony,Ophiopogon Hu composition.3.In this study,the data mining method was used,and the analysis results were basically consistent with the clinical experience of the teacher,so that the scattered experience of TCM diagnosis and treatment was more organized and systematic.Through the feedback of experts,the continuous improvement of human-machine integration is expected to become the inheritance of TCM experience.The effective method deserves further study. |
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