Research On Regularity Of Traditional Chinese Medicine Syndrome Differentiation And Treatment Of Dilated Cardiomyopathy Based On The Literature Analysis

Objective: By analyzing the clinical literature on traditional Chinese medicine(TCM)in treatment of dilated cardiomyopathy(DCM),this study explored the regularity of syndrome differentiation and treatment of DCM,and provided the reference basis for clinical work.Methods: A comprehensive search was made for the literatures on TCM in treatment of DCM in large databases at home and abroad,and the screening was carried out according to the inclusion and exclusion criteria.The information on clinical symptoms,types of syndrome and prescriptions were extracted.Then the databases were established and statistical softwares were used to analyze the data.Results:1.3385 literatures were preliminarily retrieved,and 152 literatures conforming to the standard were screened out.Among them,there were 38 literatures with records of clinical symptoms,tongue manifestations and pulse conditions,55 literatures with records of clear types of syndrome and 149 literatures with records of complete prescriptions.2.There were 61 kinds of symptoms,17 kinds of tongue manifestations and 14 kinds of pulse conditions recorded in the literatures.The symptoms with frequency of10 or more were palpitation,shortness of breath,edema,cyanotic lips,weakness,chest distress,dyspnea,fatigue,oliguria,chilly sensation and the cold limbs,spontaneous perspiration,dim complexion,cyanotic hyponychium,and lumps below the costal region.The top five high-frequency tongue manifestations were bluish purple tongue,pale tongue,bulgy tongue,thin coating and white coating.The top five high-frequency pulse conditions were thready pulse,inrregular intermittent pulse,regularly intermittent pulse,deep pulse and unsmooth pulse.3.There were 31 types of syndrome recorded in the literatures,and the top six high-frequency syndrome were syndrome of qi deficiency and blood stasis,syndrome of heart yang and qi deficiency,syndrome of heart and kidney yang deficiency,syndrome of dual deficiency of qi and yin,syndrome of yang deficiency with water flooding and syndrome of water qi intimidating the heart.There were 17 syndrome elements,and the top seven high-frequency elements were heart,kidney,qi deficiency,blood stasis,yang deficiency,water retention and yin deficiency.The results of cluster analysis showed that qi deficiency and blood stasis were gathered into one category,and heart,kidney,yang deficiency and water retention were gathered into one category,but yin deficiency was classified as a category alone.The results of association rule showed that the rule with highest degree of support was qi deficiency-blood stasis,and the rules with highest degree of confidence were yang deficiency,qi deficiency-heart and yin deficiency-qi deficiency.4.There were 155 prescriptions recorded in the literatures,involving 122 Chinese herbs.The top twenty high-frequency herbs were Radix Astragali,Poria cocos,Radix Salviae Miltiorrhizae,Radix Glycyrrhizae,Ramulus Cinnamomi,Radix Ginseng,Radix ophiopogonis,Radix Aconiti Lateralis Preparata,Rhizoma Atractylodis Macrocephalae,Fructus Schisandrae Chinensis,Radix Angelicae Sinensis,Rhizoma Chuanxiong,Semen Lepidii,Radix Codonopsis,Radix Paeoniae Rubra,Alisma orientalis,Fructus jujubae,Carthami Flos,Paeoniae Radix Alba,Herba Leonuri.There were 17 kinds of categories of Chinese herbs,and the top three were tonifying herbs,herbs with promoting blood circulation to remove blood stasis and herbs with inducing diuresis and diffusing dampness.The results of cluster analysis showed that Poria cocos,Atractylodis Macrocephalae,Radix Astragali,Radix Salviae Miltiorrhizae were gathered into one category,and Alisma orientalis,Herba Leonuri,Semen Lepidii,Paeoniae Radix Alba,Fructus jujubae,Rhizoma Chuanxiong,Radix Paeoniae Rubra,Carthami Flos,Angelicae Sinensis,Radix Codonopsis,Radix Aconiti Lateralis Preparata were gathered into one category,and Radix Ginseng,Radix ophiopogonis,Fructus Schisandrae Chinensis,Ramulus Cinnamomi,Radix Glycyrrhizae were gathered into one category.The results of association rule showed that the rule with highest degree of support was Radix Salviae Miltiorrhizae,Poria cocos-Radix Astragali,and the rule with highest degree of confidence was Radix Codonopsis-Radix Astragali.Conclusion:1.The common clinical symptoms of DCM were palpitation,shortness of breath,edema,cyanotic lips,weakness,chest distress,dyspnea,fatigue,oliguria,chilly sensation and the cold limbs.The common tongue manifestations were bluish purple tongue and pale tongue.The common single pulses were thready pulse,inrregular intermittent pulse and regularly intermittent pulse.2.The location of DCM was in heart,and it has closed connection with kidney,lung and spleen.The pathogenesis of DCM was root deficiency and branch excess.The root deficiency mainly included qi deficiency,yin deficiency and yang deficiency,and the branch excess mainly included blood stasis and water retention.3.The basic types of syndrome of DCM included syndrome of qi deficiency and blood stasis,syndrome of heart yang and qi deficiency,syndrome of heart and kidney yang deficiency,syndrome of dual deficiency of qi and yin,syndrome of yang deficiency with water flooding and syndrome of water qi intimidating the heart.In addition,these types of syndrome could occur simultaneously in the middle and late stage of DCM.4.The general principle of DCM is treating both root and branch.The main treatment of DCM is to invigorate qi and warm yang,promote blood circulation and alleviate water retention,and nourish yin as well.The commonly used medicines were Radix Astragali,Poria cocos,Radix Salviae Miltiorrhizae,Radix Glycyrrhizae,Ramulus Cinnamomi,Radix Ginseng,Radix ophiopogonis,Radix Aconiti Lateralis Preparata,Rhizoma Atractylodis Macrocephalae,Fructus Schisandrae Chinensis,Radix Angelicae Sinensis,Rhizoma Chuanxiong,Semen Lepidii,Radix Codonopsis,Radix Paeoniae Rubra,Alisma orientalis,Fructus jujubae,Carthami Flos,Paeoniae Radix Alba,Herba Leonuri.The commonly used couplet medicine was Radix Codonopsis-Radix Astragali.