Professor Sang Xisheng Studied The Drug Rules And Treatment Ideas For The Treatment Of Chronic Heart Failure

Objective:Based on the clinical case of Professor Sang Xisheng’s diagnosis and treatment of patients with chronic heart failure,this study carried out multi-angle and multi-level data mining analysis,combined with the tutor’s teaching record,aiming to systematically summarize professor Sang Xisheng’s clinical experience in the treatment of CHF,so as to facilitate the study and exploration of TCM treatment of chronic heart failure in the future.Methods:We screened and cleared the outpatient cases from Professor Sang Xisheng in The Traditional Chinese Medicine Library of Shengfang Yuan,Heilongjiang province,and selected the medical records that met the inclusion and exclusion criteria from June 2018 to November 2021.A total of 153 patients and 175 prescriptions were recorded(including the initial diagnosis and the re-diagnosis prescriptions with large changes in prescription drugs).Collect patients’ name,gender,age,primary symptom,tongue and pulse condition,the first clinical traditional Chinese medicine prescription,establishing the database and its into the "heritage of traditional Chinese medicine computing platform(V3.0)" software,adopt gender analysis,tongue like pulse condition analysis,four gas mixed belongs to the traditional Chinese medicine efficacy analysis,frequency analysis,clustering analysis and association rules between prescription drug analysis,etc.,combining with older generations,Finally extracted professor Sang Xisheng’s treatment ideas and drug experience of chronic heart failure.Results:1.Tongue image,pulse image and symptoms: there were 9kinds of tongue image elements,with the highest frequency of white tongue coating(72 times)and light tongue(69 times);The single pulse which appeared most frequently was fine pulse and pulse-sinking,and the compound pulse showed fine pulse sinking,irregular pulse rate and slightly number of pulse-sinking.A total of 110 symptoms were counted,and 17 symptoms with frequency >20 were mainly palpitation,palpitation,fatigue,shortness of breath,lower limb swelling,chest tightness,shortness of breath,insomnia,chest pain,dizziness,etc.2.Drug frequency,sexual taste and efficacy: 135 drugs were included with a total frequency of 1941,and 30 drugs were applied more than 20 times with a frequency of 1459,accounting for 75.17% of the total frequency.The top ten use frequency were Fangji,Sheng Atractylodes atractylodes,Astragalus membranaceus,Immaturus aurantii,Salvia miltiorrhiza,Jin Fei Cao,Phellodendron phellodendron,Fried Divine Qu,Chinese turtle,Acanthopanax acanthopanax.The four gases of drugs were cold,warm,flat,cold and hot.The five tastes were bitter,sweet,spicy,sour and salty.In the analysis of meridian,the first six were lung meridian,spleen meridian,liver meridian,stomach meridian,heart meridian and bladder meridian.All drugs can be divided into 17 categories,among which the frequency of tonifying deficiency,dispelling rheumatism,promoting blood circulation and removing blood stasis is the highest,followed by qi regulating drugs,heat clearing drugs,phlegm relieving cough antiasthmatic drugs,nerves calming drugs,water infiltration and dampness relieving drugs and surface relieving drugs.3.Association rules: "Support degree" was set as 50%,"confidence degree" as 95%,and a total of 26 drug combinations were obtained,including 5 TRADITIONAL Chinese medicines,among which the top 5combinations were Radix tetrandrrhizae and Rhizoma atractylodes macrocephalus;Radix japonicum and Astragalus membranaceus;Raw Atractylodes and Astragalus;Radix tetrandrrhizae,Rhizoma atractylodes,Astragalus membranaceus;Astragalus membranaceus and Aurantium aurantii.The core prescriptions were radix tetrandrrhizae,Rhizoma atractylodes macrocephala,Astragalus membranaceus,Fructus aurantii and Salvia miltiorrhiza.4.Cluster analysis: Set the "cluster number" in the formula formulation rule as 5,and obtained 5 core drug combinations,namely,Radix Fangzi,Astragalus membranaceus,Atractylodes macrocephala,Aurantii Matantii,Cassia twig and Anemarrhenae.Radix Tetrandrrhizae,Atractylodes atractylodes,Astragalus membranaceus,Immaturus aurantii,Salvia miltiorrhiza,Jin Fei Cao;Radix Tetrandrrhizae,Astragalus membranaceus,Atractylodes atractylodes,Aurantii Trifoliata,Albizia bark,Salvia miltiorrhiza;Radix Tetrandrrhizae,Astragalus membranaceus,Atractylodes macrocephala,Papaya,Jinfeicao,Aurantii Trifoliate;Radix tetrandrrhizae,Rhizoma atractylodes,Astragalus membranaceus,Aurantii Trifoliata,Honey loquat leaves,Salvia miltiorrhiza.Conclusion:1.When professor Sang Xisheng treated the disease,he believed that the disease was located in the heart,which caused the decline of the body with the continuation of the disease and the five zang organs.On the basis of the basic pathogenesis,a series of secondary pathogenesis of basic substances such as qi,blood and water took place.2.In terms of treatment,based on the basic principle of replenishing qi and benefiting water,corresponding treatment is implemented according to the evolution of qi,blood and water and the characteristics of symptoms.Meanwhile,attention is paid to fuzheng,deji,spleen and stomach,and protection of healthy qi.3.In terms of medication,mufangji Decoction and Zhizhu Decoction are added and reduced.The commonly used drugs are Fangji,Shengatractylodes atractylodes,Astragalus membranaceus,Zhizhi Aurantii,salvia miltiorrhiza,etc.