Meta-analysis Of Chinese Herbal Medicine In Treating Stable Angina Pector Is Accompanied By Anxiety And Depression And Mining The Rule Of Its Prescription And Medication

Objective:1.Conduct meta-analysis of clinical studies on the treatment of stable angina with anxiety and depressive states in traditional Chinese medicine,evaluate the effectiveness and safety of traditional Chinese medicines,and provide evidence-based medical basis for the treatment of patients with stable angina with anxiety and depressive states.2.Use data mining technology to explore the rules of prescription medication in clinical research,and provide ideas and methods for the treatment of patients with stable angina with anxiety and depression.Method:1.Meta analysis:All the clinical research literature on the treatment of stable angina with anxiety and depression with Chinese medicine were searched in the databases of CNKI,VIP,Wanfang,CBM,Pub Med and Cochrane Library.The search time was set from January 1,2017 to March 31,2022.According to the inclusion and exclusion criteria,the literature that met the criteria was screened.Two researchers extracted data from the literature on basic features and included indicators,Establish Excel table,use the bias risk assessment standard of Cochrane collaboration network to evaluate the quality of the literature,use Revman 5.4software to carry out meta-analysis of the data in the literature.2.Data mining:All the clinical research literature on the treatment of stable angina with anxiety and depression with Chinese medicine were searched in the databases of CNKI,VIP,Wanfang,CBM,Pub Med and Cochrane Library.The search time was set as follows:the database was established until March 31,2022.According to the inclusion and exclusion criteria,the literature that met the criteria was screened.The prescriptions in the selected literature were entered into Excel database.Then use the"TCM inheritance auxiliary system 3.0"software for the literature of prescription drugs for four gas,five flavors,meridian tropism,drug frequency,commonly used drug pairs and new prescription statistics mining.Outcome:1.Systematic evaluation results:Through the search and screening,43 literature articles were included,and 2842patients were actually included,1432 cases in the treatment group and 1410 cases in the control group.Meta analysis results:(1)Efficacy of angina:a total of 30 studies were included,OR=3.37,95%CI was2.66-4.28,P<0.00001,indicating that the efficacy of angina in the experimental group was better than that in the control group,and the difference was statistically significant.(2)ECG improvement:a total of 15 studies were included,OR=1.86,95%CI was1.40-2.46,P<0.0001,indicating that the ECG improvement in the experimental group was better than that in the control group,and the difference was statistically significant.(3)Nitroglycerin reduction rate:co-absorption In 10 studies,THE OR=3.27,95%CI was 2.27-4.70,and P<0.00001,suggesting that the rate of nitroglycerin in the experimental group was better than that in the control group,and the difference was statistically significant.(4)Efficacy of TCM symptoms:A total of 37 studies were included,OR=5.22,95%CI was 4.20-6.47,P<0.00001,suggesting that the TCM syndrome efficacy of the experimental group was better than that of the control group,and the difference was statistically significant.(5)Anxiety self-assessment scale score(SAS score):A total of 9 studies were included,MD=-6.15,95%CI was-8.06～-4.24,P<0.00001,suggesting that the experimental group was better than the control group in reducing the SAS score,and the difference was statistically significant.Grouping according to interventions:subgroup 1(Chinese medicine group)included three studies with MD=-5.14,95%CI-6.61 to-3.67,P<0.00001.Subgroup2(traditional Chinese medicine combined with anxiolytic depressants)included three studies,MD=-8.17,95%CI was-10.01～-6.33,P<0.00001.Heterogeneity between the two groups was Ch I~2=6.38,df=1,P=0.01,and I~2=84.3%,suggesting that the intervention was a source of SAS score heterogeneity,and that chinese medicine was coordinated with anxiolytic depressants.Grouping was based on course of treatment:subgroup 1(less than 1 month)table included a total of 5 studies,MD=-4.00,95%CI-5.34 to-2.65,P<0.00001,subgroup2(more than 1 month)included 2 studies,MD=-8.03,95%CI-9.73 to-6.33,P<0.00001.The heterogeneity between the two groups was Ch I~2=17.26,df=1,P<0.0001,and I~2=94.2%,suggesting that the course of treatment was the source of SAS score heterogeneity,and the duration of treatment was good.(6)Depression self-rating scale score(SDS score):A total of 8 studies were included,MD=-7.25,95%CI was-10.65--3.85,P<0.0001.It was suggested that the experimental group was better than the control group in reducing the SDS score,and the difference was statistically significant.According to the intervention,subgroup 1(Chinese medicine group)included three studies,MD=-4.52,95%CI was-5.65--3.40,P<0.00001.Subgroup 2(traditional Chinese medicine combined with anxiolytic depressants)included a total of 1study,MD=-7.90,95%CI of-9.90～-5.90,P<0.00001.Heterogeneity between the two groups was Ch I~2=8.30,df=1,P=0.004,and I~2=88%,suggesting that the intervention was a source of heterogeneity in SDS scores and that there was coordination between traditional Chinese medicine and anxiolytic depressants.Grouping according to the course of treatment:subgroup 1(less than 1 month)table total of 4 studies,MD=-4.71,95%CI-5.60 to-3.81,P<0.00001.Subgroup 2(greater than 1MD=-8.51,95%CI was-10.07 to-6.94,P<0.00001.The heterogeneity between the two groups was Ch I~2=17.08,df=1,P<0.0001,and I~2=94.1%,suggesting that the course of treatment was a source of SAS score heterogeneity,and the duration of treatment was good.(7)Evaluation of adverse reactions:10 studies were included,MD=0.94,95%CI0.51～1.76,P=0.85,indicating that there was no difference in adverse reactions between the experimental group and the control group.2.Data mining results:Through searching and screening,118 articles were included,including 118prescriptions involving 124 Chinese herbs.(1)There are 22 kinds of traditional Chinese medicine with medication frequency greater than 20,They were Bupleurum,Licorice,Poria,Salvia miltiorrhiza,Chuanxiong,Pinellia,Paeonia lactiflora,Curcuma,Cyperus rotundus,Aurantii,Albizzia julibrissin,orange peel,dragon bone,oyster,Angelica,Codonopsis,Cinnamon,jujube,scutellaria baicalensis,red peony root,ginger,wild jujube kernel.(2)Four Qi drugs mostly use cold and warm,five tastes mostly use bitter and bitter,drugs mostly go to liver,spleen,lung,heart four channels.(3)The first three were"Radix Bupleuri-Glycyrrhiza Uralensis,""Rhizoma Chuanxiong"and"Bupleurum-paeoniae Alba."(4)There are 9 association rules.The confidence of Bupleurum is the highest when Ligusticum chuanxiong and Radix Paeoniae Alba are used.(5)Core drugs 11 flavors,namely:Bupleurum,Salvia miltiorrhiza,Cyperus rotundus,licorice,Cortex Albizzae,Turmeric,Fructus Aurantii,Tuckahoe,Ligusticum chuanxiong,Radix Paeoniae Alba and Pinellia ternata.(6)Five prescriptions were obtained by cluster analysis:prescription 1:Bupleurum chinense,Paeonia lactiflora,Cyperus rotundus,Licorice root,Fructus aurantii,Rhizoma Chuanxiong;Prescription 2:bupleurum,pinellia,dragon bone,poria,oyster,jujube;Prescription 3:bupleurum,licorice,red peony root,salvia miltiorrhiza,ligusticum chuanxiong,safflower;Prescription 4:bupleurum,astragalus,salvia miltiorrhiza,codonopsis pilosula,licorice,poria cocos;Prescription 5:wild jujube kernel,Albizzia bark,Bupleurum,Paeonia lactiflora,Cyperus rotundus,Turmeric.Conclusions:1.Meta-analysis concluded:(1)Traditional Chinese medicine combined with conventional Western medicine treatment in improving angina pectoris,electrocardiogram,nitroglycerin stop rate,TCM syndrome,reduce the SAS score and SDS score,etc.(2)Subgroup analysis showed that intervention measures and treatment were heterogeneous sources of SAS score and SDS score.Traditional Chinese medicine and anti-anxiety and depression drugs had synergistic effect.(3)The number of literature samples included is small and there is some bias,and the quality of the literature and the level of evidence are low.2.Data mining conclusions:(1)In clinical research,the prescription of Chinese medicine is often treated from the heart and liver.(2)High frequency drugs reflect the treatment principle of soothing liver and nourishing heart and regulating qi and blood.(3)core drug for the Chaihu shugan powder modified,reflecting the liver qi,Shuanrou combination,blood and regulate the rules of the group.(4)Cluster prescription mainly reflects the thought of syndrome differentiation and treatment of soothing the liver and relieving depression,calming the nerves,activating blood to remove blood stasis,supplementing qi and activating blood circulation,eliminating dampness and resolving phlegm.