Study On The Distribution Of TCM Syndromes And Drug Laws In Elderly Patients With Coronary Heart Disease Complicated With Iron Deficiency Anemia

Objective: In this study,the clinical data of elderly patients with coronary heart disease complicated with iron deficiency anemia were retrospectively analyzed,and their TCM syndromes and medication rules were summarized to provide ideas and references for TCM syndrome differentiation and treatment of elderly patients with coronary heart disease complicated with iron deficiency anemia.Methods: The clinical data of patients who were hospitalized in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2013 to December 2022 were collected,and their TCM syndromes and prescription medication were counted.The TCM inheritance auxiliary platform(V2.5)software was used to analyze the distribution of TCM syndromes and the law of prescription medication.Results :1 General situation of elderly patients with coronary heart disease and iron deficiency anemiaA total of 207 elderly patients with coronary heart disease and iron deficiency anemia were collected,including 85 males(41.06 %)and 122females(58.94 %).There were 90 patients with mild anemia(43.48 %),97 patients with moderate anemia(46.86 %),20 patients with severe anemia(9.66 %)and 0 patients with very severe anemia.The age of patients ranged from 60 to 103 years old,with an average age of 79.51 years.There were 45 patients aged 60-69(21.74 %),48 patients aged 70-79(23.19 %),72 patients aged 80-89(34.78 %),and 42 patients aged ≥ 90(20.29 %).The elderly over 80 years old are known as the elderly,a total of 114 cases(55.07 %).2 Distribution of TCM syndromes in elderly patients with coronary heart disease complicated with iron deficiency anemiaThe TCM syndrome types of patients in descending order were qi and blood deficiency syndrome,qi deficiency and blood stasis syndrome,qi and yin deficiency syndrome,phlegm turbidity resistance syndrome,heart blood stasis resistance syndrome and yang qi deficiency syndrome.3 Study on medication rules of elderly patients with coronary heart disease and iron deficiency anemiaAmong the 207 elderly patients with coronary heart disease and iron deficiency anemia,169 took traditional Chinese medicine decoction,and the utilization rate of traditional Chinese medicine was 81.64 %,involving 169 prescriptions and 251 flavors of traditional Chinese medicine.The top 20 traditional Chinese medicines ranked by frequency of drug use were angelica,astragalus,licorice,poria,fried atractylodes,ophiopogon,dangshen,rehmannia,chuanxiong,tangerine peel,white peony,achyranthes,peach kernel,roasted licorice,red peony,schisandra,pinellia,salvia miltiorrhiza,safflower,scutellaria;in the distribution of drug efficacy,the top 6categories were tonifying deficiency,promoting blood circulation and removing blood stasis,resolving phlegm and relieving cough and asthma,regulating qi,clearing heat,and promoting diuresis and dampness.The frequency of temperature in the distribution of the four qi is the highest,followed by cold,flat,cool and hot;among the five flavors,the sweet flavor appears the most,followed by bitter,pungent,sour,salty and astringent;the highest frequency of meridian tropism is spleen meridian,followed by lung meridian,liver meridian,heart meridian,stomach meridian,kidney meridian,large intestine meridian,gallbladder meridian,bladder meridian,small intestine meridian,pericardium meridian and triple energizer meridian.Using the analysis method of association rules,the top 10 drug combinations were Astragalus-Angelica,Chuanxiong-Angelica,fried Atractylodes-Poria,Codonopsis-Angelica,Codonopsis-Astragalus,Astragalus-Poria,Angelica-Poria,Radix Rehmanniae-Angelica,Pericarpium Citri Reticulatae-Poria,Codonopsis-Poria.The first five groups of drug pairs(groups)with high correlation were safflower-chuanxiong-> angelica,safflower-taoren-> angelica,safflower-> angelica,Chuanxiong-huangqi-angelica,safflower-angelica-> Chuanxiong.Conclusion:1 Elderly patients with coronary heart disease combined with iron deficiency anemia is deficiency in origin and excess in superficiality.Deficiency of qi,blood,yin and yang can be seen in deficiency in origin,mainly deficiency of qi and blood,and blood stasis and phlegm are more common in excess in superficiality.2 The treatment of elderly patients with coronary heart disease complicated with iron deficiency anemia is based on tonifying deficiency,and removing excess is the standard.Tonifying deficiency is mostly based on sweet and warm products to tonify qi and blood,and regulate yin and yang.Qushi is mostly treated with blood-activating,phlegm-resolving,qi-regulating,heat-clearing and dampness-eliminating drugs for removing blood stasis and turbidity,promoting qi and removing dampness.