ABSTRACT
ObjectiveTo explore the rules of syndrome and treatment of cardiovascular event chain based on the results of data mining of medical records under the guidance of vessel-collateral theory. MethodMulti-source database research method was used to retrieve the medical records related to metabolic syndrome, angina pectoris of coronary heart disease, post-intervention of myocardial infarction, arrhythmia after myocardial infarction and heart failure after myocardial infarction between database inception and January 2022 from PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), VIP and China Biomedical Literature Service System (SinoMed). The fields of name, age, gender, symptoms, tongue image, pulse image, drug and disease location were extracted from these medical records, and drug efficacy classification and syndrome classification were determined based on vessel-collateral theory. The rules of syndrome and treatment of cardiovascular event chain were analyzed by data mining methods such as frequency deconstruction, systematic cluster analysis and FP-Growth association analysis. ResultThe above five key pathological links in the chain of cardiovascular event chain all showed symptoms related to the disorder of Yingwei. The proportion of dampness, phlegm, blood stasis and water secondary to the disorder of Yingwei in the above five key pathological links was different, and the frequency of corresponding drug combinations was also different. ConclusionThe disorder of Yingwei is the initiating factor of cardiovascular event chain and runs through the whole process. The abnormality of Yingwei at the terminal of vessel-collateral may lead to the disorder of Qi, blood, body fluid and essence transportation and metabolism. Body fluid accumulates into dampness, dampness accumulates into phlegm, blood stagnation accumulates into blood stasis, blood stasis accumulates into water, which becomes an internal driving factor to promote the development and aggravation of cardiovascular event chain. It leads to the transmission law of Ning-Yong-Sai-Butong, which constitutes the core pathogenesis of the development and evolution of the five key pathological links of cardiovascular event chain.
ABSTRACT
ObjectiveTo explore the rules of syndrome and treatment of cardiovascular event chain based on the results of data mining of medical records under the guidance of vessel-collateral theory. MethodMulti-source database research method was used to retrieve the medical records related to metabolic syndrome, angina pectoris of coronary heart disease, post-intervention of myocardial infarction, arrhythmia after myocardial infarction and heart failure after myocardial infarction between database inception and January 2022 from PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), VIP and China Biomedical Literature Service System (SinoMed). The fields of name, age, gender, symptoms, tongue image, pulse image, drug and disease location were extracted from these medical records, and drug efficacy classification and syndrome classification were determined based on vessel-collateral theory. The rules of syndrome and treatment of cardiovascular event chain were analyzed by data mining methods such as frequency deconstruction, systematic cluster analysis and FP-Growth association analysis. ResultThe above five key pathological links in the chain of cardiovascular event chain all showed symptoms related to the disorder of Yingwei. The proportion of dampness, phlegm, blood stasis and water secondary to the disorder of Yingwei in the above five key pathological links was different, and the frequency of corresponding drug combinations was also different. ConclusionThe disorder of Yingwei is the initiating factor of cardiovascular event chain and runs through the whole process. The abnormality of Yingwei at the terminal of vessel-collateral may lead to the disorder of Qi, blood, body fluid and essence transportation and metabolism. Body fluid accumulates into dampness, dampness accumulates into phlegm, blood stagnation accumulates into blood stasis, blood stasis accumulates into water, which becomes an internal driving factor to promote the development and aggravation of cardiovascular event chain. It leads to the transmission law of Ning-Yong-Sai-Butong, which constitutes the core pathogenesis of the development and evolution of the five key pathological links of cardiovascular event chain.
ABSTRACT
Objective:Guided by nutrient-defense stages in the vessel-collateral theory, the modern medical cases of unstable angina pectoris(UAP) were systematically collated and analyzed to explore the rules of syndrome and treatment of UAP and the molecular mechanism of core Chinese herbal combination in the treatment of UAP based on network pharmacology. Method:All medical cases with UAP treated by Chinese medicinal compounds were retrieved from PubMed,China National Knowledge Infrastructure (CNKI),Wanfang Data, VIP, and SinoMed published between database inception and November 2020. The syndromes of medical cases were determined based on the nutrient-defense stages of the vessel-collateral theory. Rules of syndrome and treatment of UAP were investigated by data mining methods, such as frequency statistics, cluster analysis, and enhanced FP-Growth algorithm. The molecular mechanism of core Chinese herbal combination in the treatment of UAP was analyzed by network pharmacology. Result:The first four syndromes of UAP with high frequencies were deficiency and stagnation of collateral Qi, blood stasis obstructing collaterals, depression and stagnation of collateral Qi, and turbid phlegm obstructing collaterals. The Chinese herbal medicines with high frequencies included Salviae Miltiorrhizae Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Chuanxiong Rhizoma, and Astragali Radix, which were effective in resolving stasis, dredging collaterals, replenishing Qi, consolidating defensive Qi, regulating Qi, relieving depression, and dispelling phlegm. The association analysis indicated that the core Chinese herbal combination in the treatment of UAP was Salviae Miltiorrhizae Radix Chuanxiong Rhizoma-Astragali Radix. Four Chinese herbal combinations were obtained by cluster analysis. As revealed by network pharmacology, the key components of Salviae Miltiorrhizae Radix et Rhizoma-Chuanxiong Rhizoma-Astragali Radix in the treatment of UAP included quercetin, luteolin, and tanshinone Ⅱ<sub>A</sub>, and the key targets included serine/threonine-protein kinase 1 (Akt1), mitogen-activated protein kinase 1 (MAPK1), Jun, interleukin (IL)-6, and MAPK8. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signaling pathway might serve as the main pathway for its therapeutic efficacy. Conclusion:The basic pathogenesis of UAP is deficiency/depression and stagnation of collateral qi and turbid phlegm obstructing collaterals. The treatment should follow the principles of replenishing Qi, resolving stasis, and dredging collaterals, assisted with regulating Qi and resolving phlegm. The therapeutic efficacy of Salviae Miltiorrhizae Radix-Chuanxiong Rhizoma-Astragali Radix was achieved via multi-component, multi-target, and multi-pathway. This study is expected to inspire future UAP-related studies at the molecular level based on vessel-collateral theory.