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.
ABSTRACT
Meridians include (Qi) channels and blood (vessels). In Duyi Suibi, ZHOU Xue-hai of qing Dynasty named the terminal of Qi channel as"fine collateral of Qi" and the terminal of blood vessel as"fine collateral of blood". Qi channels of the heart cover extensive regulating mechanisms including cardiac pacing and conducting system. Blood vessels of the heart cover circulation system of coronary artery. Cardiac Qi channels and blood vessels are coordinated mutually, and Ying and Wei run together, to jointly maintain normal functions of the heart. Abnormal Yingwei caused by various pathogenic factors leads to occurrence of arrhythmia. Based on the Yingwei theory of vessel-collateral theory, this paper puts forward treatment based on syndrome differentiation of arrhythmia guided by therapeutic principle of"regulating Yingwei in case of heart damage" (Nanjing·14thNan) as well as addresses both symptoms and root causes by prescriptions for regulating Wei, Qi, Ying and blood through sufficiently considering modern pathogenic factors and pathogenic characteristics, in order to provide beneficial reference for clinical diagnosis and treatment.
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Objective: To observe the clinical efficacy of Jinlida (JLD) granules and Tongxinluo (TXL) capsules on type 2 diabetic kidney disease (DKD) under the guidance of vessel collateral theory. Method: A total of 120 patients with type 2 DKD, were randomly divided into 2 groups:the normal control group (60 cases) and the treatment group (60 cases). The patients in normal control group were treated with dietary control and hyperglycemia control. Based on treatment in control group, patients in treatment group were additionally treated with JLD granules (1 bag, tid), and TXL capsules (4 capsules, tid). The treatment was lasted for 12 weeks. The clinical efficacy, traditional Chinese medicine(TCM) syndrome scores were observed and compared before and after treatment. At the same time, the levels of glucose metabolism indexes including fasting blood glucose (FBG),postprandial 2 h plasma glucose (2 hPG), glycosylated hemoglobin (HbA1c) and the insulin resistance (IR); the levels of lipid metabolism indexes including total cholesterol(TC),triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and the high-density lipoprotein cholesterol (HDL-C); the levels of renal function indexes including urinary albumin excretion rate (UAER) and serum creatinine (SCr); as well as nailfold microcirculation were detected and compared. Result: ①The total effective rate was 80.0% in treatment group, significantly higher than 61.67% in the normal control group (PPPPPβ2-MG in treatment group was significantly obvious than that in the control group (PPConclusion: Tongxinluo combined with Jinlida can improve the clinical symptoms of patients with type 2 diabetic nephropathy and reduce urinary trace albumin, and its mechanism may be related to lowering glucose, regulating lipid metabolism and improving microcirculation.
ABSTRACT
The blood-vein theory is inherited and developed. Combined with the related theory features of Qi and blood of traditional Chinese medicine(TCM), the progress results in two national 973 plan projects undertaken are learned from, the vessel-collateral theory guiding the prevention and treatment of vascular lesions is systematically built, the academic development of TCM collateral disease discipline is pushed from "treatment of symptoms of collateral disease" to study on "vessel-collateral theory", a new stage in the history. The pathogenesis, basic pathogenesis, clinical syndrome and syndrome differentiation therapy of vessel-collateral lesions are systematically studied, Yingwei theory, the core content of vessel-collateral theory, is proposed, the syndrome differential diagnosis standard of "vessel-collateral-vascular system disease" is established, and the blood-vessel theory of TCM is improved. The development of Yingwei theory of vessel-collateral theory is deepened. The theory of Yingwei sympathia and Yingwei's "opening by collaterals, intersecting and generating" are proposed to guide the study on prevention and control of vascular lesions. With tertiary collaterals-microvessel as a breakthrough point of research, four types of microscopic pathological features of microvessels are proposed. It is confirmed that dredging collaterals and protecting tertiary collaterals-microvessel is the common key mechanism for the treatment of major diseases of heart, brain and kidney(sugar). It protects microvessels, improves blood flow perfusion, protects tissue cells, and improves the viscera function. Dredging collaterals and protecting microvascular endothelial cells is the core mechanism of treating tertiary collaterals-microvessel lesions. It is proposed that protection of microvascular endothelial cells is a new strategy to solve the problem of microvascular lesions. After more than ten years, four studies of evidence-based medicine have been completed to solve the clinical problem of acute myocardial infarction without reflow. New drugs are provided to the international medical problem of cardiac insufficiency with premature ventricular contraction. The gap of fast and slow treatment, integration and rhythm adjustment of sinus bradycardia with premature ventricular contraction is filled. The clinical treatment effect of chronic heart failure is significantly improved, a major breakthrough in the treatment of microvascular lesions by TCM is achieved, and it is fully recognized and highly evaluated by the medical profession at home and abroad. It promotes the specialized subject platform construction and society development under the guidance of Yingwei theory of vessel-collateral theory, as well as the clinical application of syndrome differentiation diagnosis and treatment method and drugs of vessel-collateral lesions, and has significant social and economic benefits.