Research On TCM Syndrome Elements, Syndrome Characteristics And Syndrome Evolution Laws Of Coronary Heart Disease Complicated With Stroke

Purpose:This study aims to explore the main coronary heart disease(CHD)combined stroke in different stages of the disease syndrome elements,clarify the main syndrome characteristics of every period of disease,and summarize the syndrome between syndromes evolution law,provide the basis for the standardization of TCM diagnosis and treatment of coronary heart disease(CHD)with stroke.Material and method:Guided by the theory of traditional Chinese medicine,combined with characteristics of clinical disease,coronary heart disease(CHD)combined stroke scale learning methods and three rounds of Delphi method,established coronary heart disease with syndrome of stroke elements,characteristic of syndrome and evolution rule of syndrome clinical expert questionnaire.Six regions of the country(north,south,southeast,northeast,northwest,southwest)51 family hospital clinical first-line physician questionnaire investigation,a total of 1517 questionnaires,1504 qualified questionnaires.Survey results will be built into a 3 d structured relational database,using the frequency analysis,decision tree and neural networks,clustering analysis,should be the combination analysis,probability transfer matrix method to analyze the results of mathematical statistics,etc.Results: 1.Coronary heart disease(CHD)combined stroke three phases(acute stage,recovery and sequelae period),the symptoms of frequency distribution: in patients with physical distribution,mass with blood stasis and phlegm wet mass is given priority to,Yin deficiency,qi deficiency patients.Even many characteristics with onset before incentive,often aura symptoms mainly.God know change from a sudden emergency,unconscious to depression.Give priority to in order to construct the sound is not clear language function change.Paresthesia is given priority to with partial body numb.Body posture with hemiplegia without paralysis is given priority to,Movement dysfunction is given priority to with lift on upper limb weakness.The first facial expression is given priority to with comes,spat salivate.The head is given priority to with dizziness,dizziness;Shortness of breath characteristic from,pockets to cough up phlegm or phlegm,shortness of breath;Hindquarters cadres witness with water choke,dysphagia,chest tightness,Mainland witness is given priority to with constipation;Sweat characteristics is given priority to with spontaneous sweating fatigue;Not feeling is given priority to with hand,foot and heart,five upset hot;Complexion oral performance is given priority to with dull grooves,lip dark purple.For tongue pulse frequency statistics show that coronary heart disease(CHD)combined stroke many periods tongue ecchymosis,big fat,tongue state skew,pulse string;Acute phase tongue color more red,dark purple,moss greasy,thick,moss yellow color,tongue state,number of arteries and veins;Recovery tongue color more dark and red,moss greasy,thick,moss yellow color,tongue Withers softly,tremor,sink of arteries and veins;Sequela period of tongue color more dark moss and little or no,moss white of color,tongue state Withers softly,pulse fine and heavy.2.The decision tree results:(1)Coronary heart disease with acute phase of stroke syndrome factor criterion: Wind evil: "comes","tongue vibrate","stiffness","eye partial transient" and "nystagmus","all of a sudden,acute onset","mouth numb","pulse condition","partial body numb","tongue state skew","limb tic","eye closure is difficult to set","the head shake not homemade";Heat evil: "silence doesn’t open mouth","number of pulse condition","the tongue color is purple,shortening of the" tongue "and" hands grip "and" shortness of breath "," tongue tough "," red "," tongue swelling "," urine " closed," moss color yellow "," moss mass dryness ";Phlegm retention: " dizzy "," moss quality be bored with "," the word is not clear "," stun " god," moss qualitative thick "," tongue tough "," the statement is not complete "," cough up phlegm or phlegm "," pulse condition of string "," compose the sound is not clear;Spleen-deficiency: "loose stool","abdominal distention","the weak";Kidney Yin deficiency: "five upset hot","waist leg weakness".(2)The coronary heart disease(CHD)combined stroke recovery period syndrome factor criterion: Phlegm retention: "the word is not clear," "compose the sound is not clear","moss quality be bored with","moss qualitative thick","limb swelling","moss qualitative slippery","dizziness","cough up phlegm or phlegm,shortening of the" tongue "," tongue Jian cannot say "," pulse condition "," tongue tooth mark ";Temper: " the weak "," abdominal distention "," loose stool ";Liver blood deficiency: " faint are " vision," the tongue color bright white "," oral color light "," blackouts "," oral pale white ";Heart qi deficiency: " palpitation "," the weak ".(3)Coronary heart disease(CHD)with stroke sequela period syndrome factor criterion: Phlegm retention: " moss quality be bored with "," swimming "," dizziness ",shortening of the " tongue "," tongue fat big "," pulse condition "," compose the sound is not clear," the word is not clear ","tongue tooth mark","god faint","tongue Jian cannot say","the statement is not complete","moss mass corruption","phlegm sound detour","moss color grey";Temper: "the weak","loose stool","bloating";Liver blood deficiency: "faint vision are","oral color light","tongue color bright white","blackouts";Kidney Yin deficiency: "night sweats","waist leg weakness","five upset hot";Yang: "cold limbs cold","waist leg weakness".3.The results of neural networks: Three phase of the stroke and coronary heart disease(CHD)combined stroke,phlegm retention,heart deficiency,liver blood deficiency,qi deficiency,temper the stages of kidney Yin deficiency syndrome elements of the training set,evaluation set,validation set to predict wrongly rate are less than 1%,shows that the neural network better prediction effect,the model of the evaluation effect is better,and also illustrates the judgment of the decision tree.4.Cluster analysis results:(1)coronary heart disease with acute phase of stroke can clustering for the symptoms of the two groups: the first group of symptom group is shown as: the onset of all of a sudden,acute onset,before the onset of many are the cause,sudden headache,drama,such as knife splitting;All of a sudden emergency,unconscious,sweating,such as beads,such as oil,mainland since the heritage,shortness of breath,pockets,limb hemiplegia need not,paralysis,the body can’t move,comes,tongue Jian cannot speak,construct the sound is not clear,(or),aphasia and partial body is numb,chest tightness,heart palpitations,difficulty swallowing,drinking water choke.Tongue tough,skew,red tongue,yellow moss,pulse string;The second group of symptoms are presented as: the onset of a sudden,acute onset,before the onset of many,often premonitory symptoms,headache neck,back stiffness,dizzy,dizzy,walking is not straight;All of a sudden emergency,unconscious,shortness of breath,pockets,body can’t move,numbness,partial body is numb,spat askew,salivate,tongue Jian cannot speak,construct the sound is not clear,(or)aphasia,difficulty swallowing,drinking water choke,chest tightness.Tongue askew,yellow greasy moss,pulse string.(2)the coronary heart disease(CHD)combined stroke recovery can be clustering for the symptoms of the two groups: the first group of symptom group is shown as: spontaneous sweating fatigue,cough up phlegm or phlegm,spat askew,salivate,limb hemiplegia,paralysis,body relax,collapse is not warm,repose not vexed(tetraplegia),lift on upper limbs strength is weak,construct the sound is not clear,words is not clear,the statement is not complete,partial body is numb,limbs,numbness,dim complexion,dizziness,dizziness,heaviness,water choke,or hot body and cold limbs,chest tightness.Tongue askew,ecchymosis,moss yellow,greasy,pulse string;The second group of symptoms are presented as: even repeatability characteristics,shortness of breath,spontaneous sweating fatigue,limb hemiplegia need not,paralysis,finger strength is weak,lift on upper limbs strength is weak,can’t lift on shoulder,swing up slightly,skin,limbs,numbness,spat askew,salivate,the statement is not complete,water choke,steps,bosom frowsty,dizzy,dizzy,dizziness,scalp numbness.Dark,tongue ecchymosis,Withers softly,fat big,pulse string.(3)coronary heart disease(CHD)with stroke sequela period can clustering for the symptoms of the two groups: the first group of symptom group is shown as: are you a repetitive characteristic,limb hemiplegia,limb muscle atrophy,paralysis,finger strength is weak,the skin,limbs,numbness,spat askew,salivate,tongue Jian cannot speak,the sound is not clear,words is not clear,the statement is not complete,water choke,steps,dizziness,scalp numbness,head heaviness,forgetful,chest tightness.Dark,tongue ecchymosis,tongue Withers softly,skew,moss white,pulse string;The second group of symptoms are presented as: limb hemiplegia need not,stiff limb Ju Luan deformation,paralysis,limb muscle atrophy,lift on upper limbs strength is weak,construct the sound is not clear,words is not clear,the statement is not complete,spat askew,salivate,steps,dizziness,forgetfulness,chest tightness;Partial Yang deficiency and depression,form cold,cold extremities,dim complexion,spontaneous sweating fatigue,shortness of breath,urine self-interest;Partial Yin deficiency and see five upset hot.Tongue Withers softly,skew,dark tongue,whitish,pulse heavy fine.5.The transfer probability matrix results:(1)coronary heart disease with acute phase of stroke to recovery,transition probability from high to low is arranged as follows: hot poison ablaze,Yin exhaust Yang to take off the evolution of deficiency of collaterals lag syndrome(51.80%)transition probability;Wind Yang phlegm fire,blinded by the qing qiao qi deficiency card for phlegm and blood stasis syndrome(50.57%)transition probability;Wind Yang phlegm fire,blinded by the qing qiao qi deficiency card evolved into complex hysteresis syndrome(49.43%)transition probability;Dragon’s toxic heat flourishing,Yin Yang to take off the card turned into blood stasis phlegm stasis(transition probability of 48.20%).(2)the coronary heart disease(CHD)combined stroke recovery to sequela period,transition probability from high to low is arranged as follows: deficiency of phlegm and blood stasis syndrome evolution of qi deficiency blood stasis resistance syndrome(transition probability of 63.34%),deficiency of collaterals stagnation syndrome evolution for qi deficiency blood stasis resistance(transition probability of 61.39%),deficiency of network delay the evolution of kidney deficiency syndrome(transition probability of 38.61%),deficiency of phlegm and blood stasis syndrome evolution of kidney deficiency syndrome(transition probability of 36.66%).Conclusion: 1.The syndrome factors of coronary heart disease combined solid strokes all phases of the syndrome elements and virtual sex syndrome elements inclusion,phlegm retention and spleen-deficiency throughout the course of the disease has always been.Coronary heart disease with acute phase of stroke in the wind,heat,phlegm retention as the main syndrome factors,both temper deficiency,kidney Yin deficiency;Coronary heart disease(CHD)combined stroke recovery period is mainly made of phlegm retention and spleen-deficiency syndrome elements,both liver,blood deficiency,deficiency of heart;Coronary heart disease(CHD)with stroke sequela period is mainly made of phlegm retention and spleen-deficiency syndrome elements,both liver blood deficiency,kidney deficiency,kidney Yang deficiency.,the main pathogenic wind,phlegm retention,heart deficiency,liver blood deficiency,qi deficiency,temper kidney Yin deficiency distribution reflected the disease at all stages of the disease from fast to slow and from the evolution to failure.2.The syndrome characteristics of coronary heart disease(CHD)combined stroke onset syndromes is characterized by three phases: coronary heart disease with acute phase of stroke:(1)hot poison ablaze,dragon’s Yin Yang to take off the card,(2)the wind Yang phlegm fire,blinded by qing qiao syndrome;Coronary heart disease(CHD)combined stroke recovery period:(1)deficiency of phlegm and blood stasis syndrome,qi deficiency(2)the network delay;Coronary heart disease(CHD)with stroke sequela period:(1)qi deficiency and blood stasis resistance syndrome,(2)the kidney deficiency syndrome.3.The transition probability matrix obtained syndrome syndrome evolution law evolution rule is: the coronary heart disease(CHD)of the acute phase of stroke to the recovery of all qi deficiency syndrome type evolved into collaterals stagnation syndrome,blood stasis phlegm stasis.Dragon’s toxic heat flourishing,Yin Yang syndrome are more likely to development as the deficiency of collaterals lag;Wind Yang phlegm fire,blinded by the qing qiao qi deficiency syndrome are more likely to develop as phlegm and blood stasis syndrome;Coronary heart disease(CHD)combined stroke recovery and sequelae period all type evolution of deficiency of blood stasis syndrome,liver and kidney deficiency syndrome.Recovery of all type are easier for the development of qi deficiency blood stasis syndrome,the second is easy for the development of liver and kidney deficiency syndrome.