| Study 1.Study on Traditional Chinese medicine syndrome elements of hypertensive left ventricular hypertrophyObjective:To explore the distribution of Traditional Chinese medicine(TCM)syndrome elements in patients with hypertensive Left ventricular hypertrophy(LVH),and to explore the influencing factors of TCM syndrome elements.Method:Medical records of patients who were hospitalized and first diagnosed as hypertension from January 2017 to February 2023 in the Department of Cardiology,Dongfang Hospital of Beijing University of Chinese Medicine were collected by retrospective investigation.TCM syndrome elements were determined according to Syndrome elements Differentiation Scale in Syndrome Elements Differentiation edited by Professor Zhu Wenfeng,and patient data database was established using Excel.The distribution of TCM syndrome elements in patients was analyzed,and the influencing factors of each syndrome element were discussed.Results:A total of 154 patients with hypertensive LVH were included in this study,including 72 males and 82 females,mainly distributed between 50 and 89 years old.Most patients with grade 3 hypertension and cardiovascular risk stratification were "very high risk",and the complications were mainly dyslipidemia and hyperhomocysteinemia.There was distribution of single,double and multiple syndrome elements in both disease location syndrome elements and disease syndrome elements.Disease location syndrome elements were mainly liver,heart and kidney,and disease syndrome elements were mainly Qi deficiency,Yang hyperactivity,Blood stasis and Yin deficiency.There were 38 cases diagnosed with single disease location syndrome elements,mainly heart and liver.A total of 73 patients were diagnosed with double disease location syndrome elements,mainly ’heart+liver’ and ’liver+kidney’ combination.There were 41 cases diagnosed with three disease location syndrome elements,mainly ’heart+liver+kidney’ combination;There were 2 cases of four disease location syndrome elements.There were 30 cases of single disease syndrome elements,mainly Dampness,Yang hyperactivity and Qi deficiency.There were 78 cases of dual-disease syndrome elements,and the combination of ’Qi deficiency+Blood stasis’ and ’Yin deficiency+Yang hyperactivity’was the most common.There were 38 cases with three disease syndrome elements,mainly’Qi deficiency+Yin deficiency+Yang hyperactivity’,’Qi deficiency+Blood deficiency+Blood stasis’ and ’Yin deficiency+Blood stasis+Yang hyperactivity’.There were 8 cases of four disease syndrome elements,mainly ’Qi deficiency + Yin deficiency+Blood stasis+Yang hyperactivity’.Stratified study results showed that the proportions of spleen,dampness and blood stasis in male patients were higher than those in female patients(P<0.05).With the increase of age,the proportion of syndrome element "kidney" and "Yang deficiency" in hypertensive LVH patients was higher(P<0.05).With the increase of blood pressure grading,the proportion of syndrome element "heart" and "Qi deficiency" showed a decreasing trend,while the proportion of syndrome element "liver" showed an increasing trend(P<0.05).The longer the course of hypertension,the greater the proportion of patients with syndrome element "kidney"(P<0.05);There were differences in the distribution of "liver","blood stasis","dampness" and "Yang hyperactivity" in patients with coronary heart disease(P<0.05).The proportion of syndrome element "stomach" in patients with diabetes mellitus was higher(P<0.05);The proportion of syndrome elements "liver","kidney" and "Yang deficiency" in hypertensive LVH patients with chronic kidney disease was higher(P<0.05).There was no statistical significance in the distribution of TCM syndrome elements in patients with dyslipidemia and hyperuricemia.The analysis of influencing factors of syndrome element showed that age was the influencing factor of syndrome element "Qi deficiency",and the course of hypertension was the influencing factor of syndrome element "phlegm".Conclusion:The disease location syndrome elements and disease syndrome elements of hypertensive LVH have the distribution of single,double and multiple syndrome elements.The disease location syndrome elements are mainly liver,heart and kidney,while the disease syndrome elements are Qi deficiency,Yang hyperactivity,Blood stasis and Yin deficiency.There are differences in the distribution of TCM syndrome elements in patients with different gender,age,blood pressure grade,hypertension course and patients with coronary heart disease,diabetes and chronic kidney disease.Age was the influencing factor of syndrome element "Qi deficiency",and the course of hypertension was the influencing factor of syndrome element "phlegm".Study 2.Study on the administration law of oral Chinese herbal compound in the treatment of hypertensive LVH based on modern literatureObjective:To analyze the modern literature on the treatment of hypertensive LVH by oral Chinese medicine compound,and to summarize the medication rule and core Chinese medicine in the treatment of hypertensive LVH.Method:WangFang Data,CNKI,VIP,SinoMed,Pubmed,Web of Science,Cochrane Library,Embase and other Chinese and English databases were searched by computer.The literature on the treatment of hypertension LVH by TCM compounds was collected and Micrisoft Excel 2019 was used for data statistics,and the frequency of use,efficacy classification and medical property and five flavors of TCM were analyzed.IBM SPSS Modeler 18.0 software and IBM SPSS Statistics 25.0 software were used to analyze the association strength and cluster analysis among TCM.Results:A total of 77 literatures were included,involving 77 TCM prescriptions,a total of 159 TCM,and the frequency of drug use was 699 times.Medical properties are mainly flat,warm,slightly cold,cold,slightly warm and cool,the five flavours are mainly sweet,bitter and xin,and most TCM belong to liver,heart,lung,spleen,kidney and stomach channels.Drugs for promoting blood circulation and removing blood stasis were used most frequently,followed by drugs for supplementing Qi,calming liver and calming wind,clearing heat,relieving surface and supplementing Yin.Statistics of the TCM frequency showed that Astragalus membranaceus,salvia miltiorrhiza,ligusticum ligusticum,angelica sinensis,pueraria rhizome,panax notoginseng,Uncaria rattan,cassia,red peony root,safflower,mulberry parasitica and eucommia ulmoides were the core drugs for the treatment of hypertensive LVH.The analysis of drug association principle showed that Astragalus-Salvia miltiorrhiza,ligusticus-Angelica,Salvia miltiorrhiza-Pueraria,Radix notoginseng,Ungutensis-cassia,ligusticus-red peony root,ligusticus-safflower,mulberry parasiticEucommia ulmoides were the core drug pairs for the treatment of hypertensive LVH.Cluster analysis showed that high-frequency drugs could be divided into four categories.Conclusion:In the treatment of hypertensive LVH,there are many medicines for promoting blood circulation and removing blood stasis,supplementing qi,calming liver and dispelling wind,clearing heat,relieving surface and supplementing Yin.It mainly reflects the treatment of invigorating qi and promoting blood circulation,nourishing Yin and purring Yang,which is consistent with the key pathogenesis of hypertension LVH with Yin deficiency and Yang hyperactivity,Qi deficiency and blood stasis.Radix astragalus,salvia miltiorrhiza,ligusticum ligusticum,Radix Dangica,pueraria root,panax notoginseng,uncaria rattan,cassia,red peony root,safflower,mulberry and ulmoides are the core medicines for treating hypertensive LVH.Study 3.To explore the mechanism of core Traditional Chinese medicine in the treatment of hypertensive LVH based on network pharmacologyObjective:To explore the mechanism of core Traditional Chinese medicine in the treatment of hypertensive LVH based on network pharmacology.Method:Core traditional Chinese medicine active ingredients and corresponding targets were obtained through TCMSP database,SYMmap database,pubchem database and SwissTargetPrediction database,and LVH related targets were obtained through Genecards and OMIM database.The intersection of drug active ingredient target and disease target was obtained.Construct the ’drug-Active ingredient-Target’ network with Cytoscape software,construct the PPI network with STRING database,and conduct related topology analysis with Cytoscape software.The clusterProfiler,Stringin and Pathview packages were installed and run in R software using Bioconductor software.GO functional enrichment analysis and KEGG pathway enrichment analysis of biological processes were carried out on the packages,and visual display was performed through WeiShengXin platform.Results:191 core TCM active ingredients were obtained,with 654 corresponding targets of active ingredients,4656 disease-related targets and 352 interactional targets of drugs and diseases.GO enrichment analysis obtained 6386 items,including 5176 biological processes,431 cell components,and 779 molecular functions.297 items were obtained by KEGG enrichment analysis,which were mainly PI3K-Akt signaling pathway,HIF-1 signaling pathway and IL-17 signaling pathway.Conclusion:The core Traditional Chinese medicine treats hypertensive LVH through multicomponent,multi-target and multi-pathway,and 4-Hydroxybenzyl Alcohol,quercetin,vanillin,kaempferol,luteolin and tanshinone ⅡA are its main active components.The potential mechanism of action may be related to multiple biological processes and signaling pathways.Its target may be regulated by JUN,TP53,AKT1,MAPK1 and other genes. |
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