| Objective: This study explore the main elements of coronary heart disease with hypertension in different stages,confirming the main syndrome characteristics in the developing of hypertension coronary heart disease and the intrinsic evolution law, being a basic standardization of TCM diagnosis and treatment of coronary heart disease with hypertension.Materials and methods: Reference to the relevant exploration,guide,with Suggestions for coronary heart disease with hypertension disease diagnosis standard,on the basis of literature study,expert advice,by the method of document and questionnaire study,development of coronary heart disease with hypertension syndrome elements,common syndrome characteristics and evolvement law of syndrome pathogenesis clinical expert questionnaire first draft. Using three rounds of Delphi method,consulting widely domestic peer experts and statistics experts suggest,modify,add or delete the content of the questionnaire and adjustment,to ensure that the questionnaire structure and the entry word content can accurate reflection of clinical symptoms and signs of coronary heart disease with hypertension,on the questionnaire reliability and validity of the content of the good evaluation,entrust China academy of traditional Chinese medicine,bistone(Beijing) information technology co.,LTD. Development of coronary heart disease common merger disease clinical research questionnaire survey system,relying on the network database platform,realize the online to fill out the questionnaire. A national multicenter,large sample clinical expert investigation. The survey covers six of the country,respectively is: the northeast(Shenyang, Changchun) region,north China(Beijing),northwest(Gansu,Shanxi, Qinghai) region,southeast(Guangzhou,Shenzhen),southwest(Chongqing,Chengdu) region,south China(Shanghai,Jiangsu); Investigation for the six regional 51 hospital clinical frontline doctors and 1504 qualified questionnaires were collected. Questionnaire survey data of the system output file construction of coronary heart disease with hypertension syndrome elements, syndrome characteristics and evolvement law of clinical syndrome expert questionnaire three-dimensional structured relational database,using the SAS statistical analysis software,using frequency,decision trees, neural networks, clustering analysis and probability transfer matrix method of mathematical statistics to the results were statistically analyzed.Results:1.Coronary heart disease(CHD) with hypertension four stages stage(0, 1, 2, 3) symptoms of frequency distribution: in patients with physical distribution, to Yin deficiency,phlegm wet mass of blood stasis,qi depression quality, quality,and the patient is given priority to; The stimulus and joys and modern ultra,long-term depression or found in modern,irregular work and rest, overwork,addiction of alcohol,tobacco,diet section is given priority to; Headache properties from without exception to pain; Headache place mainly at the top; The characteristics of the headache with see from scalp distention, scalp distention to dizzy; from no exception,giddy discomfort to the dizzy; Visual symptoms from without exception to dizziness; Hearing symptoms from asymptomatic,ear bilges Men Du closed presses,tinnitus,such as wind,such as cicadas to had longer duration of tinnitus; God is changing from without exception,inattention to be agitated; Facial features from no change,flush on face to face getting sluggish; Neck chest discomfort from no change to the palpitation; Back discomfort no change from the limbs,waist and knee acid to the steps and foot as on cotton; Food tastes change from no change,dry mouth, bitter to the mouth and stay,Mainland changes from mainland normal urine at night; Other features from no change,lack of power to body weight. Of tongue pulse frequency statistics show that 0 stage of coronary heart disease with hypertension tongue color is pink,more tongue is more moderate, main performance are moderate,thin coating on the tongue,moss color is given priority to with white,and yellow; coronary heart disease with hypertension, no.1 stage of coronary heart disease with hypertension tongue color mostly red, pink,tongue is puffy,more moderate,teeth marks,tongue coating mainly are moderate,smooth,thin,thick,moss color is given priority to with weak yellow, white,yellow; 2 stage of coronary heart disease with hypertension tongue color is red,dark,purple more,tongue ecchymosis,swell,more teeth marks,tongue coating mainly greasy moss,thick,less or no moss,smooth,dry,moss color is given priority to with yellow,yellow,gray; 3 stage of coronary heart disease with hypertension tongue color is dark,purple,red,purple,more tongue ecchymosis,sublingual collaterals more blue circuity and sublingual veins stood out,tongue coating mainly moss less or no moss,greasy,thick,no root,moss color is given priority to with black,yellow,grey; In different stages of the disease have a tongue state Withers softly; Coronary heart disease with high blood pressure 0 visible tough tongue state; Coronary heart disease with hypertension stage 1 and 2,has a tongue state vibration performance. Stage 3 tongue coating are visible fibrillation amalgamating hypertension coronary heart disease,shortening,invaded,strong performance. 0 stage of coronary heart disease with hypertension condition mainly include strings,sink,number, smooth,fine and floating; Coronary heart disease with hypertension more than 1 stage pulse condition for string,sink,number,smooth,fine; Coronary heart disease with hypertension more than 2 stage condition for string, slide, sink, number and fine, dry, tight; Coronary heart disease with hypertension more than three phase of the stage condition for string,sink,knot,acerbity, generation,number,fine,smooth,tight.2. Decision tree results:(1) 0 stage of coronary heart disease with hypertension syndrome factor criterion: the wind: "tongue pulse condition and performance characteristics of tongue color Pale white ","tongue pulse condition and performance features tongue vibrate","tongue pulse condition and performance characteristics of moss thin quality","headache with symptoms Scalp numbness "," dizzy Dizziness, "eye closure". And "nature of headache pain","tongue pulse condition and performance characteristics Pulse condition of string"," headache with symptoms Scalp distention ","headache with light when heavy" and "systemic symptom Facial features change colour blue ", "systemic symptom The neck is the chest discomfort Threats pain ". The modern: "god is changing Irritability "," stimulus Before and after menopause" and " stimulus Long-term depression or found in modern "and" stimulus Dizziness and modern drama","characteristics With tinnitus, irritability ","knowledge change fidgety god","god is changing upset." Factors(port) on the liver Yang:"god is changing fidgety","visual change mesh expansion" and "systemic symptom Food tastes change Mouth bitter ","nature of headache pain","systemic symptom Performance. Brown urine","visual change red eyes","tongue pulse condition and performance characteristics of liver Yang syndrone pulse condition string","characteristics of dizziness Dizzy".(2) 1 stage of coronary heart disease with hypertension syndrome factor criterion: heat evil: "systemic symptom Food tastes change Mouth thirst ","visual change red eyes","knowledge change fidgety god","tongue pulse condition and performance characteristics of moss color The yellow "," god is changing upset ". Kidney Yin deficiency: " systemic symptom Back limbs discomfort Lumbar debility ", " systemic symptom Other characteristics Five upset hot " and " systemic symptom Other characteristics of hot flashes zygomatic red " and " systemic symptom Other characteristics of night sweats "," systemic symptom Back limbs discomfort Spermatorrhea taken down "," auditory abnormalities Ringing in the ears, such as wind, such as cicadas. Factors(port) on the liver Yang: "god is changing Irritability", "tongue pulse condition and performance characteristics of tongue color Red ", "nature of headache pain", "god is changing Night sleep easy to wake up" and "god knowledge change nerves", "visual change mesh expansion" and "systemic symptom Food tastes change Mouth bitter ", "god is changing much dream", "tongue pulse condition and performance characteristics of pulse condition is fine".(3) 2 stage of coronary heart disease with hypertension syndrome factor criterion: modern: "god is changing Irritability"," stimulus And modern drama ","knowledge change fidgety god"and"stimulus Before and after menopause" and "stimulus Long-term depression or found in modern ","god is changing Good jing ","god is changing upset","characteristics of dizziness With tinnitus, irritable". Heat evil: "god knowledge change fidgety","systemic symptom Food tastes change Bad breath","headache with symptoms Irritability","tongue pulse condition and performance characteristics of pulse condition number","tongue pulse condition and performance characteristics of lingual prick(red, white or black)","god is changing upset","systemic symptom The neck is the chest discomfort Short of breath ","tongue pulse condition and performance characteristics of moss color grey"and"systemic symptom Mainland constipation"performance.Kidney Yin deficiency: "systemic symptom Back limbs discomfort Lumbar debility","systemic symptom Other characteristics of hot flashes zygomatic red "and"systemic symptom Other characteristics Five upset hot "and" systemic symptom Back limbs discomfort Spermatorrhea taken down ","systemic symptom Other characteristics of night sweats","systemic symptom The neck is the chest discomfort Dry throat ".Factors(port) on the liver Yang" god is changing Irritability ","visual change mesh expansion","god is changing Night sleep awaken","god is changing much dream","knowledge change fidgety god","characteristics of dizziness Dizzy".(4) 3 stage of coronary heart disease with hypertension syndrome factor criterion: blood stasis:" tongue pulse condition and performance characteristics Sublingual collaterals blue circuity","characteristics" tongue ecchymosis tongue pulse condition and performance" tongue tongue pulse condition and performance characteristics Sublingual veins stood out show","tongue pulse condition and performance characteristics of tongue color Purple","tongue pulse condition and performance characteristics of tongue color Dark","nature of headache, pain, have a fixed place","tongue pulse condition and performance characteristics and pulse condition","systemic symptom Facial features change oral purple or dark purple","tongue pulse condition and performance characteristics of pulse condition".Modern: "tongue pulse condition and performance characteristics of pulse condition generation" and "stimulus Long-term depression or found in modern","nature of headache Pain, such as crack","god is changed Good jing","knowledge change fidgety god", "characteristics of dizziness With tinnitus, irritability" and "stimulus The joys and modern drama","god is changing Irritable". Factors port on the liver Yang: "visual change mesh expansion","characteristics of dizziness With tinnitus,irritability","tongue pulse condition and performance characteristics of pulse condition string","tongue pulse condition and performance characteristics of pulse condition number","visual change Eyes faint head dizzy","tongue pulse condition and performance characteristics of tongue color Born","knowledge change irritability","god is changing nerves","pain" visual change orders,"tongue pulse condition and performance characteristics of pulse condition" and "auditory abnormalities Sudden onset of tinnitus" and "systemic symptom Food tastes change Mouth bitter".3. Neural networks results:Four phase of the stroke and coronary heart disease,hypertension,and qi stagnation and blood stasis,modern, heat evil, kidney Yin deficiency, factors port on the liver Yang syndrome elements in different stages of the training set,validation set,evaluation set of forecasting wrongly rate are less than 1%,so the forecast effect is good,but also illustrates the judgment of the decision tree.4. Clustering analysis results:(1)0 stage of coronary heart disease with hypertension clustering for the symptoms of the two groups: the first group of symptom group is shown as: dizzy, scalp distention or numbness,headaches,to the top,the temple area,found in much by long-term depression or modern,and modern drama,irregular work and rest,overwork,eating is not triggered. Tongue reddish,tough,moss white, pulse string; The second group of symptoms are presented as: dizzy, bilge painful or ache,vertex,temporal or forehead apparent,giddy head discomfort,scalp distention or numbness,facial blushing,ear bilges Men Du force closed,mouth, thirst,or inattention and lumbar debility,with much shaped by modern ultra, addiction of alcohol,tobacco,found in long-term depression or modern, irregular work and rest,caused by overwork. Pale red tongue,white or pale white,tough, or fat big,yellow moss,pulse string,float.(2) 1 stage of coronary heart disease with hypertension can clustering for the symptoms of the two groups: the first group of symptom group is shown as: bilge painful or ache,vertex,temporal or forehead apparent,scalp distention,dizzy and giddy head discomfort,facial blushing,ear bilges Men Du force closed,upset,irritated,dry mouth,bitter mouth,brown urine,lumbar debility,two eye dryness,tinnitus,such as wind,such as cicadas,five upset hot,hot flashes red zygomatic,or inattention,fatigue,shortness of breath,shaped by more modern drama,overwork,irregular work and rest,or found in modern caused by long-term depression. Red tongue,fat big,teeth marks,moss yellow or yellowish,pulse string. A second group of symptom group is shown as: lumbar debility,upset, five upset hot,facial blushing,two dry eye,dizzy,giddy head discomfort, inattention,head ache or pain,vertex,temples,forehead,the light weight, or see the scalp numbness or distention,more than before and after onset of menopause,and excessive overworked,irregular work and rest,the brain,diet not festival,addiction of alcohol,tobacco,and found in modern stimulation, long-term depression or modern,pink or red tongue,moss thin white or yellowish,pulse string,heavy,number,and smooth.(3) 2 stage of coronary heart disease with hypertension symptoms of the two groups: the first group of symptom group is shown as: head pain,top the top or the temples,dizziness,irritability,brown urine,giddy head discomfort, chest often new frowsty,heavy limbs,pale and grey lag or accompanied by fatigue, shaped by more modern drama,or found in modern caused by long-term depression. Dark red tongue,trembling, moss yellow,thick,greasy,pulse string,slide,sink,acerbity,fine,number. The second group of symptoms are presented as: dizziness,head pain,temples,vertex or forehead apparent,or repeated attacks, in case law is aggravating,restlessness,irritability,facial blushing, palpitations,accompanied by lumbar debility,shaped by more modern ultra, addiction of alcohol,tobacco,found in long-term depression or modern,irregular sleep,overworked,diet is not triggered. Dark red tongue,yellow moss,or greasy, pulse string,slippery,heavy,number,acerbity,fine.(4) 3 stage of coronary heart disease with hypertension for the symptoms of the two groups: the first group of symptom group is shown as: dizziness,head pain,recurrent,encounter pain,eye bilges,irritability,stay,fatigue, palpitations,or with acerbity tinnitus,shaped by more modern drama,irregular work and rest,long-term depression or found in modern,addiction of alcohol, tobacco,overworked,caused by eating section,tongue dark,yellow moss,pulse string. The second group of symptoms are presented as: the head pain such as crack, cerebral door all pain,dizzy very fall,steps and foot like stepping on cotton and partial body feels obstacle,appear even transient hemiplegia,confusion and even coma,had longer duration of tinnitus,hearing loss,what is total deafness,complexion dark hysteresis,oral purple or dark purple,or tongue and taste,with much shaped by modern drama,found in long-term depression or modern, triggered by overwork,tongue dark,purple,ecchymosis,sublingual collaterals blue circuity,shortening,moss,pulse string,astringent.5. Transition probability matrix results:(1) coronary heart disease with hypertension stage 0 to 1 amalgamating hypertension coronary heart disease(CHD),transition probability from high to low is arranged as follows: liver depression and qi stagnation syndrome evolution of liver and kidney Yin deficiency syndrome(transition probability of 56.51%), liver Yang syndrone evolved into gas fire disorder syndrome(transition probability of 53.01%),liver Yang syndrone certificate for liver and kidney Yin deficiency syndrome(transition probability of 46.99%),liver depression and qi stagnation syndrome evolution of gas fire disorder syndrome(transition probability of 43.49%).(2)Coronary heart disease with hypertension stage 1 to 2 amalgamating hypertension coronary heart disease(CHD),transition probability from high to low arrangement as follows: the liver and kidney Yin deficiency syndrome evolution of phlegm heat disturbing(transition probability of 66.59%),gas fire disturbance evolution of phlegm heat disturbance heart syndrome(transition probability of 63.81%),gas fire disturbance evolution of collaterals deficiency Yang syndrome(transition probability of 36.19%),liver and kidney Yin deficiency syndrome evolution of complex virtual Yang syndrome(transition probability of 33.41%).(3) Coronary heart disease with hypertension stage 2 to 3 amalgamating hypertension coronary heart disease(CHD),transition probability from high to low is arranged as follows: phlegm heat of the evolution of soil disturbance deficiency card wood syndrone(transition probability of 64.01%),complex virtual dawn turn into soil deficiency card wood syndrone(transition probability of 63.49%),complex virtual dawn evolution of liver Yang, wind syndrome(transition probability of 36.51%),phlegm heat disturbance of the evolution of liver Yang wind syndrome(transition probability of 35.99%).Conclusion:1. Syndrome factors:Coronary heart disease with hypertension and qi stagnation and blood stasis syndrome elements,modern,heat evil,kidney Yin deficiency, factors(port) on the liver Yang general trend at all stages of the disease characterized by higher stage 0 to 2,and 3 period,reflect disease from light to heavy,by the tide of change process. By using the theory of syndrome differentiation of traditional Chinese medicine analysis of coronary heart disease with high blood pressure all the statistical results of variable frequency distribution in the questionnaire,found that the onset of the stages of excessive sex element, virtual syndrome factor, factors(liver Yang syndrone) throughout the pathogenesis.0 stage of coronary heart disease with hypertension factors port on the liver Yang,and qi stagnation,modern,wind evil as the main syndrome factors, both kidney Yin deficiency. 1stage of coronary heart disease with hypertension factors port on the liver Yang,heat evil, kidney Yin deficiency as the main syndrome elements,and qi stagnation,modern. 2 stage of coronary heart disease with hypertension factors port on the liver Yang,heat evil,and to modern,kidney Yin deficiency,and qi stagnation and blood stasis. Stage 3 long illness into collaterals,coronary heart disease with hypertension factors port on the liver Yang,and with the main function of modern hot evil,kidney Yin deficiency,modern. Decision tree statistical method based on TCM syndrome factor has carried on the exploratory data analysis,and to quantify the its importance,bluff get type differential diagnosis has important significance of factors,to direct the clinical effective. Statistical methods to judge the complex syndromes elements of neural network model can still get accurate prediction results, for the thorough development of TCM syndrome research is of great significance.2. characteristics of syndrome:coronary heart disease with hypertension disease syndromes characterized four phases: 0 stage of coronary heart disease with hypertension: liver depression and qi stagnation syndrome,liver Yang syndrone; 1 stage of coronary heart disease with hypertension: gas fire disturbance syndrome,liver and kidney Yin deficiency; 2 stage of coronary heart disease with hypertension 2: phlegm heat disturbing certificate,Xu Yang l certificate;3 stage of coronary heart disease with hypertension: soil virtual wood syndrone syndrome,liver Yang wind.3. The regulation of pathogenesis and syndrome evolution: 0 stage of coronary heart disease with hypertension pathogenesis features of liver depression and qi stagnation,kidney Yin deficiency,water does not contain the wood,and the pathological factors such as phlegm turbidity. 1 stage of coronary heart disease with hypertension pathogenesis features of liver and kidney Yin deficiency,liver wind fire,wet hysteresis pixu(spleen deficient). 2 stage of coronary heart disease with hypertension pathogenesis characteristics of phlegm heat in disturbance,collaterals emptiness,sun be the spirit Kang Cheng,pathological factors and blood stasis,etc.3 stage of coronary heart disease with hypertension pathogenesis features of spleen and stomach weakness,liver Yang Kang Cheng,liver and kidney deficiency,Yang litres of air,pathological factors and blood stasis,etc. Transition probability matrix obtained syndrome evolution law is: The rule of coronary heart disease with hypertension stage 0 to 1,is all the more easily for the development of liver and kidney Yin deficiency syndrome,gas fire disorders; coronary heart disease with hypertension,the rule of stage 1 to 2 is all card type evolution of phlegm heat disturbance more easily heart syndrome,winding xu Yang rise; coronary heart disease with hypertension,the rule of stage 2 to 3 type is all the more easily evolve into soil virtual wood syndrone syndrome,liver Yang wind.
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