Clinical Evaluation Research On The Treatment Of Cardiovascular Diseases By The Method Of Replenishing Qi And Activating Blood Based On Meta-analysis And Data Mining

Objective:1.To make a comprehensive and systematic qualitative evaluation of the recent situation of the treatment of common cardiovascular diseases by the method of Yiqi Huoxue combined with conventional Western medicine,and systematically review the eligible research,in order to provide the basis for objective evaluation of the curative effect of Yiqi Huoxue Chinese herbs on common cardiovascular diseases.2.By mining and analyzing the treatment of common cardiovascular diseases with Yiqi Huoxue Chinese herbs which meet the standards with Association Rules,to summary the frequency drug and drug laws,so as to provide reference for clinical medication,and provide theoretical basis for future research directions and clinical decision-making.Furthermore,the network pharmacological studies of Astragalus membranaceus,Salvia miltiorrhiza and Ligusticum chuanxiong,which rank in the top three in frequency,will provide some reference for the study of the mechanism of action of traditional Chinese medicine.Methods:1.Meta-analysisAfter a search of PubMed,Cochrane Library,Embase,China CNKI,Wanfang Medical Database,VIP Journal Database and Chinese Biormedical Literature Database through internet to collect the published clinical practice controlled trials(RCTs)on the treatment of common cardiovascular diseases by Yiqi Huoxue combined with conventional western medicine in recent ten years.Revman 5.3 was used for meta-analysis of the included literature.The results were presented through forest maps.Sensitivity analysis was used to assess the stability of the results.Funnel maps were used to analyze the publication bias of the literature.2.Data MiningCollect the prescriptions of Yiqi Huoxue for cardiovascular diseases from 2008 to 2018,establish Excel data set and software data mining model,set minimum support and confidence threshold,and use Apriori algorithm of the classical algorithm in SPSS Clementine 12.0 data mining software,to analyze the association rules of drug compatibility combination.To summarize and analyze the frequency drugs and their and drug laws,and provide reference for clinical diagnosis and treatment.3.Network pharmacologyThree traditional Chinese medicines with the highest frequency of use were selected to preliminarily study the components,targets and signaling pathways related to the effects of these three traditional Chinese medicines on angina pectoris of coronary heart disease,so as to provide reference for the later basic experimental research on the mechanism of Chinese medicines in the treatment of angina pectoris of coronary heart disease.Results:1.Meta-analysis results of six common cardiovascular diseases using Yiqi Huoxue prescriptions are as follows:(1)Treatment of angina pectoris by Yiqi Huoxue:81 RCTs were included according to the criteria of exhaustion.Firstly,they were stratified according to the diagnosis.The meta-analysis results showed that the combination of Yiqi Huoxue prescription and conventional western medicine could improve the clinical efficacy,electrocardiogram effect and TCM syndromes effect of stable angina pectoris,unstable angina pectoris,angina pectoris of Qi deficiency and blood stasis,and angina pectoris of coronary heart disease without definite classification,and they were superior to the conventional western medicine treatment alone.It is also superior to the control group in reducing CRP and blood lipid in patients with coronary heart disease and angina pectoris(P<0.05).(2)Treatment of post-PCI patients by Yiqi Huoxue:31 RCTs were included.The meta-analysis results showed that the combination of Yiqi Huoxue n prescription and conventional western medicine in the treatment of post-PCI patients improved the total clinical efficacy,electrocardiogram efficacy,TCM syndromes efficacy and reduced the incidence of adverse events,restenosis,CRP and lipid indicators were superior to conventional western medicine alone,with significant differences(P<0.05).。(3)Treatment of arrhythmia patients by Yiqi Huoxue:A total of 37 RCTs were included.The meta-analysis showed that the combination of Viqi Huoxue prescriptions and conventional western medicine was superior to conventional western medicine alone in improving the total clinical efficacy,electrocardiogram efficacy and reducing the incidence of adverse reactions in patients with arrhythmia(P<0.05).(4)Treatment of chronic heart failure by Yiqi Huoxue:35 RCTs were included.The meta-analysis results showed that the combination of Yiqi Huoxue prescription and conventional western medicine was superior to conventional western medicine in improving the total clinical efficacy,TCM syndromes,LVEF,reducing BNP and prolonging 6MWT in patients with chronic heart failure(P<0.05).(5)Yiqi Huoxue therapy for myocardial ischemia:A total of 17RCTs were included.The meta-analysis results showed that the combination of Yiqi Huoxue recipe and conventional western medicine in the treatment of myocardial ischemia patients in improving the clinical efficacy and electrocardiogram efficacy were better than that of conventional western medicine alone,with significant difference(P<0.05).(6)Treatment of cor pulmonale by Yiqi Huoxue:A total of 12 RCTs were included.The meta-analysis results showed that the treatment of cor pulmonale by Yiqi Huoxue combined with routine western medicine was superior to that by routine western medicine alone,with significant difference(P<0.05).2.Data Mining ResultsA total of 304 prescriptions for qi deficiency and blood stasis type of cardiovascular diseases were screened out,involving 153 herbal medicines.The total frequency of Chinese herbal medicines used was 1450 times.Among them,30 were used more than 20 times,totally 2588 times,accounting for 84.82%of the total frequency.Through Association analysis,63 eligible drug association rules were obtained.The number of three drug combinations that produced the rules was the largest,totaling 47,followed by two drug combinations,totaling 16.Among all the obtained rules,Huangqi,Danshen and honghua are the most frequently used drugs.There are 53 Association rules.These three drugs are widely used in cardiovascular diseases with Qi deficiency and blood stasis syndrome,and their compatibility is flexible and changeable.3.Network pharmacology ResultsEighty-five active ingredients and 243 nodes of Radix Astragali,Radix Salviae Miltiorrhizae and Rhizoma Chuanxiong were retrieved.Thirty-one angina pectoris targets were retrieved.After constructing protein-protein interaction network,six drug-disease related targets were finally obtained.After topological analysis,six core targets and seven core components were constructed.KEGG pathway was enriched by common targets,and three pathways were obtained.Among them,11 active components were directly related to three targets in platelet activation pathway.Conclusions:Meta-analysis showed that Yiqi Huoxue prescription combined with routine western medicine had good curative effect on common cardiovascular diseases.It had certain advantages compared with routine western medicine alone,with high safety and less adverse reactions.Through association rule analysis,we further excavate the high-frequency drug use and drug compatibility rules in the database of prescriptions for the treatment of common cardiovascular diseases by Yiqi Huoxue,so as to better guide clinical drug use.The active ingredients and potential targets of astragalus,Salvia miltiorrhiza and Ligusticum chuanxiong in the treatment of cardiovascular diseases were preliminarily revealed,which could provide reference for the development of better candidate drugs for cardiovascular diseases.