Research On The Essence Of Wind Pathogens And The Clinical Manifestation Of Wind Pathogens In Coronary Heart Disease Based On The Pathogenesis Theory Of "collateral Wind Internal Movement"

BackgroundWith the development of global economy and urbanization,coronary artery disease has become a worldwide health problem.At present,the mortality rate of coronary heart disease in China is still on the rise,and the prevention and treatment of coronary heart disease is still facing challenges.Traditional Chinese medicine(TCM)has significant advantages to improve symptoms of coronary heart disease,prevention of complications in coronary heart disease.For a long time,scholars have gradually realized the importance of the wind pathogen,which was obtained exact curative effect.On the other hand,clinical studies of the wind pathogen on coronary heart disease are still limited.Exploring the wind pathogen on cardiovascular events has important significance in coronary heart disease prevention strategy.ObjectiveWe analyzed the syndrome distribution and drug using rule of treating coronary heart disease from modern literature on wind theory through the data mining,providing reference for the theoretical research and clinical practice of wind pathogenic factors of coronary heart disease.Based on the pathogenesis theory of "collaterals wind agitation",the possible material basis of wind pathogens and the influence of wind pathogens on cardiovascular events of coronary heart disease were discussed by taking wind speed and inflammatory factors as the entry point.Exploring the clinical manifestations of wind pathogenic factors of coronary heart disease,which provides a strong basis for the identification and early warning model construction of high-risk population of coronary heart disease.Methods1.Literature research on the syndrome and treatment regularity of coronary heart disease from wind pathogenic theory.Literature related to wind pathogenic factors of CHD in CNKI database,Wanfang Data and VIP platform were searched,and frequency statistics of syndromes and wind-dispelling drugs were analysized.2.A retrospective study of the external wind and cardiovascular events based on the pathogenesis theory of "collaterals wind agitation".The patients with coronary heart disease who had cardiovascular events from July 2017 to July 2018 in Sunsimiao hospital in Tongchuan,as well as the meteorological data and air pollution data of the same period,were collected to analyze the correlation between wind speed and cardiovascular events.We also explore the relationship between external wind,wind speed and cardiovascular events3.A case-control study of the internal wind and acute coronary syndrome based on the pathogenesis theory of "collaterals wind agitation".Two groups of patients with stable angina pectoris and acute coronary syndrome were included.Baseline data of patients were collected and serum was isolated.The concentrations of hs-crp,il-6,mmp-9 and gdf-15 in the two groups were detected by enzyme-linked immunosorbent assay(Elisa).We also explore the relationship between internal wind,inflammatory factors and acute coronary syndrome.4.A cross-sectional study on the clinical characterization of wind-induced coronary artery disease based on the pathogenesis theory of "collaterals wind agitation".We investigated cases of coronary heart disease in Qixu Xueyu syndrome by cross-sectional study.And all cases were divided into stable angina group and acute coronary syndrome group.Comparing two groups of Traditional Chinese Medicine(TCM)syndrome score,symptoms,tongue and pulse conditions.We summarized the clinical features of wind-pathogen,and ROC curve was applied to evaluate the clinical efficacy of wind pathogen.5.A prospective cohort study on the clinical characterization of wind-induced coronary artery disease based on the pathogenesis theory of "collaterals wind agitation".The included cases with Qixu Xueyu syndrome of coronary heart disease were followed up to analyze the correlation between the clinical manifestations of wind pathogen and cardiovascular events within 6 months.Results1.Literature research on the syndrome and treatment regularity of coronary heart disease from wind pathogenic theory.A total of 1595 literatures were retrieved and 20 were finally included.The most common syndromes are Qixu Xueyu syndrome and Xinluo Fengdong syndrome.Heart collaterals are the most easily attacked by wind.Commonly used wind-dispelling drugs were astragalus membranaceus,ligusticum wallichii,notopterygium root,radix clematidis,paeonia lactiflora and kudzu root.2.A retrospective study of the external wind and cardiovascular events based on the pathogenesis theory of "collaterals wind agitation".Among 650 patients with coronary heart disease,325 were male and 325 were female,with an overall mean age of 69.34 years.In terms of outcome,650 patients had a total of 754 cardiovascular events.The results showed that the risk of cardiovascular events at moderate wind speed(2.00-2.60 m/s)was significantly increased,OR 3.29(95%CI,1.49-7.26),relative to low wind speed(0.70-1.90 m/s).Curve fitting of wind speed showed that when wind speed is less than 2.3m/s,the risk of cardiovascular events increases significantly,OR 2.58(95%CI 1.13,5.89)3.A case-control study of the internal wind and acute coronary syndrome based on the pathogenesis theory of "collaterals wind agitation".A total of 170 cases with Qixu Xueyu syndrome of coronary heart disease were included,and finally 57 cases of stable angina pectoris group and 57 cases of acute coronary syndrome group were in the statistical analysis after propensity score matching at 1:1.The average age of the total population was 62.35 years old,with males accounting for 72.81%.Results showed that hs-CRP,IL-6,and GDF-15 presented significant linear correlation(P<0.05)with ACS.Curve fitting results showed that the risk of ACS is increasing,OR 1.004(95%CI,1.000,1.007),when MMP-9>1200 ng/ml.4.A cross-sectional study on the clinical characterization of wind-induced coronary artery disease based on the pathogenesis theory of "collaterals wind agitation".A total of 215 patients with Qixu Xueyu syndrome of coronary heart disease(CHD),with an average age of 62.68 years,were enrolled,including 153 males and 62 females.Comparing the clinical features of stable angina pectoris group and acute coronary syndrome group,Headache,chordal pulse,number of angina pectoris sites,and nature of angina pectoris were significantly correlated with acute coronary syndrome(P<0.05),which can be clinical manifestations of wind-induced disease.5.A prospective cohort study on the clinical characterization of wind-induced coronary artery disease based on the pathogenesis theory of "collaterals wind agitation".215 cases of coronary heart disease with qi deficiency and blood stasis syndrome were included Follow-up results showed that a total of 31 cardiovascular events occurred,13 lost follow-up,and 202 cases were included in the analysis.Results showed that the risk of each clinical manifestations group of wind-pathogen was increased compared with the previous group(P=0.05).The risk of cardiovascular events was significantly increased(P<0.05)in the group with four clinical manifestations.Conclusion1.Qixu Xueyu syndrome of CHD has a close relationship with wind,which is tend to invade heart collaterals.Yiqi Huoxue and Qufeng Tongluo method are important treatment for coronary heart disease.2.Abnormal wind speed,as an important form of external wind,may be one of the core elements of external wind,while inflammatory factors may be one of the core elements of internal wind.3.Abnormal wind speed and inflammatory factors are closely related to cardiovascular events,which is consistent with the pathogenesis theory of "collaterals wind agitation".4.Headache,pulse string,multiple angina pectoris sites and a variety of angina pectoris are clinical manifestations of wind pathogenic factors of coronary heart disease,which significantly increased the risk of cardiovascular events of coronary heart disease within 6 months.