Theoretical Discussion And Clinical Research Of Traditional Chinese Medical Pathogenesis Of PAF—"Collaterals Deficiency Generates Wind"

Part? Based on the theory of collateral diseases discussing the patho-genesis of paroxysmal atrial fibrillation-“collaterals deficiency ge nerates wind”Guided by the theory of collateral diseases,combined with pathogenic characteristics and clinical manifesttations of PAF,as well as th e pathogenic characteristics of wind pathogens,the paper proposes the PAF “collaterals deficiency generates wind” Chinese medicine pathogenesis.The deficiency of qi,blood,Yin and Yang in the collaterals cause endogenous wind-evil turbulent,harassing mind and making for the palpitation unrest.Tightly holding PAF as collateral disease category,grasping its pathogenesis key from “deficiency” and “wind”,has important theoretical and clinical value for clinical accurate syndrome differentiation and prescription,and improving the level of traditional Chinese medicine treatment of PAF.Part? Data mining and analysis based on the law of wind drugs in heart palpitations of Traditional Chinese Medicine literatureObjective: Through the analysis of the medication regularity of wind drugs for heart palpitations in ancient Chinese medical literature,based on the principle of “evaluating syndrome by drug intervention”,it provides a basis for the pathogenesis of PAF “collaterals deficiency generates wind”.Methods: According to the ancient and modern doctors' understanding of the wind drugs,the list of the wind drugs is determined.Search the disease name and syndrome of palpitation-related diseases to determine the search keywords,according to the search keywords,the ancient Chinese literature on the treatment of heart palpitations is screened in the Chinese prescription database,and the retrieved data is screened one by one.The Excel 2013 software was used to establish the database,and the drugs and symptoms involved were standardized.The frequency and correlation analysis method were used to obtain the rule of wind drugs treatment for heart palpitations.The PAF pathogenesis was explored according to the method of “evaluating syndrome by drug intervention”.Results: 1.Rule of use of wind drugs Co-screening treatment of heart palpitations 925 prescriptions,involving 359 flavors of traditional Chinese medicine.Top 50 Traditional Chinese Medicine used frequently is mainly concentrated in the tonic(36.86%),tranquilizer(15.77%),wind dispelling(9.36%),and heat reliever(5.17%).It contains 51 flavors of wind drugs,accounting for 64.56% of the 79 wind drugs listed in this article,it can be seen that the treatment of heart palpitations by the ancients has made wind-dispelling medicine as an important option for the use of medicinal herbs.The highest frequency of use of phlegm drugs,accounting for about 40% of 51 flavors of wind drugs.A total of 66 groups of wind drugs combinations were selected,there are 41 pairs of three flavors of drugs,mostly with two flavors of wind drugs compatible with licorice,ginseng,angelica and other tonic drugs,of which the combination of wind medicine and qi-tonifying accounted for 30.92%,the highest proportion.From its drug combination relationship,it has refracted that “deficiency” and “wind” are the two key pathogenesis.2.Symptoms and wind drug-symptom statistics The top six symptoms are palpitate with fear,severe palpitation,distraction,palpitations,dizziness,forgetfulness.Among the symptom combinations,the most common combination of palpitate with fear and other symptoms such as distraction,severe palpitation,forgetfulness,dizziness,etc,accounted for 58.62% of the 42 syndrome combinations.According to the statistical results of the correlation between symptoms and symptoms,there were 18 groups of symptoms with importance greater than 0.4.In the frequency analysis between the wind drugs and the symptoms,the symptoms were mainly “palpitate with fear”.The combination of divergent cold medicine and palpitate with fear ?distraction accounted for 44.31%,and the combination of Chuanxiong and palpitate with fear and severe palpitation accounted for 21.08%.The combination of the relieving spasm by calming endogenous wind with palpitate with fear accounted for 17.22%,and the combination of platycodon and palpitate with fear accounted for 5.31%.The correlation analysis between the wind drugs and the symptoms show that the composition of Chuanxiong and dizziness,dizzy vision was the most important,and in the first 19 groups of related wind drug-symptom combinations,there were 6 groups involving the combination of Chuanxiong and related symptoms.Conclusions: According to the analysis of the medication regularity of wind drug for palpitation,it can be seen that wind drug for palpitation is often compatible with tonic medicine such as liquorice,ginseng,angelica or Poria cocos.Palpitation is often accompanied by symptoms such as heart deficiency,distress,forgetfulness and spontaneous sweating.The symptoms of palpitation are mostly related to deficiency of qi,blood,Yin and yang,which is preliminarily shown that “deficiency” and “wind” are the key pathogenesis of palpitation.The wind drug has a pungent taste and the characteristics of “ rising,dispersing,channeling and moving”,In Zhang Zhongjing's Treatise on Febrile Diseases and Miscellaneous Diseases of the Eastern Han Dynasty,Xuanfuhua Decoction for the Treatment of “Liver Struggling” was established,and Xinwei Tongluo Therapeutic Drug was first created;Ye Tianshi,a famous doctor in the qing dynasty,further proposed the principle of treating collaterals diseases –“the collaterals take Xin as the catharsis”,it is easy to get into the collaterals of pungent drugs.It is a commonly used drug in collateral diseases.Therefore,according to the law of wind drugs for palpitations,combined with the principle of “evaluating syndrome by drug intervention”,it is proved that “collaterals deficiency generates wind” is an important pathogenesis of PAF in traditional Chinese medicine.Part ? Investigation of clinical syndrome elements in 312 patients with PAFObjective: Through the study of clinical syndrome elements of 312 patients with PAF,it provides the basis for the pathogenesis hypothesis of “collaterals deficiency generates wind” in TCM.Methods: Patients with PAF were collected in a retrospective manner,and patients admitted to the Department of Cardiology or Emergency Department of Hebei yiling hospital and Hebei hospital of traditional Chinese medicine from January 1,2013 to December 31,2017 were selected.Subjects were patients who met the inclusion criteria of this study and excluded the exclusion criteria.Develop a PAF patient information collection form,which mainly collects basic information,morbidity,treatment and TCM syndrome information.The collected information is used Excel 2013 to establish data,and the data is statistically analyzed using SPSS 21.0.Results: 1.Incidence The onset time of 312 patients with PAF was mostly from 06:00-12:00.The top three patients with pathogenesis were 21 cases of convulsion,20 cases of winter begins,and 19 cases of qingming.The disease season was first in spring,followed by winter;common comorbidities mainly for hypertension and coronary heart disease.2.Disease location elements The factors from the highest to the lowest are heart,lung,liver,kidney and spleen.In the combination of disease location elements,the combination of double disease location elements was the main component,and the heart + lung was 69 cases,which had the highest composition ratio,followed by heart + liver 47 cases and heart + kidney 39 cases.3.Disease resistance elements Among the PAF disease resistance elements,the frequency of the windmoving syndrome was the highest,accounting for 100%,followed by 218 cases of qi deficiency syndrome(69.87%),128 cases of yin deficiency syndrome(41.03%),81 cases of blood stasis syndrome(25.96%),and 53 cases(16.99%)with phlegm syndrome.The combination forms of syndrome elements include : two-factor syndrome(128 cases),three-factor combination certificate(123 cases),and four-factor syndrome(61 cases).PAF two-factor combination syndrome,in which 57 cases(18.27%)of qi deficiency + wind movement,accounting for the highest proportion,followed by 48 cases(15.38%)of yin deficiency + wind movement;three factors combination the syndrome,in which qi deficiency + yin deficiency + wind movement 32 cases(10.26%),the highest proportion;followed by qi deficiency + blood sputum + wind movement 30 cases(9.62%),qi deficiency + turbidity + wind movement 23 cases(7.37%).The four-factor combination syndrome,in which the combination is qi deficiency + yin deficiency + blood sputum + wind movement is 24 cases(7.69%),the highest proportion.Conclusions: PAF is associated with wind evil in the cause of onset,onset time,onset season and comorbidities.The wind-moving syndrome is a common syndrome factor in PAF;in the combination of PAF syndrome elements,Qi deficiency,Yin deficiency,blood stasis,phlegm turbidity and wind-moving syndrome often appear.PAF “collaterals deficiency generates wind ” syndrome has the closest relationship with qi deficiency syndrome,followed by yin deficiency syndrome.