| This paper consists of three parts:literature review,rule and experience summary of traditional Chinese medicine medication and animal experiment.In the part of literature review,the inheritance method of TCM doctors’academic thought and clinical experience,the combination of etiology,pathogenesis and syndrome of coronary heart disease and angina pectoris are introduced.First,based on the traditional Chinese Medicine Inheritance assistant platform,Professor Zhong Jingbai’s effective medical records for treating angina pectoris of coronary heart disease were data mining,and Professor Zhong’s clinical medication rules and clinical experience for treating angina pectoris of coronary heart disease were summarized.The second study is based on Professor Zhong’s experience in treating coronary heart disease and angina pectoris.The Fuxin and Mai Decoction was developed in combination with previous clinical trials to verify its effect on acute myocardial ischemia-reperfusion injury in rats,and to explore the possible protective mechanism.1.Professor Zhong Jingbai’s Experience in Treating Angina Pectoris of Coronary Heart DiseaseObjective:Based on the tutor’s medical record database,the effective medical records of angina pectoris of coronary heart disease were sorted out and screened out.Data mining methods such as association rules and complex system entropy clustering in the software of"Chinese Medicine Inheritance Assistant System(V2.5),were used to study the frequency of use of prescription drugs,the relationship between prescription drugs and the law of prescription compatibility.In order to clarify Professor Zhong Jingbai’s clinical experience in the diagnosis and treatment of coronary heart disease and angina pectoris.To enrich the clinical diagnosis and treatment of coronary heart disease and angina pectoris.Methods:From Jan.2009 to Jan.2019,Professor Zhong Jingbai’s outpatient medical records screened out the effective medical records with the main purpose of"coronary heart disease angina pectoris".The medical records were established.The general information,symptoms and signs,diagnosis,prescriptions and curative effects of patients were recorded in the medical records,and then entered into the software of"Traditional Chinese Medicine Inheritance Assistant Platform(V2.5)",using software.The"data analysis system”and"statistical report system"in the document include frequency analysis,association rule analysis and clustering analysis of the prescription data.According to the statistical results of frequency of traditional Chinese medicine,the kinds and frequency of Chinese medicine with frequency greater than or equal to 10 times were counted.Results:General data:A total of 285 prescriptions were collected from 71 patients with angina pectoris treated by Professor Zhong Jingbai from January 2009 to January 2019.Among them,34 were males and 37 were females,aged between 44 and 93 years,with an average age of 68.1 years.Distribution of Four Qis and Five Tastes:Four Qis in descending order:temperature(1624 times,49.0%)>cold(1142 times,34.5%)>Ping(694 times,20.9%)>cool(108 times,3.26%)>heat(47 times,1.32%);five flavors in descending order:bitter(1867 times,56.3%)>sweet(1736 times,52.4%)>bitter(1514 times,45.7%)>acid(264 times,8.0%)>salty(10.23%)astringent(8.92%).Distribution of meridian tropism of traditional Chinese medicine:the top 6 in order of meridian tropism frequency:spleen(1667 times)>liver(1599 times)>lung(1421 times)>stomach(1399 times)>heart(1249 times)>kidney(678 times).Drug frequency:285 prescriptions contained 227 Chinese medicines,the total frequency of drug use was 3818 times.The order of frequency from high to low was:Danshen(216 times)>Astragalus membranaceus(163 times)>Honghua(126 times)>Sharen(117 times)>Ligusticum Chuanxiong(109 times).The remaining medicines with frequencies of more than 20%were raw liquorice>Xiebai>Trichosanthes melon>Paeonia rubra>Ophiopogon j aponicus.Efficacy Main Classification:High-frequency drugs(frequency more than 10 times)in descending order are:tonic drugs,blood-activating and stasis-removing drugs,heat-clearing drugs,Qi-regulating drugs,dampness-removing drugs,food-dispelling drugs and so on.Among them,Qi-tonifying drugs and Yin-tonifying drugs are frequently used.Drug dosage:the smallest dosage of the first 10 medicines appeared frequently,the usual dosage,the largest dosage was:Danshen(10g,30g,30g),Huangqi(15g,30g,90g),Honghua(10g,10g,15g),Sharen(3g,10g,15g),Chuanxiong(6g,10g,15g),Xiebai(10g,10g),Gancao(3g,5g,10g),Chishao(10g,30g),Gualou(10g,30g,30g)and Maidong(10g,10g,30g).For medicine,horn medicine and core prescriptions:the highest frequency of occurrence is Danshen+Huangqi(115 times),the second is Honghua+Danshen(99 times),the third is Danshen+Sharen(95 times),the fourth is Honghua+Huangqi(80 times),the fifth is Chuanxiong+Honghua(71 times),and the rest are Chuanxiong+Huangqi,Sharen+Huangqi.Astragalus membranaceus(72 times),Honghua+Chuanxiong+Danshen(63 times),Chuanxiong+Danshen+Huangqi(58 times),etc.Core Prescription:The number of support was set to 57,42 and 28,and the confid ence was set to 0.8.Three core prescriptions were obtained.Prescription 1:Danshen,Sharen,Chuanxiong,Honghua and Huangqi which contains 5 medicines.Prescriptio n 2:Danshen,Sharen,Chuanxiong,Honghua,Huangqi,Dangshen,Xiebai,Chishao,Gancao,Guolou,Maidong a total of 10 medicines.Prescription 3:Danshen,Sharen,C huanxiong,Honghua,Huangqi,Dangshen,Xiebai,Chishao,Liaoqiao,Gancao,Gualou,Maido ng,Jineijin,Zisugeng,Chenpi,Sanqi,Zhiqiao,Foushou,Taizishen,Xingren,Fuling and Pugong ying which contain 22 flavor.The new analysis yielded seven small compound formulas.Compound 1 is composed of Yiyiren,Huoxiang,Niubangzi,Jinyinhua,Yejuhua.Compound 2 is composed of Maidong,Dazao,Mudanpi,Chuanxiong,Danshen and Honghua;Compound 3 is composed of Shengma,Huangqi,Shanzhuyu,Shegnhuangqi,Niuxi,Taoren.Compound 4 is composed of Shenqu,Foshou,Pugongying,Chaihu,raw dragon bone;Compound 5 is composed of Yinchen,Zhimu,Cangzhu,Chuanshanlong,Dongguaren.Compound 6 is composed of raw Huangqi,Danshen,Honghua,Binglang,Houpo and Danggui;Compound 7 is composed of fried maiya,fried Shenqu,Gaoliangjiang,Xiangyuan,Baidoukou,Yujin and Wuzhuyu.Conclusions:Professor Zhong Jingbai’s experience in the treatment of coronary heart disease and angina pectoris,the characteristics of drug use and the way of formulat ion are revealed.Professor Zhong Jingbai’s clinical treatment for angina pectoris of c oronary heart disease is mainly to supplement qi and promote blood circulation,with Qi deficiency and blood stasis as the core pathogenesis.The commonly used drugs are Huangqi,Danshen,Chuanxiong,Honghua.Ligusticum are Danshen+Huangqi,Hongh ua+Huangqi,Chuanxiong+Huangqi.The angular drugs are mainly Honghua + Danshen+ Huangqi,Honghua + Chuanxiong +Huangqi,etc.On the basis of blood-activating drugs,syndrome differentiation is often supplemented with phlegm-resolving,qi-acti vating,detoxification,qi-nourishing and Yin-nourishing to protect the spleen and sto mach.In the aspect of promoting blood circulation and removing blood stasis,Dans hen+Gualou is commonly used,and Gualou+Xiebai +Danshen is used as corner med icine.In terms of promoting blood circulation and promoting qi,Danshen+Sharen,X iebai+Danshen are commonly used as the main medicines.In addition,Danshen+Zisu geng,Danshen+ChenPi,Danshen+Zhiqiao,Danshen+Foushou are also used.In the as pect of promoting blood circulation and detoxification,the commonly used drugs are Lianqiao+ Danshen,Pugongying+ Danshen,and the commonly used horn medicine is Honghua + Lianqiao+ Danshen.In the aspect of promoting blood circulation,invi gorating qi and nourishing yin,Maidong+ Danshen +Huangqi.In the aspect of guara nteeing spleen and stomach,Xiangsha Liujunzi Decoction is used as the basic prescr iption,compatible with Foushou’s breath,Zisugeng width,chicken gold diet and so on.Xiaofufang three with xiaofufang six is a new prescription for treating angina pe ctoris of coronary heart disease.2.Animal experimental study of Fuxinhemai Decoction on acute myocardial ischemia-reperfusion injury in ratsObjective:To observe the protective effect of Fuxinhemai Decoction on acute myocardial ischemia reperfusion injury in rats and its possible mechanism.Methods:The rat model of myocardial ischemia-reperfusion injury was established by ligating the left anterior descending branch of coronary artery,and the effect of Fuxinhemai Decoction on acute myocardial ischemia-reperfusion injury was observed.115 rats were randomly divided into 6 groups.The groups were as follows:sham operation group,ischemia/reperfusion group model group(model group),Hexinshuang group,atorvastatin group,Fuxinhemai 7 days group and Fuxinhemai 1 day group.The administration methods were as follows:sham operation group and model group:Ig for 7 days before operation with saline of the same volume.Hexinshuang 1 day group:1D Ig(2mg/kg)before Hexinshuang operation.Atorvastatin group:Ig(20 mg/kg)for 7 days before operation.Fuxinhemai 7 days group:Fuxinhemai Decoction suspension for 7 days before operation(12 mg/kg),Fuxin hem 1 day group:Fuxinhemai Decoction suspension for 1 day before operation(12 mg/kg).Establishment of rat model of myocardial ischemia-reperfusion injury:Rats exposed their hearts to open chest,ligated the left anterior descending branch of coronary artery,and cut the ligation line 45 minutes after ligation of the left anterior descending branch of coronary artery to achieve reperfusion process.The experiment was completed 120 minutes later.Serum lactate dehydrogenase(LDH),creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)were measured in all rats.Some rats were stripped and stained with TTC.The infarct area and total myocardial area were measured and the percentage of myocardial infarct area to total myocardial area was calculated.The Beclin-1 and LC3B protein contents in myocardial tissue were measured in the other rats.Result:The results showed that Fuxinhemai Decoction could alleviate myocardial ischemia-reperfusion injury in rats 7 days in advance,and the percentage of myocardial infarction area in total myocardial area decreased.Compared with model group,it had significant statistical significance(P<0.01).CK-MB decreased significantly(P<0.05),CK and LDH also decreased.At the same time,protein results showed that the content of Beclin-1 in myocardial tissue was significantly lower than that in model group,while the content of LC3II did not change significantly after Fuxinhemai Decoction was administered 7 days in advance.CK-MB of Fuxin and Mai Decoction was also decreased one day earlier than that of Fuxin and Mai Decoction.However,the infarct size and Beclin-1 of myocardial tissue had no significant difference compared with the model group.Conclusion:Fuxinhemai Decoction can alleviate myocardial reperfusion injury,which is positively correlated with the duration of administration.Its mechanism is related to the inhibition of autophagy-related protein Beclin-1 level. |
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