| Objectives To explore the TCM syndrome distribution,medication characteristics and basic pathogenesis of dyslipidemia.Methods1.Literature research:By searching the clinical research literatures on dyspadias in the past 10 years in CNKI,VIP and wanfang databases,the syndromes,treatment rules and drugs involved in the literatures meeting the inclusion criteria were extracted,and the data were statistically analyzed by frequency,association rules and complex system entropy cluster analysis.2.Experiment research:40 Wistar rats were randomly divided into normal group(n=8),model group(n=8),spleen and phlegm invigorating group(n=8),spleen and kidney invigorating group(n=8),atorvastatin group(n=8)after adaptive feeding for 1 week,and 8 rats/cages were grouped and numbered.All rats were fed with normal feed and provided with drinking water.In the model group and each treatment group,20ml/lkg/d high-fat emulsion was used for gavage.The high-fat emulsion formula was:20g lard,5g cholesterol,5g yolk powder,0.25g propylthiouracil,4ml tween 80 and 100ml distilled water.At the same time,the normal group was given an equal dose of distilled water,20ml/lkg/d.Mold making continued for 2 weeks.From the third week of the experiment,rats in each group were still kept as before.Meanwhile,distilled water was used for gavage in the normal group and the model group according to 20ml/Ikg/d.Rats in each treatment group were given drug intervention,the specific dosage was as follows:jianpi huatan group 10.000g/kg/d;Spleen and kidney tonifying group 12.803g/kg/d;The atorvastatin group received 4.167mg/kg/d once a day for 4 weeks.Results1.Literature research results:Among the 515 cases that met the inclusion and exclusion criteria,213 cases involved TCM syndromes and 33 syndromes,among which the cases clearly related to spleen accounted for 22.43%of the occurrence frequency of all syndromes,and the cases clearly related to kidney accounted for 17.83%of the occurrence frequency of all syndromes.27 types of basic syndromes were extracted in this paper,among which those clearly related to spleen accounted for about 13.73%of the occurrence frequency of all basic syndromes,and those clearly related to kidney accounted for about 10.99%of the occurrence frequency of all basic syndromes.There were 470 literatures related to the principles of treatment,and 19 kinds of basic principles of treatment were extracted.Among them,those explicitly related to the spleen accounted for 19.77%of the occurrence frequency of all the principles of treatment,and those explicitly related to the kidney accounted for 10.19%of the occurrence frequency of all the principles of treatment.There were 515 literatures involving effective treatment cases,including 584 prescriptions,including 278 traditional Chinese medicines.Among them,the most frequently used drugs were hawthorn,salvia miltiorrhiza,alisma orientalis,tuckahoe,tuber fleeceflower,etc.Among the 584 prescriptions,the teqi of the drug was the most warming,42.37%.The frequency of the five flavors was 36.09%.The drugs that belong to liver meridian are the most important in the meridian of drugs.In the 584 prescriptions,a total of 25 pairs of common drugs were extracted,respectively:(1)dan shen-shan zha;(2)ze xie-shan zha;(3)dan shen-ze xie;(4)dan shen-ze xie-shan zha;(5)jue mingzi-shan zha,etc;A total of 10 groups of commonly used drug combinations were extracted,respectively:(1)chen pi,ban xia,fu ling,shen qu,ju hong;(2)chen pi,gan cao,fu ling,zhi qiao,chai hu,jie geng;(3)dang shen,sha ren,shan yao,ba jitian;(4)gou teng,tian ma,di long,shen qu,ju hong,mai ya;(5)shan yao,shan zhuyu,ba jitian,shu dihuang,mu danpi,etc.2.Experimental research results①After the comparison of serum lipid indexes between the model group and the treatment groups,it was found that the mean values of TC and LDL-C in the spleen-invigorating phlegm group were lower than those in the model group,and the differences were statistically significant(all P<0.05).The LDL-C mean of the spleen and kidney strengthening group was lower than that of the model group,and the difference was statistically significant(P<0.01).The mean values of TC,ldl-c and HDL-C in the atorvastatin group were lower than those in the model group,and the differences were statistically significant(P<0.01 in order).P<0.05;P<0.05).Among them,the average HDL-C of the spleen and kidney strengthening group was significantly higher than that of the atorvastatin group,and the difference was statistically significant(P<0.01).2.jian pi wen shen prescription can significantly reduce serum LDL-C level in rats with dyspadias.②After the comparison of blood lipid indexes before and after treatment in each group,it was found that the mean values of LDL-C and HDL-C in the model group were significantly increased,and the differences were statistically significant(all P<0.05).The HDL-C mean value of the spleen-invigorating phlegm group was significantly increased,and the difference was statistically significant(P<0.01).The average HDL-C of the spleen and kidney strengthening group was significantly increased,and the difference was statistically significant(P<0.01).The TG mean of atorvastatin group was significantly decreased,while the LDL-C and HDL-C mean were significantly increased,and the differences were statistically significant(all P<0.05).③The difference of serum lipid index between the model group and each group before and after treatment was compared,and it was found that:there was no significant difference in the mean value of TC difference between the groups(P>0.05).The mean value of TG difference in atorvastatin group was significantly higher than that in model group,spleen-strengthening phlegm-resolving group and spleen-warming kidney group,and the difference was statistically significant(all P<0.01).The average value of HDL-C difference in the atorvastatin group was significantly higher than that in the model group and the spleen and kidney strengthening group,and the difference was statistically significant(P<0.05 in order).P<0.01),the difference was not significant(P>0.05).The mean difference of LDL-C between the spleen-tonifying phlegm group and spleen-warming kidney group was significantly higher than that of the model group,and the difference was statistically significant(P<0.05 in order).P<0.01),there was no statistical difference in the mean difference of LDL-C between the model group and the atorvastatin group(P>0.05).Conclusion:"spleen" and "kidney" play an important role in the pathogenesis of dyslipidemia.Spleen insufficiency is the basic pathogenesis of dyslipidemia,and strengthening spleen and resolving phlegm is the basic treatment principle of dyslipidemia.Warming and tonifying the kidney Yang can strengthen the spleen’s health function,so as to improve the therapeutic effect of serum LDL-C index. |
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