Evaluation Of The Effectiveness Of Treating Vascular Dementia From The Perspective Of Phlegm And Blood Stasis And Exploration Of The Rules Of Traditional Chinese Medicine Compound Prescription

Objective(1)This topic aims to objectively evaluate the effectiveness and safety of treating vascular dementia with phlegm and blood stasis as the main treatment method by collecting relevant literature on randomized controlled trials of treating vascular dementia based on phlegm and blood stasis theory,and organizing,comparing,and statistically analyzing studies that meet the inclusion and exclusion criteria from multiple dimensions,providing reliable evidence-based medical evidence from multiple perspectives.(2)By conducting data mining and chart presentation on the collected traditional Chinese medicine prescriptions for the treatment of vascular dementia with the main treatment method of resolving phlegm and removing blood stasis,summarizing and guiding clinical diagnosis and treatment from the perspectives of drug properties,taste,classic prescriptions,and relevant treatment methods,and providing a basis for the research and development of relevant new drugs,it ultimately plays a role in early intervention and prevention and treatment of vascular dementia.Method(1)Meta analysis:Computer search of Wanfang Database platform(Wan Fang Date),China National Knowledge Infrastructure(CNKI),Pubmed,VIP Database,China Biomedical Literature Database(CBM),and strict screening of randomized controlled clinical trials on the treatment of vascular dementia based on phlegm and blood stasis according to inclusion criteria.Establish a literature information database for the included literature,and use RevMan 5.3 for literature quality evaluation and meta-analysis of related efficacy indicators.(2)Data mining:Computer search of Wanfang Database platform(Wan Fang Date),China National Knowledge Infrastructure(CNKI),Pubmed,VIP Database,China Biomedical Literature Database(CBM),and strict screening traditional Chinese medicine compound literature on the treatment of vascular dementia with phlegm and blood stasis elimination as the main treatment method based on inclusion criteria,establishing databases of treatment methods,prescriptions,etc.,and using Microsoft Excel to standardize data cleaning and processing,Use SPSS Modeler 18.0 for association rule analysis,and SPSS 25.0 for cluster analysis to explore the medication patterns of treating vascular dementia from the perspective of phlegm and blood stasis.Results(1)Meta analysis:This study included a total of 18 references,with a total of 1379 treated cases,including 710 in the experimental group and 669 in the control group.There are 2 high-quality literature and the remaining 16 are all of low quality.The total effective rate was selected for literature bias risk assessment,and there is no heterogeneity among the studies(I2=0%;P=0.95),Using a fixed effects model analysis,the funnel plot shows a low degree of publication bias and the results are generally reliable.There was a statistically significant difference in total effective rate between the experimental group and the control group(OR=3.36,95%CI[2.52,4.49],P<0.05);The difference in MMSE scale scores is statistically significant(MD=4.02,95%CI[2.85,5.19],P<0.05);The difference in ADL scale scores was statistically significant(MD=-4.62,95%CI[-6.73,-2.50],P<0.05);The difference in HDS scale scores was statistically significant(MD=5.53,95%CI[2.59,8.46],P=0.0002);The difference in traditional Chinese medicine syndrome scores is statistically significant(MD=-4.24,95%CI[-6.59,-1.89],P=0.0004);The difference in plasma viscosity was statistically significant(MD=-0.28,95%CI[-0.40,-0.15],P<0.05);The incidence of adverse reactions showed no heterogeneity among the studies(I2=0%;P=0.47),and the differences were not statistically significant when calculated using a fixed effects model(OR=0.57,95%CI[0.23,1.40],P=0.22).(2)Data mining:Data mining:A total of 48 articles were included,and after data cleaning and statistics,a total of 90 traditional Chinese medicines were involved,with a total frequency of use of 626 times.The traditional Chinese medicines that have been used more than 15 times are Shichangpu、Chuanxiong、Banxia、Chenpi、Fulin、Taoren、Honghua、Chishao、Gancao、Danggui、Yujin、Yuanzhi、Danshen、Dilong、Shuizhi、Tiannanxing.The commonly used types of drugs include tonifying deficiency drugs,promoting blood circulation and resolving blood stasis drugs,and resolving phlegm,relieving cough,and relieving asthma drugs.The most commonly used treatment for vascular dementia based on the theory of phlegm and blood stasis is the tonifying method;From the perspective of the four gases of drugs,the most commonly used are warm and mild drugs;From the perspective of the five flavors of drugs,the most frequently used are spicy and bitter drugs,with the most types of drugs containing sweet flavors;From the perspective of drug meridian tropism,the most commonly used drugs are those that belong to the liver meridian,followed by the lung meridian,spleen meridian,and heart meridian,with little difference among the three.Through association rule analysis,among the two drug associations,Shichangpu-Chuanxiong has the highest support and confidence level,among the three drug associations,the group of Shichangpu,Taoren-Honghua has the highest support and confidence level.Through cluster analysis,when 37 high-frequency drugs were included,they could be clustered into 5 categories;When 48 high-frequency drugs are included,they can be grouped into 4 categories.ConclusionsThe effectiveness of treating vascular dementia based on the theory of phlegm and blood stasis is better than using Western medicine alone.The safety still needs to be evaluated through larger and more standardized RCT tests and meta-analysis.Overall,the main treatment method for vascular dementia is to dissipate phlegm and blood stasis,which is worth recommending.Regarding the traditional Chinese medicine compound formula that mainly treats vascular dementia by resolving phlegm and removing blood stasis,the most commonly used formulas are Shichangpu,Chuanxiong,Banxia,etc.The main focus is on the addition and subtraction of prescriptions such as Wendan Tang,Taoren Honghua Jian,Danggui Shaoyao San,Tongqiao Huoxue Tang,Erhuang San,Changpu Yujin Tang,etc.The combination of tonifying the kidney and filling the lean qi is used to consolidate the foundation,while insect drugs are used to channel and unblock the body.