| Research 1:Systematic Review of Traditional Chinese Medicine for the Treatment of Qi Deficiency and Blood Stasis Type Ventricular Premature BeatsObjective:To evaluate the efficacy and safety of Chinese medicine in the treatment of Qi deficiency and blood stasis type ventricular premature beats,and to provide evidence-based medical support for the treatment of Qi deficiency and blood stasis type ventricular premature beats with Chinese medicine.Methods:A comprehensive search of domestic databases(CNKI,Wanfang,VIP,and SinoMed),international databases(PubMed,Web of Science,Cochrane Library,and Embase),and other databases,including the China Clinical Trial Registration Center,Clinical Trials,and International Clinical Trials Registry Platform(WHO-ICTRP),was conducted to identify randomized controlled trials of Chinese medicine in the treatment of Qi deficiency and blood stasis type ventricular premature beats from inception to December 31,2022.The treatment group received Chinese medicine or a combination of Chinese medicine and conventional Western medicine,while the control group received a placebo or FDA or CFDA-approved drugs.The Cochrane risk of bias tool,recommended and applied by the International Evidence-Based Medicine Alliance,was used to comprehensively evaluate the quality of randomized controlled trials.The RevMan5.4.1 software was used to conduct a meta-analysis of outcome indicators.Results:A total of 1781 articles on Chinese medicine treatment of ventricular premature beats were retrieved.After screening and rigorous evaluation,26 studies involving 1346 patients were included in the analysis.The meta-analysis revealed the following:(1)Chinese medicine can improve clinical symptoms and dynamic ECG efficacy in patients with ventricular preterm contraction.①Chinese medicine had a significant effect on improving the efficacy of ventricular preterm contraction(n=1296,RR=1.29,95%CI[1.21,1.37],P<0.05).②Chinese medicine significantly reduced the number of ventricular anterior contraction episodes(n=1145,MD=-594.67,95%CI[-850.26,-339.08],P<0.05).③Chinese medicine improved the efficacy of 24-h dynamic ECG of ventricular precontraction(n=438,RR=1.14,95%CI[1.00,1.31],P=0.05).(2)Chinese medicine can improve the TCM symptoms in patients with ventricular preterm contraction.①The efficacy of Chinese medicine in treating Chinese medical evidence in patients with ventricular preterm contraction was better than that of the control group(n=1055,RR=1.30,95%CI[1.22,1.38],P<0.05),and the efficacy of the treatment group was better than that of the control group when Chinese medicine was compared with Western medicine,Chinese medicine combined with Western medicine compared with Western medicine,and Chinese medicine compared with placebo or blank control.②There was a statistically significant difference between Chinese medicine to reduce the TCM evidence score in patients with ventricular preterm contraction compared with the control group(SMD=-1.29,95%CI[-1.61,-0.94],P<0.05).(3)Chinese medicine can improve cardiac function in patients with ventricular prophase contraction①Chinese medicine could improve left ventricular ejection fraction in patients with ventricular preterm contraction(n=466,RR=6.71,95%CI[1.26,12.15],P=0.02<0.05).②Chinese medicine improved heart rate variability in patients with ventricular asystole(n=173,RR=17.91,95%CI[7.52,28.29],P<0.05).(4)The side effects of Chinese medicine for ventricular asystole were relatively few.The incidence of adverse reactions in ventricular asystole treated with Chinese medicine was significantly lower than that in the western control group(n=709,RR=0.35,95%CI[0.20,0.61],P<0.05),and the results were statistically significantConclusion:This Meta-analysis showed that there were statistical differences between the Chinese medicine group and the non-Chinese medicine control group in improving the efficacy of ventricular preterm contraction,improving the efficacy of TCM evidence,reducing the number of occurrences of ventricular preterm contraction,reducing the TCM evidence score,improving the efficacy of 24h ambulatory ECG,improving the left ventricular ejection fraction(LVEF)and improving the heart rate variability index SDNN.The effectiveness of Chinese herbal medicine in treating Qi deficiency and blood stasis type of ventricular preterm contraction was demonstrated.In addition,the incidence of adverse effects of oral Chinese medicine was less than that of other antiarrhythmic drugs,demonstrating the safety of oral Chinese medicine in the treatment of ventricular preterm contraction.This study provides more guidance and reference for the clinical treatment of ventricular asystole with Qi deficiency and blood stasis.Research 2:Investigating the Medication Rules of Professor Lu Weixing’s Treatment of Ventricular Premature Contractions Based on Data MiningObjective:This study aims to use data mining methods to collect and organize clinical data on ventricular premature contractions treated by Professor Lu Weixing.The purpose is to analyze the medication rules,summarize the common prescriptions and clinical experience of Professor Lu Weixing in treating ventricular premature contractions,and provide a reference for the prescription of Traditional Chinese Medicine(TCM)in treating ventricular premature contractions.Methods:Medical records of ventricular premature contraction patients treated by Professor Lu Weixing at the Third Affiliated Hospital of Beijing University of Chinese Medicine and the Dongzhimen Hospital of Beijing University of Chinese Medicine between September 1,2020,and March 1,2023,were collected.A database was established using the Ancient and Modern Medical Case Cloud Platform,and frequency analysis of drug efficacy,classification of the Four Qi,Five Flavors,and Meridian properties were conducted,along with cluster analysis,association rule analysis,and complex network mapping.Results:(1)A total of 223 prescriptions containing 181 Chinese medicines were included in this study,with a total medication frequency of 3160 times.Based on drug frequency analysis,the top 10 Chinese medicines were Salvia miltiorrhiza,Coptis chinensis,Paeonia rubra,Polygonatum sibiricum,Ziziphus jujuba seed,Earthworm,Astragalus,Cyathula officinalis,Atractylodes macrocephala,and Glycyrrhiza uralensis,with a usage frequency exceeding 100 times each.The top five categories of drug efficacy were heat-clearing and damp-drying,spleen-tonifying,blood-activating and stasis-removing,diuretic,and heart-calming and mindsoothing medicines,accounting for similar percentages(around 6.5%)and relatively balanced distribution.Therefore,they can be classified into three major categories:tonifying deficiency(40.92%),purging excess(52.01%),and calming the mind(12.12%).(2)In terms of drug properties,neutral medicines had the highest frequency of occurrence(911 times),followed by warm(655 times)and cold(595 times)medicines.Bitter flavor had the highest frequency(1533 times),followed by sweet(1505 times)and pungent(907 times)flavors.Liver meridian had the highest frequency(1655 times),followed by heart meridian(1219 times)and spleen meridian(1214 times).(3)According to association rule analysis,the highest support degree was Paeonia rubra→Salvia miltiorrhiza,with a support degree of 6.3;the highest confidence degrees were Paeonia rubra→Salvia miltiorrhiza,Paeonia rubra+Polygonatum sibiricum→Salvia miltiorrhiza,and Paeonia rubra+Earthworm→Salvia miltiorrhiza,all with a confidence degree of 1.Based on complex network analysis,the core medicines were Salvia miltiorrhiza,Paeonia rubra,Polygonatum sibiricum,Coptis chinensis,Earthworm,Cyathula officinalis,Ziziphus jujuba seed,and Astragalus,which comprised the core prescription of Professor Lu Weixing for treating ventricular premature contractions.(4)According to cluster analysis,four groups of different efficacy combinations were obtained:Group 1:Polygala tenuifolia and Ephedra sinica;Group 2:Coptis chinensis,Glycyrrhiza uralensis,and Sophora flavescens;Group 3:Ziziphus jujuba seed,Salvia miltiorrhiza,and Paeonia rubra;Group 4:Crataegus pinnatifida,Astragalus membranaceus,Poria cocos,Polygonatum sibiricum,Earthworm,Cyathula officinalis,Atractylodes macrocephala,Leonurus japonicus,and Ze-Lan.Conclusion:Based on the traditional theory of qi and blood in the treatment of cardiac diseases,Prof.Lu introduced dampness and heat into the treatment of ventricular preterm contraction in conjunction with modern clinical practice,enriching the treatment of ventricular preterm contraction with "qi deficiency and blood stasis" as the pathogenic mechanism.Professor Lu’s treatment of ventricular anterior contraction is mostly based on deficiency of Qi and blood,internal stasis of blood,and dampness and heat disturbing the heart and mind,and he believes that the disease is characterized by deficiency with actuality and actuality with deficiency,and that evidence of mixed deficiency and actuality is common in clinical practice.The treatment is based on tonifying the deficient and dipping the actual,supporting the righteous and dispelling the evil,and is divided into three methods:"benefit the qi and blood,nourish the heart and mind;resolve blood stasis,calm the palpitations;clear dampness and heat,and take into account the deficiency and reality.In the clinical evidence,reference is also made to herbs with anti-arrhythmic effects in modern pharmacology.Professor Lu also has unique insights into the relevance of spleen-strengthening herbs to the theory of Qi and Blood,providing new ideas and methods for clinical diagnosis and treatment. |
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