Study on syndrome differentiation strategy of phlegm and blood stasis syndromes of coronary heart disease based on expert consultation on medical cases

Abstract

Background: It is becoming more and more important to judge whether patients with coronary heart disease (CHD) have phlegm and blood stasis syndromes in the process of traditional Chinese medicine (TCM) diagnosis and treatment of CHD. The syndrome differentiation strategy of phlegm and blood stasis syndromes of CHD is still not standardized, and it is particularly necessary to make syndrome differentiation simpler and more accurate.Methods: Twenty-eight medical cases that met the criteria, comprising 10 ancient medical cases and 18 modern ones, were selected from the TCM literature, which were then analyzed by 57 experts via questionnaire. Statistical analysis of the data was mainly based on frequency analysis.Results: (I) The average age of the 57 experts from 20 provinces was 48.9±8.5 years; 89.5% were associate professor or above, and 75.4% of them worked at a tertiary hospital. (II) Consistency of expert consultation over medical cases: for the ancient medical cases, the diagnostic consistency rate of phlegm syndrome was 27/34 (79.4%) and additional diagnosis rate of the blood stasis syndrome was 27/57 (47.4%); for the modern medical cases, the consistency rate compared with the original diagnosis of phlegm syndrome was 54/80 (67.5%) and that of blood stasis syndrome was 73/90 (81.1%). (III) The top five experts' diagnostic basics of phlegm syndrome were oppression in the chest, slippery pulse, greasy fur, coughing of phlegm, and chest pain; the top five diagnostic basics of blood stasis syndrome were chest pain, dark tongue, oppression in chest, red tongue, and ecchymosis on tongue. (IV) In the questionnaire consultation on CHD phlegm-blood stasis syndrome cases, the diagnostic basis of "symptom or (and) tongue manifestation" accounted for 12/27 (44.4%) of the diagnostic basics of phlegm syndrome and 28/38 (73.7%) of that of blood stasis syndrome basis.Conclusions: Modern Chinese medicine experts pay much attention to the diagnosis and treatment of CHD based on TCM pathology theories of phlegm and blood stasis. To collect and detect the patients' symptoms and tongue manifestation is an important strategy of the experts for CHD phlegm and blood stasis syndrome differentiation.

The Eye-image Features of Patients with Coronary Heart Disease Assed: A prospective, observational study of traditional Chinese medicine combined with modern medicine

“…Epidemiological studies in recent years have shown that stasis is the main syndrome of CHD, among 5284 patients with CHD, blood stasis accounted for 79.3% [7] , In our study on eye-image features and their relation to CHD, yellowish mounds were the most commonly associated feature in Western medicine. These mounds are typically attributed to damp phlegm and blood stasis, as found in previous research [1,18] . According to research [14] , this condition is exacerbated by consuming large amounts of high-fat food and a lack of exercise, leading to the accumulation of lipids, increased blood lipid and blood cell adhesion, and the development of blood stasis [1] .…”

“…Another important aspect is syndrome differentiation and treatment, as only accurate differentiation can lead to effective treatment. In TCM, CHD is diagnosed through patient Zheng hou (known as symptoms in Western medicine), which include cold and heat, deficiency and excess, phlegm dampness, and stasis [1,18] . The disease Zheng hou of patients with CHD can be determined by analyzing the eye-image characteristics of the heart-eye area.…”

“…Coronary heart disease (CHD) is mainly caused by coronary atherosclerotic plaque or coronary artery spasm, leading to coronary artery stenosis, blood supply restriction, and myocardial ischemia and hypoxia [1] . Many studies have confirmed that CHD is the leading cause of cardiovascular death and chronic disability worldwide [2] , becoming one of the health-threatening problems [3] .…”

Acupuncture Combined with Traditional Chinese Medicine and Drug Therapy for the Treatment of Cerebral Infarction (Phlegm-Blood Stasis Syndrome) and Carotid Atherosclerotic Plaque: A Preliminary Randomized Controlled Study

“…The characteristics of CAP in CI patients are related to TCM phlegm-blood stasis syndrome [ 29 ]. Phlegm syndrome has been shown to be associated with various diseases, and blood stasis can occur after a long time; thus, CAP belongs to the category of “phlegm-blood stasis” of TCM [ 30 , 31 ]. The following treatments implemented in this study showed promising results in resolving phlegm and reducing stasis: two matured substance decoction for reducing phlegm-damp, peach kernel and Carthamus four substance decoction for alleviating blood stasis, Chinese hawthorn fruit for removing food accumulation, gold theragran for lowering the blood lipid level, and red yeast rice for promoting circulation, dissolving stasis, and lowering blood lipid.…”

Exploring the “gene–protein–metabolite” network of coronary heart disease with phlegm and blood stasis syndrome by integrated multi-omics strategy

“…PBS syndrome has recently emerged as a hot research topic in the TCM field. Objective diagnosis, expert consultations, and efficacy evaluation scales have been developed for PBS syndrome ( Ren et al, 2020 ; Liu et al, 2021 ; Zheng et al, 2022 ). The concept of “omics” originates from the genome.…”