Objective

2

To mine the characteristics of traditional Chinese medicine （TCM） syndromes of coronary heart disease （CHD） from 2010 to 2021 through literature， and to summarize the evolution law of the TCM syndromes of CHD in 1970—2021 based on the previous study.

Methods

2

Databases including CNKI and VIP were searched for relevant literature on TCM syndromes of CHD published between July 1st， 2010 and June 30th， 2021， and the distribution characteristics of TCM syndromes and syndrome elements of the included literature were statistically analyzed. Based on the team's previous research， the evolution law of TCM syndrome characteristics of CHD in 1970—2021 was summarized.

Results

2

A total of 129 papers involving 52 090 patients were eventually included， of which 107 papers reported compound TCM syndromes involving 36 224 patients. From 2010 to 2021， the top 10 clinical TCM syndrome types were internal obstruction of phlegm-turbidity （8519 cases， 23.52%），heart blood stasis obstruction （5094 cases， 14.06%），

qi

deficiency and blood stasis （5022 cases， 13.86%），both

qi

and

yin

deficiency （4432 cases， 12.23%），

qi

stagnation and blood stasis （2285 cases， 6.31%），

yang qi

depletion （1683 cases， 4.65%）， heart

qi

insufficiency （1474 cases， 4.07%）， cold congealing in the heart vessel （1271 cases， 3.51%），

qi

deficiency and phlegm stasis （1243 cases， 3.43%）， and

yin

deficiency of heart and kidney （771 cases， 2.13%）. A total of 102 965 cases of syndrome elements were extracted， including 10 syndrome elements， which were 27 825 cases of blood stasis （27.02%）， 23 872 cases of

qi

deficiency （23.18%）， 19 493 cases of turbid phlegm （18.93%）， 11 249 cases of

yin

deficiency （10.93%）， 5602 cases of

yang

deficiency （5.44%）， 5584 cases of

qi

stagnation （5.42%）， 3615 cases of heat （toxin） （3.51%）， 2367 cases of cold congealing （2.30%）， 2135 cases （2.07%） of fluid rheum， and 1223 cases （1.19%） of blood deficiency. Combined with the characteristics of TCM syndromes and syndrome elements of CHD from 1970 to 2010， the results showed that the proportion of internal obstruction of phlegm-turbidity syndrome and

qi

deficiency and blood stasis syndrome gradually increased from 1970 to 2021， and the proportion of heart blood stasis obstruction syndrome significantly increased during 1990 to 1999 and 2000 to 2010 when compared to that in 1970—1989， but decreased during 2010 to 2021. The proportion of

qi

staganation and blood stasis syndrome in 1990—2021 was lower than that in 1970—1989. The total proportion of simple deficiency syndromes， including both

qi

and

yin

deficiency， heart

qi

insufficiency， and

yang

qi

depletion， gradually decreased. The total proportion of excess syndrome elements such as turbid phlegm and blood stasis showed a significant increase trend， while that of deficiency syndrome elements such as

qi

deficiency，

yin

deficiency and

yang

deficiency gradually decreased.

Conclusion

2

The overall characteristics of the “weak pulse at

yang

and wiry pulse at

yin

” of CHD have not changed， and it is still the syndrome of deficiency in root and excess in branches. The syndrome elements of branch excess mainly manifested as turbid phlegm and blood stasis have gradually dominated. It shows a trend of phlegm with stasis regarding the TCM syndrome of CHD in the future.