In recent years, Chinese medicine has made many advances in the prevention and treatment of cardiovascular diseases, such as activating blood circulation and removing blood stasis to treat angina pectoris in coronary heart disease, invigorating blood circulation and invigorating blood circulation to treat acute myocardial infarction or cardiac insufficiency, invigorating blood circulation and invigorating blood circulation to treat slow arrhythmias, invigorating blood circulation and invigorating blood circulation to treat viral myocarditis, and preventing restenosis after interventional treatment of coronary heart disease, all of which have shown positive effects. Although their effects are not as strong as those of chemically synthesized drugs, they have shown certain advantages in preventing and treating many diseases of the cardiovascular system. How to make full use of the advantages of both Chinese and Western medicine in the prevention and treatment of cardiovascular diseases, and further improve the clinical efficacy, is a realistic problem that cannot be avoided in modern Chinese medicine clinics. The organic combination of evidence-based and disease-specific treatment is not a recent concept in Chinese medicine, but due to the limitations of historical conditions, this inherent method of disease identification and treatment in Chinese medicine has not been developed as it should be with the development of history, but has been overshadowed by the ever-prominent evidence-based treatment. The reason for this is that under historical conditions, people could only draw analogies and generalize “disease names” based on disease symptoms and phenomena in nature. For example, “chest paralysis”, first seen in the “Golden Plaque”, “the disease of chest paralysis, wheezing, coughing and spitting, chest and back pain, shortage of breath, inch mouth pulse sinking and late, small tight number on the Guan”. Due to the uncertainty of the connotation of diseases in Chinese medicine (including the cause, nature, and location) and the arbitrariness of the physician’s imagery, it is difficult to identify the disease with a Chinese rope to base on. In modern clinical terms, chest paralysis can include coronary heart disease, pneumonia, pulmonary infarction, pleurisy, lung cancer, and many other canker sores in Western medicine, and obviously their clinical treatment in Chinese medicine will have certain differences, even if they show the same “evidence” at a certain stage of the disease. The “identification” of the cardiovascular system in TCM should not be a purely Western diagnosis and TCM treatment by type, which is not true TCM “identification”. For example, coronary heart disease is mostly classified in TCM books as heart-blood stasis, phlegm congestion, yin-cold stagnation, heart-kidney yin deficiency, qi-yin deficiency, yang qi deficiency, etc. However, when examined clinically, patients with coronary heart disease can exhibit various “evidence” depending on their environment, endowment and stage of development, which is far from several ” The “evidence type” can not be generalized. Moreover, simple typing will to some extent conceal the complexity and variability of the disease and lead the physician to a single and one-sided thinking, i.e., the linear pattern of disease – evidence – prescription, which will hinder the improvement of clinical efficacy of TCM. Western medicine diseases are mostly diagnosed and named by “pathophysiological” changes that distinguish them from other diseases, and they have their own unique evolutionary rules. At a certain stage of disease development, the pathological changes are basically the same, and the symptoms reflected in the clinic are mostly the same. For example, the basic pathological changes of angina pectoris in coronary artery disease are atherosclerotic stenosis, spasm and microthrombosis, and the prominent symptoms are paroxysmal discomfort, crushing pain and stuffiness in the precordial area; the basic pathological changes of left heart insufficiency are stasis of blood in the pulmonary circulation, which mostly manifests as coughing, coughing or coughing up blood, shortness of breath when moving, and even inability to lie down. These commonalities are reflected in the identification of diseases in TCM, which should also have its own rules to find. The treatment of TCM cardiovascular diseases can be summarized in the following aspects: (1) In response to the pathological changes of the disease or the results of modern pharmacological research, the same drugs are administered regardless of the type of TCM diagnosis: for example, in coronary heart disease, in response to the basic pathological changes of coronary artery stenosis, spasm, platelet adhesion and thrombosis, regardless of whether the diagnosis is phlegm blockage, chest Yang, or cold clotting of blood vessels and stasis of heart vessels, the same drugs are always administered to The basic pathological changes are phlegm blockage, thoracic Yang blockage, cold blood clotting and stasis of the heart vessels. The Cardiovascular Disease Committee of the Chinese Society of Integrative Medicine classifies angina pectoris in coronary heart disease into Qi deficiency and blood stasis type, Qi and Yin deficiency and blood stasis type, Qi stagnation and blood stasis type and phlegm and blood stasis mutual obstruction type, each type contains blood stasis as the pathological basis, which is, to a certain extent, a summary of the pathological and physiological changes. For example, for arrhythmias and rapid arrhythmias, the method of clearing heat and tranquilizing the heart is used; for slow arrhythmias, the method of benefiting qi and warming yang is used; (3) Combining the results of modern pharmacological research with medicine to strengthen the target of medicine. Modern pharmacological research proves that the tonic herbs He Shou Wu, Sang Sang Sang, Lingzhi, the dampness-boosting Ze Xie and Yin Chen, the blood-boosting Jiang Huang, the food-eliminating drug Shanzha, the downward-transferring drug Rhubarb and cassia have certain lipid-regulating effects. In the treatment of hyperlipidemia, the above-mentioned drugs can be added on the basis of evidence to enhance the effect of lowering lipids; for example, the treatment of tachyarrhythmias, modern pharmacological research shows that Gangsong, Huanglian, Medlar, Calamus, etc. have different degrees of anti-arrhythmic effects, which can be selected on the basis of evidence; (4) the identification and treatment of hidden latent evidence: according to the location and characteristics of the disease, identify the etiology and pathogenesis of the disease, and apply targeted treatment. Many diseases, especially chronic diseases and difficult diseases, have a long latent period, or are clinically asymptomatic, but the pathological changes are progressing. For example, in asymptomatic myocardial ischemia, TCM practitioners can treat it with blood activation and blood stasis treatment according to the characteristics of its pathological changes, and most of them can obtain certain efficacy. It should be noted that the treatment of Chinese medicine is not a simple match with the pathological and physiological changes of Western medicine, but a method of using Chinese medicine theory to recognize the pathological and physiological changes observed by modern scientific and technological methods, and to explore the rules of disease identification and treatment, and the treatment of Chinese medicine under the guidance of disease identification is more targeted and repeatable than that of evidence identification. 2, the ambiguity of the evidence and the standardization of the evidence of Chinese medicine, due to the doctor’s understanding of the perspective, level and the subjective judgment of the doctor’s ability to vary, the “evidence” will be very different. To a certain extent, the accuracy of identification and treatment depends on the doctor’s theoretical level of TCM and clinical experience, which is called “the doctor’s intention”. For example, the understanding of vertigo. In Su Wen? In the book “The Great Treatise on the Supreme Truth”, it is said that “all wind and dizziness belong to the liver”; in the book “Danxi Xinfa? Dizziness”, and “no dizziness without phlegm”, suggesting that treating phlegm is the first priority; “Jing Yue Quan Shu? Dizziness and Dizziness” emphasizes that “no deficiency can make dizziness”. Clinical diagnosis and treatment requires the development of certain scientific norms, including clear boundaries and descriptions of the characteristics and connotations of “evidence”. It is an important part of the standardization of the evidence to expand one’s vision and recognize the physiopathological phenomena observed by modern science and technology and methods. This microscopic method of evidence identification is more valuable to the development of TCM and the improvement of clinical efficacy than confirming the scientific nature of TCM with modern science and technology. The development of modern medicine has provided us with technical support to broaden the horizon of evidence identification, such as echocardiography, ambulatory blood pressure testing, exercise plate electrocardiography, radionuclide myocardial scan, coronary angiography, cardiac electrophysiological examination, intravascular ultrasound, detection of various vasoactive substances, etc., which have all contributed to the study of evidence identification objectivity in some aspects. The research on the evidence related to cardiovascular diseases should be based on the combination of macroscopic generalization and microscopic observation, and gradually summarize and analyze the characteristics and rules of its manifestation and repetitiveness. For example, in the study of blood stasis and blood stasis remedies, our scholars have worked on microcirculation, blood rheology, platelet function, organ blood flow, prostacyclin and thromboxane metabolism and fibrinolytic system changes, combined with traditional Chinese medicine’s understanding of blood stasis, developed diagnostic criteria for blood stasis, comparatively studied the effects of commonly used blood stasis remedies, broadened the indications for blood stasis remedies, and improved the clinical treatment of cardiovascular diseases in Chinese medicine. This has broadened the indications of TCM prescriptions for activating blood stasis and improving the efficacy of TCM clinical treatment of cardiovascular diseases. However, this study is currently limited to a few evidence in TCM, which cannot meet the clinical needs. The main way of traditional Chinese medicine to treat diseases is to identify and summarize the “evidence” (the state of imbalance of yin and yang in a certain stage of the body) through the four diagnoses, and to adjust the yin and yang of the body by using the yin and yang properties of natural medicines (cold and heat, elevation and declination, moistening and drying, etc.) to make it reach a new state of balance. This holistic approach to disease prevention and treatment still shows vigorous vitality today. Modern medicine still lacks ideal treatment for certain cardiovascular diseases, such as viral myocarditis, dilated cardiomyopathy, etc. These diseases involve the body’s neurological, humoral, immune, endocrine and other systems. The ability to maintain a dynamic balance among the organ systems of the body determines the occurrence and healing of diseases. In a normal physiological state, the human body has the self-control ability to maintain its various movements in a certain relative balance in order to keep itself in order and stability, such as absorption and excretion, heat production and dissipation, antigen and antibody in immune response, etc., all of which are in relative balance in the unity of opposites, that is, the so-called “yin and yang secret”. In the pathological state, if the various movements of the body tend to be in relative balance and stable and orderly state, the disease will be healed; if it deviates from the relative balance and stable and orderly state, the disease will progress or deteriorate. For example, chronic heart failure often undergoes a long compensatory phase of cardiac function before clinical symptoms appear, in which the body mobilizes various factors to maintain tissue perfusion and achieve a state of equilibrium. The development of atherosclerosis is also due to the imbalance of vascular-related regulatory factors including systolic and diastolic, proliferative and anti-proliferative, coagulation and anti-coagulation, collagen synthesis and collagen degradation. How to restore the body’s ability to regulate the dynamic balance is the key to clinical prevention and treatment of diseases in TCM. The specific pathological state of the disease is similar to the “evidence” in TCM: “evidence” is the external manifestation of multiple internal and external factors acting on the human body, so it can reflect the specific state of the organism more comprehensively than a certain symptom, sign, biochemical index or physical and chemical examination result. Take the example of restenosis after coronary heart disease intermediary treatment. Clinical attempts were made to find a predictor or major factor for the occurrence of restenosis. The results are not very satisfactory. The main reason is that a certain index or factor has its limitations and cannot objectively and comprehensively reflect the specific functional state of the body. By studying the occurrence of restenosis in patients with different “evidence” of coronary artery disease after intervention, it is possible to discover certain intrinsic patterns that can provide guidance for the prevention of restenosis. During the “8th Five-Year Plan” and “9th Five-Year Plan” period, the research group led by Academician Chen Keji found through clinical research that although there are different types of coronary heart disease patients, all of them have certain signs of blood stasis, and the preoperative blood stasis score of coronary interventions is positively correlated with the occurrence of restenosis after the operation. The positive correlation between the preoperative blood stasis score and the occurrence of postoperative restenosis suggests that blood stasis may be a special pathological condition of patients with restenosis. To address the intrinsic relationship between the occurrence of restenosis after coronary intervention and “blood stasis evidence”, we used the traditional Chinese medicine recipe for blood circulation and stasis removal, which was shown to inhibit smooth muscle cell proliferation after percutaneous transluminal angioplasty, reduce intima-media thickness, and regulate related gene expression. On this basis, the representative drugs in the formula, Chuan Shao and Chi Shao, were selected to activate blood circulation and resolve blood stasis, and their effective parts were taken to make capsules for the prevention of restenosis after balloon injury in porcine coronary arteries, which showed that the drug could play a role in preventing restenosis formation by affecting several aspects such as smooth muscle cell proliferation-related gene and protein expression, apoptosis, transmembrane signaling, and collagen accumulation. Of course, herbal medicine is not a panacea and cannot act specifically on so many links. The possible mechanism is that herbal medicine stimulates the body’s self-regulatory ability, thus avoiding too much or too little on the opposing sides of multiple pathological links and restoring a relative balance at a new level. In terms of modern gene therapy for cardiovascular diseases, the current gene therapy only introduces a normal gene to compensate for the deficiency of a certain gene expression product in the body; or introduces an antisense RNA or DNA to inhibit the transcription and expression of a certain gene in the body. Such gene therapy is still preliminary and imperfect for the treatment of polygenic cardiovascular diseases, and it is difficult to produce truly effective therapeutic effects. The future direction is to develop in vivo homologous recombination technology to stimulate the body’s own DNA repair and regulation ability. In addition, modern medicine has expanded the object of study from the biological person to the social person, and expanded the treatment of disease to the treatment of the patient, paying more attention to the human body itself. For example, the treatment of hypertension has developed from the original step therapy to the current individualized treatment, with the ultimate goal of reasonable blood pressure reduction, reduction of target organ damage, improvement of long-term prognosis of patients and improvement of quality of life. This has some similarities with the holistic concept of TCM. 4. The complex composition and multi-channel and multi-target intervention of Chinese medicine The effect of Chinese medicine on a single target or several targets is often weaker than that of Western medicine, for example, the treatment of coronary heart disease is obviously at a disadvantage compared with Western medicine such as nitric acid and calcium antagonists in terms of dilating coronary arteries, improving myocardial blood supply and reducing myocardial oxygen consumption, but Chinese medicine can indeed improve the long-term prognosis of patients and reduce the occurrence of ischemic events. What is the reason? A natural medicinal plant can contain hundreds of chemical components, and a compound consisting of 4-5 herbs may have 200-500 chemical components at the microgram level, and the mechanism of its efficacy is obviously the combined result of the interaction of these components. Chemically synthesized drugs have a single target point of action, while Chinese herbal medicine compound ingredients are complex and their action may involve many targets and links. For example, the targets of the drugs Danshen, Chuanxiong and Panax notoginseng for cardiovascular diseases may include ion channels, adrenergic receptors, free radicals, platelet-activating factors, angiotensin-converting enzymes, endothelium-dependent diastolic factors and so on. To improve the clinical efficacy of TCM, the development of new drugs from natural plant monomers is certainly one of the effective ways, but we also need to take advantage of TCM’s multi-component, multi-target and multi-path prevention and treatment advantages. Using modern pharmacochemical analysis and extraction technology, combined with pharmacological methods, we search for the effective action parts or active ingredients of Chinese medicine to optimize the combination, and develop new Chinese medicines to prevent and treat cardiovascular diseases. For example, the drug is a lipid regulator refined from special red currant. In recent years, a large number of clinical observations have proved its reliable efficacy and low side effects. Its pharmacological mechanism involves adjusting blood lipid metabolism, inhibiting lipid deposition in liver, protecting vascular endothelial cell function, inhibiting vascular smooth muscle cell proliferation and migration, improving red blood cell aggregation, and reducing blood viscosity. As for the treatment of hypertension, the previous anti-hypertensive treatment mainly focused on reducing blood pressure levels, but it is now believed that the ideal anti-hypertensive drugs should be able to reverse the damage to the target organs of hypertension. Although Chinese medicines are not as effective as Western medicines in lowering blood pressure, their effects are long-lasting. However, their effects are long-lasting, and many herbal medicines and prescriptions have been shown to reduce left ventricular hypertrophy in patients and to affect blood rheology and lipid metabolism while lowering blood pressure, thereby reducing the incidence of coronary heart disease, which is important for the long-term management of patients with hypertension. The therapeutic mechanism of Chinese medicine compound, Chinese medicine or its active parts, due to its complex composition, can involve antagonism, supplementation, balancing, regulation, stimulation and other forms, and the site and link of its action can also involve multiple systems and multiple cells. In the field of cardiovascular disease, where multifactorial and polygenic cardiovascular diseases are dominant, perhaps this multi-link and multi-site integrated treatment mode is more suitable for the needs of healthcare. 5. Combination of traditional Chinese medicine theory and modern pharmacological research to improve the clinical dispensing of drugs Modern preparation, pharmacochemical and pharmacological technologies applied to the research of Chinese medicine have made progress in many aspects. Pharmacological research on the regulation of lipid metabolism by Chinese medicine shows that Chinese medicine can exert therapeutic effects through the following links: (1) promoting lipid excretion: for example, Yin Chen can promote cholesterol excretion through its choleretic effect; (2) inhibiting lipid absorption: for example, He Shou Wu and Cassia can increase intestinal peristalsis and inhibit fat and cholesterol absorption; (3) inhibiting lipid synthesis in the body: for example, Hawthorn, He Shou Wu, Rhubarb and Cassia can inhibit 3-lithium -Under the guidance of identification theory, the correct application of the above drugs can improve the clinical effect of lipid regulation. The combination of Chinese compound drugs has its special material basis and interaction mechanism, which can increase the effectiveness, reduce the toxicity and control the bias. For example, Si Wei Tang has the effect of elevating blood pressure and strengthening heart, and Radix et Rhizoma can not only strengthen myocardial contraction, but also have the effect of elevating blood pressure, while Dry Ginger has no obvious effect and Licorice only has the effect of elevating blood pressure, but the combination of three flavors can make the strength and duration of myocardial contraction exceed that of Radix et Rhizoma alone, and the effect of elevating blood pressure is also greater than that of each single medicine, and the side effect of ectopic arrhythmia caused by Radix et Rhizoma can be reduced, which indicates that there is a synergistic effect between the adjuvant and the ruling medicine and monitor the toxicity. The synergistic relationship between the adjuvant and the ruler has been demonstrated. Due to the complex composition of compound Chinese medicine, it is still difficult to explain the mechanism of drug interaction and in vivo metabolic changes in compound prescriptions, but using modern quantitative pharmacology principles, taking pharmacological efficacy as an indicator and the theory of “formula evidence” in Chinese medicine as a guide, it is important to deeply study the mechanism of drug combination and changes in addition and subtraction of compound prescriptions to improve the clinical level of prescription use. It is of great significance to improve the level of clinical prescriptions. The characteristic of Chinese medicine is to adjust the imbalance of yin and yang of the organism by following the characteristics of the disease location and internal organs, and always pay attention to the movement, cold and temperature, and rise and fall of each other. Many treatments in Chinese medicine, such as helping to dispel evil, lifting and lowering qi, promoting lung and asthma, and regulating qi and blood, all take into account both sides of the contradiction to adjust the balance of yin and yang, so that qi and blood can restore the nature of harmony. For example, in the acute stage of viral myocarditis, patients have the characteristics of blood and yin heat toxins that are difficult to clear and difficult to resolve, in addition to the application of cool blood circulation, blood dispersing drugs and antipyretic drugs (red peony, salvia, tiger sage, ground bark, honeysuckle, purple flower, panacea, etc.), but also need to pay attention to the characteristics of the heart, the main blood vessels, the use of drugs should not be too cold, should be cool blood circulation drugs with a little warm blood activators such as safflower, jiao shan ballast, etc., to take its The effect of cold and warmth, warmth and dispersion make the evil poison easy to penetrate and easy to solve. For example, in the treatment of hypertension with hyperactivity of liver and yang, one should not use too much of liver and subtle yang products, such as peony, mother of pearl, and storage stone, but should soften the liver, harmonize the qi and blood, and calm the liver and subtle yang. Even if the Liver Yang is hyperactive, when emphasizing the suppression and pacification of the Liver, it should also be accompanied by Yin Chen, Ma Ma Ma, Chai Hu and other liver-strengthening drugs, in order to follow the nature of the Liver and to ascend before descending. Therefore, Chinese medicine focuses on the yin and yang properties of natural drugs that ascend, descend, float, and sink, not just on the efficacy of Chinese medicine. The use of prescriptions is closely related to the theory of identification and treatment. The theory of identification and treatment is to use the overall theory of Chinese medicine, the theory of qi and blood, the theory of yin and yang, the five elements, and the four diagnostic methods to identify the nature of the disease and establish the corresponding treatment method; the use of prescriptions is guided by the treatment method, and the properties and functions of Chinese medicine are collected into “prescriptions” corresponding to this treatment method. It is obvious that this combination of “prescriptions” should be in accordance with the understanding of the disease mechanism and the biochemical theory of yin and yang qi and blood in Chinese medicine. This is the essence of TCM prescriptions and medicines, and is also the key to improving clinical efficacy. If we only emphasize the efficacy of TCM prescriptions, or even focus on the mechanism of action proven by modern pharmacological research, and ignore the guiding role of TCM theory of yin and yang, qi and blood biochemistry in diagnosis and treatment, we cannot master the skills of TCM prescriptions and use of drugs, and we cannot talk about the improvement of clinical efficacy of TCM in preventing and treating cardiovascular diseases.