HHO optimized support vector machine classifier for traditional Chinese medicine syndrome differentiation of diabetic retinopathy

AIM:To develop a classifier for traditional Chinese medicine(TCM)syndrome differentiation of diabetic retinopathy(DR),using optimized machine learning algorithms,which can provide the basis for TCM objective and intelligent syndrome differentiation.METHODS:Collated data on real-world DR cases were collected.A variety of machine learning methods were used to construct TCM syndrome classification model,and the best performance was selected as the basic model.Genetic Algorithm(GA)was used for feature selection to obtain the optimal feature combination.Harris Hawk Optimization(HHO)was used for parameter optimization,and a classification model based on feature selection and parameter optimization was constructed.The performance of the model was compared with other optimization algorithms.The models were evaluated with accuracy,precision,recall,and F1 score as indicators.RESULTS:Data on 970 cases that met screening requirements were collected.Support Vector Machine(SVM)was the best basic classification model.The accuracy rate of the model was 82.05%,the precision rate was 82.34%,the recall rate was 81.81%,and the F1 value was 81.76%.After GA screening,the optimal feature combination contained 37 feature values,which was consistent with TCM clinical practice.The model based on optimal combination and SVM(GA_SVM)had an accuracy improvement of 1.92%compared to the basic classifier.SVM model based on HHO and GA optimization(HHO_GA_SVM)had the best performance and convergence speed compared with other optimization algorithms.Compared with the basic classification model,the accuracy was improved by 3.51%.CONCLUSION:HHO and GA optimization can improve the model performance of SVM in TCM syndrome differentiation of DR.It provides a new method and research idea for TCM intelligent assisted syndrome differentiation.

Clinical study on microscopic syndrome differentiation and traditional Chinese medicine treatment for liver stomach disharmony in chronic gastritis

BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P<0.01).The treatment group also showed a significantly higher improvement rate in endoscopic findings than the control group(81.25%vs 53.13%,P<0.05).The improvement rates of histopathological findings and microcosmic syndrome scores were not significantly different between the two groups(P>0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.

Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD

[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.

Nursing Based on Syndrome Differentiation Combined with Auricular Plaster Therapy in Alleviating Insomnia

Objective:To observe the effect of auricular point pressing combined with nursing based on syndrome differentiation in the treatment of insomnia patients.Methods:Totally 92 patients with insomnia were randomly divided into the observation groupgiven auricular point pressing combined with nursing care based on syndrome differentiation and the control group treated with auricular point pressing alone.The improvement of Pittsburgh Sleep Quality Index(PSQI),TCM Syndrome Score and nursing satisfaction were compared between the 2 groups.Results:The time effect of PSQI total score and 6 factors in both groups were statistically significant(P<0.05).The time effect,interaction effect and inter-group effect of subjective sleep quality,PSQI total score were statistically significant(P<0.05);the 4 inter-group factors of sleep quality,sleep latency,sleep duration and daytime function were statistically significant(P<0.05).The total score of TCM syndromes in the observation group was lower than that in the control group(P<0.05),and the satisfaction rate in the observation group higher than that in the control group(80.43%vs.60.86%,P<0.05).Conclusion:Auricular point pressing combined withnursing based on syndrome differentiation can effectively improve the sleep quality of insomnia patients,and has significant advantages in improving TCM syndromes,as well as gained higher nursing satisfaction from patients.

Clinical Observation on Quality of Life in Coronary Artery Bypass Grafting Patients Treated According to Syndrome Differentiation of TCM

Objective: To evaluate the clinical effect and quality of life (QOL) in coronary artery bypass grafting (CABG) patients treated according to syndrome differentiation of TCM. Methods: Eighty-two CABG patients were allocated in the control group (n = 39) treated with conventional method of western medicine, and the TCM-treated group (n

Treatment of oral ulcer based on TCM syndrome differentiation

Oral ulcer is a kind of ulcerative injury that occurs in the oral mucosa and is very common in clinic.In severe case,it can affect the quality of life of the patients.Western medicine treatment of oral ulcer is often prone to relapse,while the effect of traditional Chinese medicine treatment is remarkable.

The Comparative Study on Two Models of Syndrome Differentiation of the Hand, Foot and Mouth Disease: An Investigation Analysis of the Signs and Symptoms on 2325 Cases

Objective To realize the characteristics of "zheng" differentiation-treatment for hand, foot and mouth disease(HFMD), a new methodology of syndrome differentiation for different stages of HFMD has been explored. Methods Total of 2 325 cases with HFMD were recorded by distributing them into exterior syndrome stage, interior syndrome stage, severe syndrome stage and recovered syndrome stage, respectively, and the main symptoms and subsidiary symptoms of different stages of HFMD have been observed. The major and minor pathogenesis of HFMD in different stages were obtained, and compared with the "2010 Guideline for the Diagnosis and Treatment of HFMD". Results It was found that the major pathogenesis of exterior stage was defined as "the invation of the wenevil to the defender of the body with the collaterals got involved ", and the minor as "qi deficiency"; in interior stage, "the fury of Gan-Yang" was the main pathogenesis, and "qi in chaos and qi deficiency" was the minor; in severe syndrome stage, "the damage of heart, liver and lung" was the main pathogenesis, and "qi in chaos" was the minor; and the pathogenesis of recovered stage was "qi-yin deficiency". Compared with the "2010 Guideline for the Diagnosis and Treatment of HFMD", it showed that "the obstruction of the fei-pi qi by the mixture of shi-re evil" and "the mixture of shi-re" in vivo was quite difficult to be explained in completely different context in the general situation; in the severe stage, the TCM clinical characteristics of syndrome differentiation might lose; in the early acute severe cases, the phenomenon that xin-yang and fei-qi almost ran out was difficult to be observed, then, the line between the severe and the acute severe became vague.Conclusions The theory of syndrome differentiation by stages of HFMD was reasonable in the actual situation of clinical description on HFMD which was expected to be further tested and widely applied in the "zheng" differentiation-treatment of HFMD in the future.

Regularity of syndrome differentiation and treatment of traditional Chinese medicine for Henoch-Schonlein purpura based on data mining techniques

Objective:This study aims to explore the regularity of syndrome differentiation and treatment of traditional Chinese medicine(TCM)for allergic purpura.Methods:CNKI,Weipu Chinese science and technology database,wanfang medical network database,and Chinese biomedical literature database were searched for eligible studies.Medical records including complete patient personal information,patient symptoms,TCM syndromes,treatment,and medication were included.The data was analyzed using the Chinese medicine heritage support platform provided by the Chinese Academy of Chinese medicine(V2.5).Results:Differentiation of health gas camp blood was the most commonly used method of differentiation of symptoms and signs in famous veteran TCM.The treatment included cooling blood,activating blood circulation,clearing heat and detoxifying toxins,removing blood stasis and stopping bleeding.Honeysuckle,Forsythia suspensa,cicada slough and other drugs were interrelated.Potential drug pair combinations and drug networks showed the basic drug composition of Qingying Decoction.According to the entropy cluster analysis,28 core drug combination and 12 new formulations were obtained.Conclusion:The regularity of syndrome differentiation and treatment of traditional Chinese medicine for Henoch-Schonlein purpura based on the famous and old TCM doctors was complex.Further researches are still needed.

Summary of Experience in Treating Hyperthyroidism with TCM Syndrome Differentiation

Syndrome differentiation is the characteristic and soul of Traditional Chinese Medicine (TCM), which has certain advantages in the treatment of hyperthyroidism. TCM mainly divides its syndrome differentiation into four types: exuberant liver fire type, yin deficiency and fire exuberant type, qi-yin deficiency type and phlegm stagnation type. This paper summarizes the treatment of hyperthyroidism by TCM syndrome differentiation, in order to provide some reference for the treatment of this disease.

Treatment of Oral Ulcer based on TCM Syndrome Differentiation

Oral ulcer is a kind of ulcerative injury that occurs in the oral mucosa and is very common in clinic.In severe case,it can affect the quality of life of the patients.Western medicine treatment of oral ulcer is often prone to relapse,while the effect of traditional Chinese medicine treatment is remarkable.

Progress of traditional Chinese Medicine on ADHD Treatment Based on Syndrome Differentiation

Attention-Deficit Hyperactivity Disorder(ADHD)is a common neurodevelopmental disorder in childhood.Syndrome differentiation for ADHD in traditional Chinese medicine is complex without common uniform,it is important to propose unified standards.Based on the principle of syndrome differentiation,this article focused on the different names of different syndrome differentiation methods but the same essence,and summarized Chinese medicine compounds according to syndrome factors.By collecting relevant literature on ADHD treatment with Chinese herbal compound in recent years,ADHD is classified into 7 different syndrome types,and Chinese herbal compound is classified correspondingly for reference and selection of clinical treatment of ADHD.

Summary on Professor QIAO Bao-zhang's Experience in Syndrome Differentiation and Treatment for Pancreatic Cancer

Objective:To summarize clinical experience of Professor QIAO Bao-zhang in treatment for pancreatic cancer,and to provide reference for clinicians.Methods:Through learning from Professor QIAO during his clinical practice and listening to his lectures,Professor QIAO Bao-zhang's clinically proved cases of treating pancreatic cancer based on syndrome differentiation were organized and summarized.From aspects like etiology,pathogenesis,treatment principles and treatment methods of pancreatic cancer,Professor QIAO's experience in diagnosis and treatment for this disease was analyzed and explored,and characteristics of medication were summarized.Two typical cases were selected as proof,and his treatment ideas and methods were explored.Results:Professor QIAO believes that the pathogenesis is mostly deficiency of vital Qi(正气),and stagnation of phlegm,heat and dampness in Zang-Fu(脏腑)and meridians.Around intermingled deficiency and excess,syndrome differentiation and treatment were performed.Due to treatment methods such as strengthening vital Qi to eliminate pathogenic factor,clearing heat,eliminating dampness and resolving phlegm,as well as removing toxicity and resolving hard mass,progress of malignant tumors was inhibited and recurrence and metastasis of malignant tumors were delayed.Conclusion:Professor QIAO's experience in treating pancreatic cancer is worth learning.

Study on the Correlation between Syndrome Differentiation of Malignant Pleural Effusion Treated by External Treatment of Traditional Chinese Medicine and Immunohistochemistry of Biopsy Tissue Based on Medical Video-assisted Thoracoscope

Objective:Guided by the theory of syndrome differentiation of yin and yang in traditional Chinese medicine surgery,through visual observation of internal medicine thoracoscope,comprehensive observation of pleural cavity and immunohistochemistry of biopsy tissue,to classify malignant pleural effusion according to syndrome differentiation,and to explore the scientific nature of its theory.Methods:From March 1,2014 to February 28,2015,40 cases of malignant pleural effusion were treated in Beijing Chaoyang Hospital affiliated to Capital Medical University.According to the proposed TCM diagnostic criteria for yin and yang syndrome differentiation,and collect age,gender,course of disease,clinical symptoms,tumor primary focus,histomorphological manifestations and immunohistochemical results and other related information,and carry out statistical data processing.Results:The positive syndrome was mainly metastatic lung adenocarcinoma,which accounted for the majority of all MPE cases,up to 75%.The immunohistochemical results of biopsy tissues were mainly CEA and TTF-1 positive;While pleural effusion caused by pleural mesothelioma was the main type of yin syndrome,and the results of immunohistochemistry combined with biopsy were mainly positive for D2-40,Calretinin,WT-1 and CK5/6.Conclusion:TCM syndrome differentiation of MPE based on internal thoracoscopy combined with biopsy immunohistochemical results has sufficient theoretical basis and certain scientific nature,and further clinical research is needed to verify its effectiveness and practicability in the future.

Chief Physician Wang Defen’s Experience in Treating Thyroid Nodules based on Syndrome Differentiation

To summarize the experience of Chief Physician Wang Defen in the treatment of thyroid nodules.According to many years of clinical experience,Chief Physician Wang Defen believes that the occurrence of thyroid nodules is mostly affected by emotional factors.Qi stagnation,liver depression and fire,phlegm and Qi are the pathogenesis of the disease,which is closely related to liver Qi stagnation.Based on the basic treatment principle of Nourishing Yin,clearing heat,soothing liver and strengthening spleen,the prescription chose Danzhi Xiaoyao Powder plus or minus can often achieve good clinical efficacy.

Analysis on the Law of Chinese Medicine Use of Ulcerative Colitis and TCM Syndrome Differentiation and Treatment

Ulcerative colitis is a kind of inflammatory bowel disease.The disease is slow and easy to relapse.Western medicine treatment mainly focuses on symptomatic treatment,which has certain side effects on liver and kidney function.Ulcerative colitis has unique advantages in disease,so by studying a large amount of information,mainly from the law of traditional Chinese medicine use of UC,and a brief summary of the treatment of TCM syndromes,this article provide s ideas and basis for clinical diagnosis and treatment of the disease.

Progress of TCM Syndrome Differentiation and Treatment of Hypertension with Sleep Disorders

It has been discovered that the number of hypertensive patients with various types of sleep disorders is on the rise,which significantly increases the morbidity and mortality of cardiovascular diseases.Modern medicine has not reached a consensus on the mechanism and treatment of these diseases but relies on drugs to improve sleep disorders and blood pressure.We regard TCM syndrome differentiation as the breakthrough point,along with comprehensive modern and traditional medical methods based on dialectical thinking as means of holistic and symptomatic treatment of Western medicine integrated with the eight principles of TCM diagnosis,Zang-Fu organs,six meridians,Qi,blood and fluid,as well as other dialectical methods,in order to provide a broader idea for TCM treatment and lay a foundation for further and better development of integrated TCM and Western medicine treatment.

Clinical Study of Western Medicine Combined with Chinese Medicine Based on Syndrome Differentiation in the Patients with Polarized Hypertension

Objective： To investigate the effects and safety of Western medicine combined with Chinese medicine （CM） based on syndrome differentiation in the treatment of elderly polarized hypertension （PHPT）, or isolated systolic hypertension with low diastolic blood pressure （DBP）. Methods： A total of 125 elderly patients with PHPT were randomly assigned to two groups： 59 in the control group treated by Western medicine and 66 in the intervention group treated by Western medicine combined with CM treatment. Based on syndrome differentiation, the patients in the intervention group were further divided into subgroups of yang-qi deficiency and yin-qi deficiency. All subjects were treated with Western medicine of Amlodipine Besylate Tablets and Irbesartan Tablets （or Irbesartan and Hydrochlorothiazide Tablets）, to decrease their systolic blood pressure （SBP） slowly to 125-135 mm Hg in 2-6 weeks. In the intervention group, Shiyiwei Shenqi Capsule （十一味参芪） was given additionally to the subgroup of yang-qi deficiency at the dosage of 3-5 capsules, thrice a day, while Dengzhan Shengmai Capsule （灯盏生脉胶囊） was given additionally to the subgroup of yin-qi deficiency at the dosage of 2 capsules, 2-3 times per day. For all subjects, SBP, pulse pressure （PP）, and DBP were measured before treatment and at the terminal of a 6-week treatment. For subjects in the intervention group, left ventricular ejection fraction （LVEF） was also recorded. Results： After a 6-week treatment, the SBP in the two groups and the PP in the intervention group decreased significantly compared to those before treatment （P〈0.05）, while the PP in the control group showed no significant difference between prior and post-treatment （P〉0.05）. After treatment, the DBP in the control group decreased （P〉0.05）, while the DBP and LVEF in the intervention group showed an increase tendency although it had no statistical significance （P〉0.05）. When subjects in the intervention group were classified further by the course of disease, the DBP and LVEF of subjects whose course of disease were less than 2 years, increased significantly after treatment （P〈0.05）. Conclusion： Western medicine combined with CM treatment based on syndrome differentiation was safer and more effective than Western medicine alone in the treatment of elderly PHPT, because it not only reduced SBP but also improved DBP, which might lower the incidence of the cardiovascular and cerebrovascular events.

A Systematic Review and Meta-Analysis of Type 2 Diabetes Mellitus Treatment Based on the "Three-Typed Syndrome Differentiation" Theory in Chinese Medicine

Objective： To evaluate the efficacy and safety of ＂Three-Typed Syndrome Differentiation＂ （I-TSD） in treating type 2 diabetes mellitus patients. Methods： A systematic review and meta-analysis was done based on the clinical diabetes treatment literature of the ＂I-I＇SD＂. Overseas databases like the PubMed/MEDLINE, EMBASE, Cochrane Library and Cochrane Central Register of Controlled Clinical Trials, and China databases like China Biology Medicine Disc （CBM）, Chinese national Knowledge Infrastructure （CNKI）, Wanfang database, and VIP database, without limitation on language, were included with the time limitation from Jan 1982 to Dec 2012 by retrieval of relative original clinical research articles. Results： Nineteen articles where contains 1,840 diabetes patients were obtained, in which no adverse reactions were reported. Of these, 14 literatures involved the effect of fasting blood glucose （FBG）, 10 involved that of postprandial 2-h blood glucose （P2hBG）, and 19 involved the overall efficacy based on the national Chinese medicine （CM） diagnosis and treatment standard of diabetes. All the meta-analysis results prefer to the ＂TTSD＂ groups （CM＋Westem medicine Based on I-I＇SD）. The results show that, beside the efficacy of Westem medicine, the concentrations of FBG and P2hBG in ＂TTSD＂ groups continue to drop with statistical significance. For ＂TTSD＂ groups, the FBG subsequently dropped 1.03 mmol/L, 95%CI [1.24,0.82] （P〈0.00001）, the P2hBG subsequently dropped 1.09 mmol/L, 95% CI [1.61, 0.57] （P〈0.0001）, and the overall efficacies benefit 3.46 times those of Western medicine alone, 95% CI [2.67,4.48] （P〈0.00001）. Conclusions： The CM by the diagnosis and treatment of type 2 diabetes based on ＂TTSD might be safe and effective, and could better improve both blood glucose and the overall status of patients, including symptoms.

Effect of Treatment Based on Syndrome Differentiation by Chinese Medicine on Post-traumatic Elbow Arthritis

Objective：To compare the clinical efficacy of treatment based on syndrome differentiation of Chinese medicine and modern conservative therapeutic program on post-traumatic elbow arthritis（PTEA） in order to provide the guidance in clinical practice.Methods：Seventy-six patients with PTEA requesting the conservative therapy were equally assigned to two groups randomly.The 38 patients in the treated group were administered with Chinese herbal medicines according to their syndrome typing for oral intake and external washing; while the other 38 patients in the control group were treated orally with glucosamine hydrochloride and Celecoxib,combined with intra-articular injection of sodium hyaluronate and peri-articular pain spot blocking with Triamcinolone Acetonaide Acetate injection.All were followed-up for six months with the therapeutic efficacy assessed by Japanese Orthopaedic Association（JOA）and the Hospital for Special Surgery（HSS）Scale scoring.Results：All the 76 patients completed the trial.The JOA and HSS scores in the two groups were not significantly different before treatment（P〉0.05）,but they did show significant difference after treatment in terms of total score,joint pain,range of motion,and daily activity（P〈0.05）.However,there was no difference between the two groups in the improvement of joint stability and deformity（P〉0.05）.Conclusion：Both the Chinese drug therapy according to syndrome differentiation and modern conservative therapy are effective in treating PTEA, but the former shows more superiority,and so it is worthy of clinical spreading.

A Systematic Analysis of the Theory and Practice of Syndrome Differentiation

Syndrome differentiation is a methodology unique to Chinese medicine. It threads the diagnosis process with clinical treatment into a holistic web of links to determine and regulate the patterns of dysfunctions in the human body. It is seen as the essence of Chinese medicine because it takes into account the theoretical principles, diagnostic methodologies and the modality of treatment holistically. In this process the progressive development and changes of syndromes are also considered by the physician. This paper is a systematic study of the methodology of syndrome differentiation in relation to its clinical applications in the treatment of diseases. To illustrate the efficacy of syndrome differentiation, the relationship between pattern identification and diseases is analysed to provide a guiding principle for integration between Chinese medicine and Western medicine. nclude cancer, cardiovascular and metabolic syndromes. A study of renal and hepatic Diseases being selected include cancer, cardiovascular and metabolic syndromes. A study of renal and hepatic diseases related to lifestyle is also included to highlight the clinical efficacy of syndrome differentiation. The paper also includes an analytical summary of the theoretical advancements made in integrative differentiation methodology during the past five decades which links to the recent clinical thinking and practice.