Study on the rules of TCM syndromes and Chinese herbal medicines about IgAN based on data mining

Objective:To analyze the clinical research literatures of TCM syndromes and treatment of Immunoglobulin A Nephropathy(IgAN)on data-mining technology,and explore the rules of TCM syndromes and Chinese medication.Methods:By searching the clinical literatures about TCM syndromes and treatment of IgAN had published in China Biomedical Literature Database,CNKI Database,Wanfang Database,and Chongqing Weipu Database from January 2000 to September 2019.Strictly according to the inclusion and exclusion criteria,included documents and established the databases.Applicated of statistical software for frequency analysis of TCM syndromes,Chinese herbal medicines,and analyzed the commonly used Chinese herbal medicines by factor analysis and cluster analysis.Results:292 literatures were finally included,involving 28 syndromes.A total of 479 prescriptions and 254 Chinese herbs were used.The rules of syndromes in IgA nephropathy are as follows:the syndromes are mainly composed of Qi and Yin deficiency syndrome,followed by the Spleen and kidney qi deficiency syndrome,Liver and Kidney Yin Deficiency Syndrome,Spleen and kidney yang deficiency syndrome.The blood-stasis syndrome,damp-heat syndrome and wind-heat disturbance syndrome are accompanied by other syndrome.The characteristics of traditional Chinese medicines for IgA nephropathy is mainly composed of tonic deficiency medicines,supplemented by blood-activating and stasis-eliminating medicines,heat-clearing medicines,inducing diuresis and excreting dampness medicines and astringent medicines to combine with formulas.Conclusion:Through Data-mining method systematically summarized the rules of TCM syndromes and Chinese medication in treating IgAN and provided scientific theoretical guidance for the treatment of IgAN.

The prescription rule analysis of the New Theory on Spleen Dampness Syndrome by Academician TONG Xiaolin

Objective To analyze the basic characteristics,drug features,prescription rules,and drug-symptom relationships of patients in the splenic deficiency and impairment stage,by data mining of medical records under the New Theory on Spleen Dampness Syndrome(Pi Dan Xin Lun,《脾瘅新论》).Methods Medical records listed in the“New Theory on Spleen Dampness Syndrome-Under-standing and Treatment of Metabolic Syndrome from the Perspective of Traditional Chinese Medicine”,and which were diagnosed with the spleen dampness syndrome at the splenic de-ficiency and impairment stage,during January 2004 and December 2016 were selected.These patients’data,including basic information,clinical symptoms,laboratory examination res-ults,traditional Chinese medicine(TCM)and western medicine diagnoses,treatment meth-ods,prescriptions,etc.,were collected.The collected data were subsequently compiled into a medical record database using the Epidata 3.1 data management software,followed by the use of Apriori algorithm provided in the SPSS Modeler 14.2 statistical software to investigate the association rules between drug-drug,drug-symptom,and drug-western medicine indices.Results(i)A total of 51 medical records were included,involving 17 types of syndromes.Among them,the top three with frequency≥3 included“Phlegm and blood stasis,and thoracic obstruction”“Deficiency-weakness of the spleen Qi,and static blood blocking collat-erals”,and“Deficiency-weakness of the spleen Qi,and static blood blocking collaterals”.Al-ternatively,of the 14 treatment methods,the top three treatments with frequency of≥3 in-cluded“Activating Yang and eliminating turbidity,and removing phlegm and dredging chan-nel blockage”“Strengthening the spleen and benefiting Qi,and eliminating phlegm to activ-ate the channels”,and“Warming Yang and benefiting Qi,and expelling cold to remove ob-structions”.Among the 15 prescriptions,the top three used with frequency≥3 included Huangqi Guizhi Wuwu Tang(黄芪桂枝五物汤),Gualou Xiebai Banxia Tang(瓜蒌薤白半夏汤),and Ganjiang Huangqin Huanglian Renshen Tang(干姜黄芩黄连人参汤).Lastly,of the 83 drugs used for a total of 476 times,those with frequency≥15 included Huanglian(Coptid-is Rhizoma),Huangqi(Astragali Radix),Jiudahuang(Wine-processed Rhei Radix et Rhizoma),Jixueteng(Spatholobi Caulis),Shengjiang(Zingiberis Rhizoma Recens),Huangqin(Scutellariae Radix),and Guizhi(Cinnamomi Ramulus).(ii)For the drug-drug associations,under the criteria of support≥15%and confidence=100%,seven second-order association rules,seven third-order rules,and six fourth-order roles were identified.The top-ranking rule of each was“Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”“Ganjiang(Zingiberis Rhizoma)+Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”,and“Baishao(Paeoniae Radix Alba)+Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatho-lobi Caulis)→Huangqin(Scutellariae Radix)”,respectively.Alternatively,the drug-symptom associations were analyzed under the criteria of support≥5%and confidence=100%,which derived eight second-order association rules,31 third-order rules,and 30 fourth-order rules.The top-ranking association rule of each order was“Huangqi(Astragali Radix)→Limb ed-ema”“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)→Limb numbness and pain”,and“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)+Huangqi(As-tragali Radix)→Limb numbness and pain”,respectively.Similarly,the drug-western medi-cine index associations were investigated under the criteria of support≥5%and confidence=100%,and five second-order association rules,16 third-order rules,and 16 fourth-order rules were identified.In this category,the top-ranking association rule of each order was“Qinpi(Fraxini Cortex)→Uric acid”“Huanglian(Coptidis Rhizoma)+Ganjiang(Zingiberis Rhizoma)→Glycated hemoglobin”,and“Huanglian(Coptidis Rhizoma)+Ganjiang(Zing-iberis Rhizoma)+Huangqin(Scutellariae Radix)→Glycated hemoglobin”,respectively.Conclusion Through association rule mining,this study objectively and quantitatively demonstrated the drug-drug,drug-symptom,and drug-physicochemical index associations of patients with the spleen dampness syndrome at the splenic deficiency and impairment stage treated by Academician TONG Xiaolin.The results indicated that treatment for these patients adopted the“state-target”syndrome differentiation method.The drug combination was characterized by“small prescriptions”,targeting both the patient’s symptoms and signs(syndrome target)and western medicine indices(treatment target).This study could provide references for future research on the academic thoughts and medical experience of Academi-cian TONG Xiaolin.

Rules of Ren Shunping's prescription for trearing Spleen Deficiency and Qi Stagnation Syndrome of Functional Dyspepsia Based on Data Mining

Objective:To explore the medication rules of Professor Ren Shunping treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,so as to provide reference for clinical prevention and development of new drugs.Methods:The 144 Chinese herbal formulas considered as active prescribed by professor Ren Shunping for the first time treating the patients with spleen deficiency and qi stagnation syndrome of functional dyspepsia were collected,entered into TCM inheritance auxiliary platform(V2.5),and then mined by some data mining methods of the software,such as the association rules and unsupervised entropy hierarchical clustering.Results:This study involved 144 Chinese herbal formulas,including a total of 56 Chinese herbal medicines.Of these Chinese herbal medicines,the herbs of cold and warm nature,and pungent,bitter and sweet in flavors were used in a quite high frequency,all of which act on spleen,stomach,lungs,large intestine,liver and gallbladder meridians.One core Chinese herbal formula was excavated,composed of patchouli,perilla stem,radix bupleuri,scutellaria,ginger pinellia,codonopsispilosula,magnolia bark,tangerine peel,large-headed atractylodes,immature bitter orange,wood incense,fructus amomi,inula britannica chinensis,ginger,medicated leaven,fried rice and fried malt based on the association rules.And a total of 17 groups of core used drugs and 2 groups of new Chinese herbal formulas undiscovered were mined based on unsupervised entropy hierarchical clustering.Conclusion:In treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,professor Ren is good at treating spleen deficiency and qi stagnation syndrome of functional dyspepsia from the perspective of"tong jiang",using the"five-in-one"strategy of strengthening the spleen,evacuating the liver,coming down qi from the stomach,dispersing lung,and bowel-reflexing to treat patients as a whole.And the herbal medicines were light in dose,lovely and mild in nature for the formulars.At the same time,he paid attention to the combination of syndromes and symptoms,and flexible arbitration.

Artificial Intelligence and Network Pharmacology Reveal the Medication Rules of Professor Wang Yu-Ying in the Treatment of Climacteric Syndrome

Objective: The objective of this study was to explore the medication rules and academic ideas of Professor Wang Yu-Ying in the treatment of climacteric syndrome(CLS) and to predict new prescriptions. Materials and Methods: The characteristics of frequency, clustering, four properties, and five flavors were analyzed, and new prescriptions were predicted through an artificial intelligence(AI)-based method. The potential pathways of new prescriptions were explored through network pharmacology-based analysis. Results: The top 16 medicinals used by Professor Wang Yu-Ying in the treatment of CLS included Danggui, Longgu, Muli, Fuling, Chuanxiong, Gancao, Xiangfu, and Tusizi. The AI method was applied to predict the basic prescription for treating CLS: Danggui 15 g, Duanlonggu 30 g, Duanmuli 30 g, Fuling 28 g, Chuanxiong 10 g, Gancao 6 g, Xiangfu 12 g, Tusizi 14 g, etc., Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses showed that the pathogenesis of CLS might be related to the estrogen pathway, involving typical steroid responses. Conclusions: This study summarized Professor Wang's medication experience in the treatment of CLS based on the data mining of clinical diagnoses and treatment cases. The AI method was used to predict the new prescription of CLS treatment, which was found to be reasonable by network pharmacology studies on its multi-target and multi-pathway mechanisms.

The mechanism of Astragalus membranaceus in treating peritoneal fibrosis by intervening the key syndrome and pathology based on Q-marker theory

Objective:To evaluate the mechanism of Astragalus membranaceus(AM)by intervening peritoneal mesothelial cells(PMCs),epithelial-mesenchymal transition(EMT),and spleen deficiency syndrome(SDS)in peritoneal fibrosis(PF),we base on employing the strategy of Q-marker theory combination network pharmacology method.Methods:First,we obtained the Q-markers of AM by searching the relevant literature and its pharmacological information was collected based on SwissADME.The SwissTargetPrediction and pharmmaper were employed to predict its potential target.Secondly,GeneCards,DisGeNET,and OMIM databases were employed to search the related targets of EMT,SDS,and PF.VENNY2.1 tool was employed to obtain the intersection targets of AM and the three;then the“AM potential target-SDS-EMT-PF”Venn diagram was constructed.The common targets of AM,EMT and SDS were uploaded to the STRING database and obtained the PPI protein interaction network map.Cytoscape 3.7.2 was employed to evaluate the core target of PPI network.PATHER and Metascape databases were used to analyze protein type,GO biological process,and KEGG pathway.Finally,a network diagram of the“TCM-component-disease target-pathway”was drawn.Results:A total of 10 AM Q-makers were screened out,corresponding to 335 targets of AM,2,728 targets of SDS,373 of EMT,and 612 PF targets were found.Among them,there are 155 common AM targets related to SDS and EMT.Key targets such as ALB,AKT1,VEGFA,TNF,EGFR,CASP3,SRC,STAT3,HSP90AA1,and ESR1 were obtained.The core drug include quercetin,astragalosideIII,Calycosin-7-O-beta-D-glucoside,astragalosideIV,etc.The types of PPI proteins include protein modification enzymes,metabolite transferases,transmembrane signal receptors,etc.Biological processes include the regulation of kinase activity,the positive regulation of transferase activity,and the regulation of kinase activity.The key pathways may include PI3K-Akt signaling pathways,the non-smad pathway of the TGF-βsignaling pathway,and the AGE-RAGE signaling pathway.Conclusion:AM could prevent and treat PF through a multi-component multi-target-multi-path mechanism.Astragalus saponins may be the main component types of AM intervening EMT pathology by strengthening the spleen and nourishing Qi.AstragalosideIV and astragalosideIII may be the constituents that can invigorate the spleen and replenish Qi.The results of this study contribute to a more comprehensive understanding of the critical components and mechanisms of AM by intervening SDS and EMT in the treatment of PF.

Coexistence of pneumothorax and chilaiditi sign:A case report

We present a case of 50 year old male patient with coexistence of Pneumothorax and Chilaiditi sign.Chilaiditi sign is an incidental radiographic finding of a usually asymptomatic condition in which a part of intestine is located between the liver and diaphragm;however,the term"Chilaiditi syndrome"is used for symptomatic hepatodiaphragmatic interposition.The patient had no symptoms of abdominal pain,constipation,diarrhea,or emesis.Incidentally,Chilaiditi sign was diagnosed on chest radiography.Pneumothorax is defined as air in the pleural space.Pneumothoraces are classified as spontaneous or traumatic.Spontaneous pneumothorax is labelled as primary when no underlying lung disease is present,or secondary,when it is associated with pre-existing lung disease.Our case is the rare in the literature indicating the coexistence of Chilaiditi sign and pneumothorax.

Prescription and treatment rules for the prescriptions containing Poria cocos and Atractylodes macrocephala couplet medicine based on traditional Chinese Medicine inheritance support platform

Objectives:To provide a theoretical basis for the development of the new products of Poria cocos-Atractylodes macrocephala couplet medicine.Methods:All prescription preparations containing Poria cocos and Atractylodes macrocephala were collected from the Drug Standards of the Ministry of Public Health Drug Standard·Traditional Chinese Medicine Set Prescription Preparation(called Traditional Chinese Medicine Set Prescription Preparation for short).After standardization,the information of each prescription preparation was input into the Chinese Traditional Medicine Inheritance Support Platform(V2.5),and the relevant rules of the software were adopted.Data mining methods were used to analyze the frequency of drugs,main symptoms and diseases in prescriptions,and to analyze the regularity of prescriptions.The prescription rules of top 2 high frequency attending syndromes and diseases were analyzed.Results:There were total of 337 prescription preparations containing couplet medicine of Poria cocos and Atractylodes macrocephala,107 kinds of main symptoms and 66 kinds of diseases.The high frequency syndromes were deficiency of Qi and blood and weakness of spleen and stomach,and the high frequency syndromes were anorexia and irregular menstruation.Conclusion:The couplet medicine of Poria cocos-atractylodes macrocephala prescription is mainly used to treat digestive tract diseases and gynecological diseases;it mostly takes tonifying deficiency efficat.It can treat different diseases being compatible with different medicinal materials.The study can provide theoretical basis for clinical application and new drug development of the couplet medicine of Poria cocos-atractylodes macrocephala.

CT and MR Imaging Findings in the Joubert Syndrome,a“Ciliopathy”

A 7-year-old boy presented with cerebellar ataxia with reduced tonicity, deficits of the fine and gross motor coordination skills and vestibular stimulus processing, as well as significantly delayed language development. MR imaging showed the so-called “molar tooth sign”, which was highly pathognomonic for the Joubert-Syndrome—an inherited cerebellar ataxia with a variety of clinical symptoms—and related entities. It is caused by a complex malformation of the cerebellar vermis and the midbrain. The cerebellar vermis is hypoplastic or completely absent;at the same time, the superior cerebellar peduncles are thickened. There is a lack of normal decussation of the fiber tracts in mesencephalon, which follow an abnormal horizontal course, as well as a lack of the decussation of the corticospinal fiber tracts in the caudal medulla oblongata and deformity of the 4th ventricle. Clinically, the triad of cerebellar ataxia, developmental retardation, and abnormal eye movements is indicating a related syndrome of this spectrum. The appearance of the involved children is characterized by dysmorphic facial features with epicanthus, broad nose bridge, low set ears and typically triangularly shaped and opened mouth. The diagnosis is usually made by imaging and clinical findings. Recently, advantages were made in genetic research on the Joubert syndrome and interesting findings published about diffusion tensor imaging and tractography. However, standard MR imaging, applying an adequate imaging protocol including sequences with excellent T1 contrast and 3D imaging with isotropic spatial resolution allowing reconstructions in all orientations, remains an essential tool for making this diagnosis.

Signs and syndromes in acute appendicitis:A pathophysiologic approach

Physical examination signs have not been well studied,and their accuracy and reliability in diagnosis remain unknown.The few studies available are limited in that the method of performing the sign was not stated,the technique used was not standardized,and the position of the appendix was not correlated with imaging or surgical findings.Some appendiceal signs were written in a non-English language and may not have been appropriately translated(e.g.,Blumberg-Shchetkin and Rovsing).In other cases,the sign described differs from the original report(e.g.,Rovsing,Blumberg-Shchetkin,and Cope sign,Murphy syndrome).Because of these studies limitations,gaps remain regarding the signs’utility in the bedside diagnosis of acute appendicitis.Based on the few studies available with these limitations in mind,the results suggest that a positive test is more likely to be found in acute appendicitis.However,a negative test does not exclude the diagnosis.Hence,these tests increase the likelihood of ruling in acute appendicitis when positive but are less helpful in ruling out disease when negative.Knowledge about the correct method of performing the sign may be a valuable adjunct to the surgeon in further increasing their pretest probability of disease.Furthermore,it may allow surgeons to study these signs further to better understand their role in clinical practice.In the interim,these signs should continue to be used as a tool to supplement the clinical diagnosis.

An Analysis of Medication Rules of Chinese Medicine for Restless Legs Syndrome Based on Data Mining

Objective: Based on data mining, to explore the medication rules of Chinese medicine for the treatment of restless legs syndrome(RLS). Methods: The CNKI, WANFANG, and VIP were taken as data sources, and "restless legs syndrome, RLS" as the key words, and "Chinese medicine, Chinese materia medica, traditional Chinese medicine(TCM), traditional Chinese and Western medicine" as sub key words, the data was extracted from the journals and literature related to the treatment of RLS by TCM from the establishment of the database to 2020, and data mining techniques(frequency analysis, cluster analysis, association rules) were used to analyze the core drugs and drug pair(group) rules. Results: A total of 87 prescriptions met the requirements of this study, involving 142 Chinese herbal medicines. The top 5 Chinese herbal medicines with a higher frequency of use were Radix Paeoniae Alba, Radix Glycyrrhizae, Radix Angelicae Sinensis, Fructus Chaenomelis and Radix Astragali seu Hedysari. The four Qi(气) of the medicine were mainly warm and neutral, the five flavors were mainly sweet, bitter, and pungent. The main channels of the meridian were mainly the liver meridian, spleen meridian and heart meridian. The medication categories were mainly tonifying deficiency herbs, blood activating and removing blood stasis herbs, and eliminating wind and dampness herbs. The association rule analysis yielded 24 Chinese medicine combinations with high support, and the hierarchical cluster analysis yielded a total of 5 clusters. Conclusion: TCM treatment of RLS is based on tonifying deficiency herbs, especially to replenish Qi and blood throughout the course of the disease, supplemented by herbs for promoting blood circulation and removing blood stasis, and herbs for eliminating wind and dampness, as well as combined with herbs for reliving superficies and herbs for calming the liver to stop the wind.

The Effectiveness of the Functional Magnetic Stimulation Therapy in Treating Sciatica Syndrome

Introduction: Degenerative or traumatic causes are most common in generating sciatica syndrome, which is normally treated with well-known physical therapy methods. A relatively new way of treating sciatica problems is so-called functional magnetic stimulation (FMS), whose principle is based on electromagnetic field inducing electrical field inside the body. Electrical field triggers action potential of nerve cells and that way stimulates peripheral motor nerve system. Aim: Aim of this study is to measure and estimate the effectiveness of implementing therapy with functional magnetic stimulation in regular physical treatment of sciatica syndrome. Materials and Methods: 28 male patients aged between 30 and 55 with back problem were recruited on an outpatient basis. FMS therapy was performed with TESLA Stym? device (Iskra Medical d.o.o., Slovenia) treating lumbosacral region equally on both sides of the spine. Physical examination was performed to evaluate tree parameters: the mobility of the lumbar spine in flexion and extension, together with the straight leg raise test (Lasegue sign). We estimated patients’ progress, comparing angle values of mobility from the first examination day with other examination days. Results: In FMS treated group of patients, lumbosacral flexion, extension and Lasegue test angle were significantly higher compared to day 0 on the first physical examination day (day 3) (p < 0.05). In control group such increase of a measured angle was not noticed until a second physical examination day (day 5) or a third physical examination day (day 8) (p < 0.05). Discussion: Results in this study showed that applying FMS therapy along with other standard physical therapy methods rapidly increased effectiveness of the treatment of sciatica syndrome (lat. ischialgia). It suggests that functional magnetic therapy could be suggested as a regular physical therapy method in treating this kind of pain syndromes.

Etiology and consequences of thrombosis in abdominal vessels

The thrombophilia which can be either congenital or acquired in adult life has major implications in the abdominal vessels. The resulting portal vein thrombosis, Budd-Chiari syndrome and mesenteric vein thrombosis have a variety of consequences ranging from acute abdomen to chronic hepatomegaly and even totally asymp- tomatic patient in whom the only finding is pancytopenia. The complications like esophageal varices, portal gastropathy, ascites, severe hypersplenism, liver failure requiring liver transplantation are well known. Interesting features of collateral venous circulation showing itself as pseudocholangiocarcinoma sign and its possible clinical reflection as cholestasis are also known from a long time. The management strategies for these complications of intraabdominal vessel thrombosis are not different from their counterpart which is cirrhotic portal hypertension, but the prognosis is unquestionably better in former cases. In this review we presented and discussed the abdominal venous thrombosis, etiology and the resulting clinical pictures. There are controversial issues both in nomenclature, and management including anticoagulation problems and follow up strategies. In light of the current knowledge, we discussed some controversial issues in literature and presented our experience and our proposals about this group of patients.

Champagne bottle neck sign in a patient with Moyamoya syndrome

The champagne bottle neck(CBN) sign refers to a reduction in the diameter of the proximal portion of the internal carotid artery that resembles a CBN, and is a characteristic feature of Moyamoya disease. A 43-yearold woman with an infarction of the posterior limb of the left internal capsule was diagnosed with Moyamoya syndrome associated with Graves' disease. The CBN sign was observed bilaterally. Cerebral revascularization surgery was performed, including left-sided superficial temporal artery to middle cerebral artery anastomosis. During four years of follow-up, she maintained a euthyroid state and did not have any further cerebral ischemic events. The CBN signs remained unchanged on both sides during this time. This is the first report of the CBN sign in a patient with Moyamoya syndrome associated with Graves' disease.

Cecal volvulus associated with mobile cecum in Cornelia de Lange syndrome: Report of a case

We report a case of cecal volvulus in an 11-year-old girl who had been diagnosed with Cornelia de Lange syndrome. She had undergone operative fundoplication several years earlier and was referred to our institute for treatment of intestinal obstruction. A severely dilated colon was detected on abdominal roentgenogram, and abdominal CT and colonic enema strongly suggested cecal volvulus. Emergency operation was performed and cecal volvulus with mobile cecum was ascertained;the volvulus was corrected and the mobile cecum was fixed to the peritoneum on the right side. Neurologically handicapped patients sometimes suffer from cecal volvulus, and patients with Cornelia de Lange syndrome are at especially high risk. Moreover, operative fundoplication promotes intestinal dilatation and it may be another risk factor for cecal volvulus.

Malignant acanthosis nigricans with Leser–Trélat sign and tripe palms:A case report

BACKGROUND Acanthosis nigricans(AN),Leser–Trélat sign,and tripe palm are all skin diseases.To date,reports of these appearing as a paraneoplastic syndrome in a gastric cancer patient are quite rare.CASE SUMMARY We report the case of a 61-year-old man with darkened skin color in the face and torso with no obvious inducement after 1 year of treatment for Riehl’s melanosis.He had 40 brown maculopapular eruptions on his face and the top of his head with obvious itching.Papillary wart-like hyperkeratosis with dark brown pigmentation was also observed on both sides of the areola.He had papillomalike lesions on the face,around the orbit,and on the neck.His bilateral palms had small,smooth,papillary projections with millet-like appearance.Histopathological examination of the skin showed that the patient was suffering from AN,tripe palms,and Leser–Trélat sign.Gastroscopy showed the patient’s cardia was affected,and pathological biopsy revealed that he had moderate-to-poorly differentiated adenocarcinoma.Computed tomography test results showed that his cardia wall had thickened.Based on these histological and skin characteristics,the patient was diagnosed with gastric cancer with AN,tripe palms,and Leser–Trélat sign.CONCLUSION Researchers should follow up on patients with malignant AN,Leser–Trélat sign,and tripe palms.

中医辨证治疗前庭性偏头痛的多中心前瞻性队列研究

目的:评价中医辨证治疗前庭性偏头痛的临床疗效,探讨中医辨证用药规律。方法:采用前瞻性队列研究方法,选取前庭性偏头痛患者197例,根据是否采用中医辨证治疗为暴露因素,分为中药组与西药组,分别为123例与74例。观察两组治疗第4、8、12周的眩晕复发率及相关结局指标。结果:治疗第4、8、12周,眩晕复发率中药组依次为14.9%、18.4%、29.7%,西药组依次为12.3%、32.8%、55.6%,其中第8、12周两组比较差异有统计学意义(P<0.05);治疗后第4周,眩晕残障量表评分(dizziness handicap inventory,DHI)、VAS评分改善情况西药组优于中药组,但差异无统计学意义(P>0.05),第8、12周DHI、VAS评分改善情况中药组均优于西药组(P<0.05);共收集门诊处方273首,涉及中药76味,使用频率前十位的中药依次为天麻、法半夏、柴胡、茯神、远志、茯苓、酸枣仁、煅龙骨、珍珠母、黄芩。结论:中医辨证治疗前庭性偏头痛在改善眩晕症状,控制眩晕复发方面优势明显,但起效速度方面不及西药治疗。临床用药以疏肝解郁、重镇安神为主,安神之法应贯穿治疗始终。

基于数据挖掘方法探讨脾胃名家李德新教授临床诊疗虚劳疾病规律

目的基于数据挖掘技术探讨李德新教授治疗虚劳疾病的用药规律。方法收集、整理李德新教授临床诊疗虚劳疾病的病例,运用频数、频率、聚类分析、关联分析等方法对病例中的证型诊断和处方用药进行统计分析和数据挖掘,归纳整理后对医案数据进行科学计算。结果共纳入治疗标准医案虚劳741例,挖掘出与疾病相对应的高频症状、高频证型、高频中药,并对中药进行聚类分析得到有效配伍,同时进行症状、证型与相关中药的关联分析。结论利用数据挖掘技术,可初步揭示李德新教授临床诊疗虚劳疾病的规律,从虚劳论治,培补虚劳对于疾病的治疗具有重要意义,有助于更好地传承李德新教授的学术思想,具有较高的临床参考和学习价值。

基于真实世界数据的青春期异常子宫出血用药规律研究

目的:通过对女童青春期异常子宫出血患儿临床实际诊疗病例资料进行数据挖掘分析其中药治疗的用药规律。方法:基于医院信息管理系统提取2020年1月至2022年12月首都医科大学附属北京儿童医院女童青春期异常子宫出血患儿的病历数据,分为止血期和调理期2个阶段,总结归纳其辨治规律。结果:纳入止血期663例患儿,1020例病历;调理期796例患儿,2047例病历。止血期涉及中药169味,排名前5位为侧柏炭、牡丹皮、小蓟、麸炒椿皮和白芍,性味以寒、苦药为最多,归经以肝经为最多,功效以止血、补虚类药物为最多;调理期涉及中药232味,排名前5位为当归、酒女贞子、炙淫羊藿、黄芪和生地黄,性味以温、甘药最多,归经以肝、肾经为最多,功效以补虚类为最多。聚类分析分别获得4类和5类核心药物组合。结论:真实世界临床数据显示肾阴亏虚、血热内扰为青春期异常子宫出血常见证型,治则先以止血为主,待崩漏缓解后,重在调补脾肾以复旧,组方注重止血、补虚、收涩和清热等药物的配伍应用。

中医药预防大肠息肉术后复发证型证素分布及用药规律研究

目的:探讨近二十年各医家预防大肠息肉术后复发证型证素分布及用药规律,为中医药预防大肠息肉术后复发提供新的思路。方法:以各医家处方为切入点,提取处方涉及的证候类型、病位证素、病性证素及药物组成,基于中医传承辅助平台(V2.5)软件,运用关联规则、系统熵聚类等一系列高级的数据挖掘方法,总结处方的证型证素分布、用药频次、性味、归经、药物相关性以及聚类情况。结果:共收集到数据库相关文献所载预防大肠息肉复发的处方105首,涉及中医证型30种,中药186味。其中核心药物组合139对,潜在常用药对157对,新处方3首。结论:脾胃虚弱是大肠息肉的核心病机,治疗当以健脾益胃为基础,根据不同患者血瘀、湿阻、痰凝、热毒等的差异,佐以活血、祛湿、化痰、清热之法,标本兼治,方获良效。

基于隐结构模型结合关联规则研究冠心病稳定型心绞痛中医证候特征

目的探讨冠心病稳定型心绞痛中医证候的分布及特征,为今后冠心病稳定型心绞痛的辨证论治提供客观可靠的依据。方法计算机检索中国期刊全文数据库(CNKI)、万方(WanFang)、维普(VIP)等数据库内自建库以来至2022年1月的名老中医治疗冠心病稳定型心绞痛的医案及临床经验,采用孔明灯Lantern5.0软件,应用爬山法(LTM-EAST)算法建立症状隐结构模型并进行综合聚类分析;采用SPSS Modeler 15.1软件,用Apriori算法,对中医证素进行关联规则分析并绘制复杂网络图。结果①纳入的206例医案共涉及24个中医证候,其中频次较高(>5%)的分别为心血瘀阻证、痰瘀互结证、气滞血瘀证、痰湿阻滞证、气虚血瘀证、心阳虚证、气阴两虚证。②将共计121个症状作为显变量,应用LTM-EAST算法构建结构模型,得出30个隐变量,对得出的30个隐变量进行综合聚类,共得出9个综合聚类模型即9个中医证候,分别为气滞血瘀证、心血瘀阻证、气虚血瘀证、心阳虚证、气阴两虚证、痰瘀互结证、痰湿内阻证、痰热内闭证、心肾阳虚证。③对24个中医证候提取的17个证素进行关联规则分析,推导出7个中医证候,分别为心血瘀阻证、心阳虚衰证、痰瘀互结证、气阴两虚证、阳虚血瘀证、气虚血瘀证、气滞血瘀证。结论综合归纳,最终得出6个中医常见证候,分别为:气滞血瘀证、心血瘀阻证、气虚血瘀证、心阳虚证、气阴两虚证、痰瘀互结证。