Research On The TCM Five-viscera Correlation Theory Of Myasthenia Gravis Based On Data Mining

The TCM five-viscera correlation theory is proposed by famous professor Deng Tietao. He thinks the heart, liver, spleen, lungs, kidneys and correlative six hollow organs, four limbs, skin, tendon, blood vessel, muscles, five-sense organs and seven orifices make up human body's five-viscera system. In physiology conditions, horizontal, vertical, and crossed multidimensional relations exist in zang-fu interior, between zang-fu system and zang-fu system, between zang-fu system and nature, society, which promote and inhibit reciprocally, exert different functions, and harmonize organismic normal activities. In pathology conditions, the five-viscera system influences reciprocally. The theory combines the five elements theory with the zang-fu theory, explains human physiology and correlative pathology, and guides clinic diagnosis and treatment.Myasthenia gravis is a clinical difficult disease, with features of repeated pathogenetic condition, long course of treatment, difficult treatment and poor prognosis. Chinese medicine therapeutic effect of myasthenia gravis is significant. However, TCM differentiation of symptoms knowledge is ambiguity and inconsistency, and lack of large sample clinical investigation as well as objective and rigorous analysis of data which greatly affects the evaluation of the Chinese medicine diagnosis and treatment of myasthenia gravis. Data mining is good at discovering hidden and meaning knowledge from the mass data. So data mining can be applied for study on TCM syndromes.1. Objective:Study the TCM five-viscera correlation theory of myasthenia gravis based on data mining, and conclude TCM Zang-fu pathogenesis and progress model of myasthenia gravis viscera.2. Methods:(1)Collected 447 cases of patients according to diagnosis and classification standards of myasthenia gravis(2)Designed five-viscera correlation clinical information collection questionnaire of myasthenia gravis, collected clinical information on patients with myasthenia gravis, filled out the questionnaire form.(3)Inputed information and established a database of myasthenia gravis disease.(4)Data preprocessing, including data standardization, quantification and data cleaning, preparation for data mining.(5)Frequency statistical analysis of sex, age, clinical symptoms, complications, five internal organs diseases, frequently used traditional Chinese medicine, herbals meridian distribution on myasthenia gravis by using SPSS statistical software.(6) Approached TCM Zang-fu pathogenesis of myasthenia gravis and the relevance of different types myasthenia gravis and TCM Zang-fu pathogenesis by using KNEX, SQL Server data mining software and robust regression, Naive Bayes.3. Results:(1) Frequency statistical analysis1)Myasthenia gravis incidence of women is higher than men, aged 21-40 years is morbility peak.2)Myasthenia gravis is often complicating with thymic abnormalities, and thyroid disease, rheumatoid arthritis, systemic lupus erythematosus, polymyositis and other autoimmune diseases.3)Common clinical symptoms of myasthenia gravis include:ptosis, general fatigue, eyelid fatigue, lassitude, weakness of chewing swallowing, by deficiency syndromes. The characteristic of symptoms is weak.4)About five viscera lesions, the most common four viscera simultaneously is involved, followed by three viscera simultaneously involved, the two viscera simultaneously involved, the five viscera simultaneously involved, the spleen alone involved. Cumulative frequency statistics for the five organs of myasthenia gravis indicate the spleen is involved all along, followed by kidney, liver, lung, heart.5)Ⅰtype damages spleen, liver mainly,Ⅱ-A type damages spleen, liver, kidney mainly,Ⅱ-B type damages spleen, kidney, liver mainly,Ⅲtype damages spleen, kidney, lung, liver mainly,Ⅳtype damages spleen, kidney, lung, heart mainly.6)Frequently traditional Chinese medicine include herbals of invigorating vital energy and spleen such as astragalus, licorice, Wu Zhao Long, Atractylodes, Cimicifuga, Bupleurum, tangerine peel, Chinese angelica, Codonopsis, and herbals of invigorating kidney and warming yang such as cornus, Eucommia, Morinda officinalis, Cistanche, Polygonummultiflorum, etc. The results indicate that morbility of myasthenia gravis is most closely with spleen and kidney.7)Meridian distribution of herbals show up the percentage of the spleen system is maximum, accounting for 73.7%, followed by the liver system, kidney system, lung system, heart system.(2) Data mining1)Results of KNEX software by using robust regression algorithms:①Weakness of chewing swallowing is the most important symptom of myasthenia gravis symptoms, followed by general fatigue, salivation, respiratory weakness, unclear articulation, ptosis, cough, fatigue, bucking when drinking water, loose stools, blurred vision, neck weakness, limbs weary and weight, apthy, rugitus, chest distress. It indicates that weakness of chewing swallowing may serve as an indication of disease severity.②In addition to the spleen, the importance analysis of other viscera on myasthenia gravis shows the kidney is the most important, followed by lung, heart. The liver don't appear in the results of data mining system. The results indicates that morbility of myasthenia gravis is most closely with spleen, kidney and lung.2)Results of SQL Server software by using Naive Bayes algorithms about important influencing factor of various clinical type of myasthenia gravis:①Ⅰtype primary factors:age<19 years old, not appearing general fatigue; secondary factors:not appearing weakness of chewing and swallowing, lassitude.②Ⅱ-A type primary factors:not appearing weakness of chewing and swallowing; secondary factors:not appearing salivation, respiratory weakness, unclear articulation.③Ⅱ-B type primary factors:appearing general fatigue; secondary factors: appearing weakness of chewing and swallowing, unclear articulation.④Ⅲtype primary factors:appearing respiratory weakness; secondary factors: appearing weakness of chewing and swallowing, dyspnea with rapid and short breath, low speech, weak knee, complicating with pulmonary infection.⑤Ⅳtype primary factors:complicating with myasthenic crisis, appearing respiratory weakness; secondary factors:appearing weakness of chewing and swallowing, stethocatharsis, salivation, unclear articulation, complicating with thymoma①In addition to spleen, involved other viscera about various clinical types of myasthenia gravis as follows:Ⅰtype primary factors:not involving renal; secondary factors:not involving lung and heart.Ⅱ-A type primary factors:not involving lung; secondary factors:not involving renal.Ⅱ-B type primary factors:involving renal; secondary factors:involving lung and heart.Ⅲtype primary factors:involving lung; secondary factors:involving heart and lung.Ⅳtype primary factors:involving lung; secondary factors:involving heart and lung.3. Conclusion:(1) Myasthenia gravis is involved with spleen mainly, related with kidney, lungs closely, and also related with heart and liver secondly. This is consistent with pathogenesis "spleen deficiency and five-viscera correlation" which is summed up by Professor Deng Tietao.(2)Weakness of chewing swallowing, general fatigue, respiratory weakness, unclear articulation are key symptoms to identify the clinical type of myasthenia gravis. Weakness of chewing swallowing is the most important symptom for determining disease severity, comparing with other symptoms. It is not onlyⅡ-A type andⅡ-B type differentiation point but also the clinical indication of using corticosteroids such as prednisone.(3)Ⅰtype damages spleen, liver mainly;Ⅱ-A type damages spleen, kidney mainly and liver;Ⅱ-B type damages spleen, kidney, lung mainly,Ⅲtype damages spleen, kidney, lung mainly and heart;Ⅳtype damages spleen, kidney, lung mainly and heart. (4) During the period of myasthenia gravis, spleen is diseased all along. With aggravation of pathogenetic condition, two viscera diseased simultaneously happen, then three viscera diseased simultaneously, four viscera diseased simultaneously, five viscera diseased simultaneously. Five-viscera correlation Pathogenesis mode of myasthenia gravis include: spleen and liver diseased simultaneously, spleen and kidney diseased simultaneously, liver and spleen and kidney diseased simultaneously, spleen and kidney and lung diseased simultaneously, spleen and kidney and lung and heart diseased simultaneously, five viscera diseased simultaneously.(5) "Spleen deficiency and five-viscera correlation " theory of professor Deng Tietao is not only significant in guiding diagnosis and treatment of myasthenia gravis, but also in other critical illness diagnosis and treatment of difficult diseases.(6)This study proves the correctness of professor Deng Tietao's theory, by starting from objective clinical information, the introduction of data mining technology, concluding the TCM Zang-Fu pathogenesis of myasthenia gravis. It also indicates that data mining technology is effective in studying TCM five-viscera correlation theory.