Research On The Academic Thinkings And Inheritance Of Experience Of Professor Li Saimei In Diagnosing And Treating Type2Diabetes Mellitus

Object i veTo be directed against the lack of standardization of Chinese medicine diagnosing and treating diabetes mellitus, high randomness in prescription of herbs and treatment effectiveness depending on experiences of expert, in addition to the lack of integrity and scientific in inheritance and usage of academic experience of famous Chinese medicine practitioners leading to a situation that those experiences can hardly be used in service of the public, this paper proposed a new method for data discovery based on non-statistical partial-order structure model of formal concept analysis, graph theory and partial-order theory, in order to achieve thorough knowledge discovery of Professor Li Saimei’s clinical experience in treating Type2diabetes mellitus, and to transform into inheritable and usable scientific knowledge. It summarized in full and inherited the academic thought of Professor Li, providing a new thinking for inheriting and preserving the experience of famous Chinese medicine practitioners.Methods:1Collection and entry of clinical data:With reference to the issue "Research on the knowledge discovery method for famous Chinese medicine practitioners diagnosing and treating diabetes mellitus based on information fusion of medical records and machine learning" of2012National Natural Science Foundation of China, a clinical diagnosis and treatment survey was formulated.991medical records of type2diabetes mellitus which met the inclusion and exclusion criteria were collected in Professor Li Saimei’s clinic from January to December2013. Clinical data were entered into a software namely "Expert system for famous Chinese medicine practitioner Professor Li Saimei diagnosing and treating diabetes mellitus with integrated medicine", so as to achieve their standardized stockpiling. The focus here was to maintain the original appearance of the treatment process of Professor Li and to emphasize the characteristics in treatment.2Establishment and optimization of formal background:In the theory of formal concept analysis, construction of formal background between objects and attributes is the fundamental way of describing things. According to the differences of research content, this paper considered medical records as object, whereas syndromes, symptoms, main formula, herbal composition as attributes, establishing four formal background. Based on a matrix description, with the greatest coverage of attributes as principle, stratified optimization of formal background was performed.3Generation of attributes partial-order structure diagram and proposition of knowledge discovery method of non-statistical partial-order structure model:Based on the theory of formal concept analysis, partial-order theory and graph theory, attributes partial-order structure diagrams were generated, which in turns, help put forward a discovery method of non-statistical partial-order structure.4Research on clinical experience:On the basis of knowledge discovery method, appropriate knowledges were extracted and congregated in order in this visualized data structure diagram for investigating Professor Li*s regular pattern in treating type2diabetes mellitus from a multi-angle, multi-level aspect.Results:1Characteristics of syndromes:Syndromes involve six meridians, with concurrent sickness in two meridians or three meridians in common. Liver, spleen and kidneys are the main location of disease. Pharynx and the exterior are emphasized for Taiyang syndrome; spleen for Yangming syndrome and Taiyin syndrome; liver for Shaoyang syndrome and Jueyin syndrome; and kidney for Shaoyin syndrome. In consideration of the nature of disease, yang asthenia, blood stasis and damp-heat are the main features. Specifically, pathogenic heat and wind are emphasized for Taiyang syndrome; damp-heat, phlegm-heat and blood stasis for Yangming syndrome; qi stagnation, damp-heat and blood stasis for Shaoyang syndrome; yang asthenia and food retention for Taiyin syndrome; yang asthenia and yin asthenia for Shaoyin syndrome; qi stagnation for Jueyin syndrome.2Characteristic of symptoms:For Shaoyang syndrome, the features of symptoms and signs are dizziness, dry throat, dry mouth, bitter taste in the mouth, dull pain in the hypochondrium, vexation, sore arm, shoulder pain and wiry pulse. When it accompanied by yang asthenia, the symptoms are:chills, aching in the loins, loose stool, preference for hot water, pale tongue and deep pulse. Symptoms for damp-heat, are sweating, heat intolerance, yellow urine, sticky stool, dry stool, yellow sputum, yellow and greasy fur on the tongue, slippery pulse and rapid pulse; Symptoms for blood stasis are numbness in the four limbs, menstruation with blood clots, dark red menses, dark red tongue and light dark tongue. Analysis of the characteristics of symptoms and signs for six common syndromes:Corresponding major symptoms and signs①for Shaoyang, kidney yang asthenia, Taiyang, blood stasis syndrome are dry mouth, bitter taste in the mouth, wiry pulse, numbness in the four limbs, severe neck pain and tiredness;②for Shaoyang, kidney yang asthenia, damp-heat emcumbering the spleen syndrome are dry mouth, bitter taste in the mouth, wiry pulse, tiredness, yellow and greasy fur on the tongue, thready pulse, pale red tongue and pale tongue;③for Shaoyang, kidney yang asthenia, Taiyin syndrome are dry mouth, bitter taste in the mouth, wiry pulse, loose stool, pale red tongue and thready pulse;④for Shaoyang, kidney yang asthenia, blood stasis syndrome are dry mouth, bitter taste in the mouth, wiry pulse, numbness in the four limbs, yellow urine, poor sleep, dark red tongue, thready pulse and slippery pulse;⑤for Shaoyang, kidney yang asthenia, phlegm-heat emcumbering the spleen syndrome are dry mouth, bitter taste in the mouth, wiry pulse, yellow urine, dry stool, red tongue, dark red tongue, yellow and greasy fur on the tongue and thready pulse;⑥for Shaoyang, kidney yang asthenia, Yangming syndrome are dry mouth, bitter taste in the mouth, wiry pulse, dry stool, yellow and greasy fur on the tongue and preference for hot water.3Characteristics of the main formula:Xiao Chaihu decoction and its analogues are regarded as the main formulae for Shaoyang syndrome. Analysis of the regular pattern of main formula for six common syndromes:Corresponding main formula①for Shaoyang, kidney yang asthenia, Taiyang, blood stasis syndrome is Chaihu guizhi decoction, combined with Guizhi plus gegeng decoction and/or Danggui shaoyao powder;②or Shaoyang, kidney yang asthenia, damp-heat emcumbering the spleen syndrome is Xiao chaihu decoction, combined with Gegeng qin liang decoction and/or Mahuang fuzi xixin decoction;③for Shaoyang, kidney yang asthenia, Taiyin syndrome is Chaihu guizhi ganjiang decoction, combined with Fuzi li zhong decoction and/or Chai shao liu jun decoction;④for Shaoyang, kidney yang asthenia, blood stasis syndrome is Xiao chaihu decoction, combined with Si ni powder, Ping wei powder and/or Si wu decoction;⑤for Shaoyang, kidney yang asthenia, phlegm-heat emcumbering the spleen syndrome is Xiao chaihu decoction, combined with Wen dan decoction and/or Da chaihu decoction;⑥for Shaoyang, kidney yang asthenia, Yangming syndrome is Xiao chaihu decoction, combined with Da chaihu decoction and/or Shaoyao gancao decoction.4Regular pattern in herbal prescription:For Shaoyang syndrome, the common addition and reduction of herbs in Xiao chaihu decoction are as follows:①Add Danggui and Chuanxiong for dark red tongue, numbness in the limbs, etc;②Add Guizhi, Baishao and Gegeng for shoulder pain, sever neck pain, etc;③Add Lianqiao, Xuanshen and Zhebei for coughing, sputum in the pharynx, etc;④Add Yinyanghuo and Sharen for tiredness, deep pulse, etc;⑤Add Cangzhu and Huanglian for red tongue, yellow and greasy fur on the tongue. Analysis of the corresponding dosage-effect relationship for Chaihu10g, Chaihu15-20g and Huanglian10g, Huanglian15-20g:①The common dosage of Xiao chaihu decoction is Chaihu lOg, Shengjiang10g, Shudangshen30g, Huangqin lOg, Fabanxia10g, Zhigancao6-10g and Heizao10g.②When Shaoyang bladder heat is severely stagnated, it is prescribed as Chaihu15-20g, Shengjiang10g, Fabanxia lOg, Shudangshen30g, Zhigancao6-10g, Heizao10g and Huangqin15-20g。③The common dosage of Huanglian is10-15g, always combined with Cangzhu30g.④When there is a severe damp-heat encumbering, the dosage of Huanglian becomes20-30g with Cangzhu in30g. It is found that several common pairs of herb are:①Cangzhu30g and Huanglian10-15g/20-30g;②Yinyanghuo15g and Sharen6g;③Lianqiao30g, Xuanshen15g and Zhebei15g;④Fuling15-20g and Baizhu10-20g;⑤Danggui15g and Chuanxiong15g。Conelusion:The clinical experiences of Professor Li Saimei in diagnosing and treating type2diabetes mellitus are as follows:①Using six meridians syndrome differentiation method as the basic system and merging multiple syndrome differentiation methods in one;②Concerning about the main characteristics of the disease and emphasizing on the concept of unity;③Stressing on the consistency of syndrome-formula and Frequently combining various formulae;④Changing of herbs and varying the dosages of herb in accordance with the symptoms, and skillfully using pairs of herb. Based on the new data discovery method of non-statistical partial-order structure model, it could efficiently discover the clinical experiences of Professor Li Saimei’s in diagnosing and treating type2diabetes mellitus. Applying this knowledge discovery method with distinctive features on the currently unresolved inheritance and preservation of the academic knowledge and experience of famous Chinese medicine practitioners will be of significant values in academic research and practical use.