Research Of Data Mining Based On Method Of Regulating Qi For Asthma Treated By Professor Wang Shouchuan

Objective:To explore the understanding of Tutor professor WANG Shou-chuan on etiology and pathogenesis of childhood asthma and his academic viewpoint and clinical application of syndrome differentiation divided into three stages.By observing the clinical efficacy on treating asthma children in the three stages to provide an objective evaluation basis for his clinical medication,and applying modern data mining technology to analyze the medication regularity of Tutor on treating asthma in three stages in the recent ten years.To summarize the clinical experience on pediatric asthma by syndrome differentiation in traditional Chinese medicine(TCM)and to inherit the significance on academic thought of Tutor.Methods:The study is divided into three parts as theoretical research,clinical observation,and retrospective analysis.For the theoretical part,Tutor’s works were read to understand his academic thought of the endowment of latent wind,and the syndrome differentiation mainly divided into three stages.For the clinical part,subjects collected from Tutor’s outpatient children was observed to compare the quantitative indicators of syndromes before and after treatment during 2017/1-2018/10.For retrospective analysis,data inputted from electronic images of Tutor’s clinical archives on asthma children from 2009 to 2018 was regularized,cleaned,and analyzed with the descriptive statistical method and association rule mining method applied to extract the medication regularities of Tutor for treating asthma in three stages.Results:For the theoretical part,the fact that the children’s lung is usually insufficient,spleen is usually deficiency,and kidney qi is not ample was emphasized by Tutor.If the external pathogen of wind induces the interior latent wind and phlegm,the treatment should focus on the lung in the emergency while the treatment should focus on lung,spleen,and kidney without urgency.Other than the attack stage and remission stage categorized by conventional syndrome differentiation of asthma,the prolonged stage shall be included and the syndrome differentiation shall be mainly divided into three stages.The therapy for attack stage is to dispel wind and resolve phlegm,and to counter pathogen and treat the lung;the therapy for prolonged stage is to treat both the tip and root,and to eliminate the latent wind and reinforce the healthy qi;the therapy for remission stage is to harmonies the lung,spleen,and kidney,and to strengthen pneuma and defend against the pathogenic factor of wind.In addition,some asthma children were either having new external pathogenic factors with no relapse yet,or having no asthma attack temporarily after treatment while the excess of pathogenic factor still exists.These two issues were neither recognized as the attack stage nor prolonged stage,but the prevention of the recurrence of asthma should be carefully considered.Therefore,it was recognized as a"sub-attack period" temporarily.As well as the prolonged stage and remission stage,the theory of pre-treatment in TCM should be taken seriously during this period,with both the idea of preventing before disease and preventing disease from exacerbating shall be given consideration.For the clinical observation part,107 treatment courses for 100 children were included,with a total of 547 visits.Among all visits,91 ones were in the attack stage,137 ones were in the prolonged stage,118 ones were in the remission stage,and the other 201 ones were in the period defined as "sub-attack" according to the theoretical result above.SPSS 20.0 statistical software was applied to analyze the information of clinical research.The results showed that the total effective rate was 90.67%in four weeks,and 88.57%in twelve weeks.In the aspect of TCM syndrome integral,the scores were improved both after the 2nd week and the final treatment(P<0.01).Compared with the total effective rate of TCM syndromes,the group of final treatment(the mean course of treatment is 10.43 ± 7.897 weeks)was better than the group after the 2nd week(90.65%:80.37%)with significant difference(P<0.05).There were no serious adverse reactions during the courses of treatment.For retrospective analysis part,373 medical records of children with bronchial asthma were collected,with a total of 1971 visits.The results showed that the most frequent asthma stage of clinical visits was the prolonged stage,and its majority TCM syndrome is wind-phlegm lingering in lung and dual deficiency of the lung-spleen,followed by remission stage with the majority syndrome of dual deficiency of the lung-spleen,and the attack stage with the majority syndrome of phlegm-heat obstruction.On the aspect of proportion of medicinal material tend to reinforcing the healthy qi or eliminating the pathogenic factors,the use of expelling medicinal was at most in the attack stage(86%)and at least in the remission stage(43.3%);while the use of reinforcing medicinal was at most in the remission stage(49.5%)and at least in the attack stage(10%).In terms of medication regularity in the attack stage,362 TCM prescriptions were included in this study with 95 kinds of medicinal involved.The frequencies of occurrence medicinal in the top three were Zhi Ma-huang,Qian-hu,and Huang-qin.According to the statistics of medicinal attribute,it was found that more cold and warm among four qi,mostly bitter followed by pungent among five flavor,and the lung meridian is the most frequent meridian entry.SPSS Apriori association rule method was applied to analyze the highest association frequency on tetravalent medicinal combination is "Huang-qin,Ting-li-zi+ Qian-hu +Zhi Ma-huang".By integrating the software methods,which include the network graph of high frequency drug association and tree chart of cluster combination,and the clinical experience of Tutor,the obtained predominant prescription after analyzation was "Zhi Ma-huang,Huang-qin,Ting-li-zi,Zi-su-zi,Qian-hu,Ku-xin-ren".In terms of medication regularity in the prolonged stage,461 TCM prescriptions were included in this study with 155 kinds of medicinal involved.The frequencies of occurrence medicinal in the top three were Xin-yi,Bai-zhu,and Fang-feng.According to the statistics of medicinal attribute,it was found that more warm and cold among four qi,mostly sweet followed by bitter and pungent among five flavor,and the lung meridian was the most frequent meridian entry.The highest association frequency on tetravalent medicinal combination was "Bai-Zhu,Duan Mu-li+Duan Long-gu+Fang-feng".By integrating the software methods and the clinical experience of Tutor,the obtained predominant prescriptions after analyzation were"Duan Long-gu,Duan Mu-li,Bai-zhu,Fang-feng,Zhi Huang-qi","Jie-geng,Zhe-bei-mu,Jin-yin-hua,Sang-bai-pi",and "Zhi Ma-huang,Ku-xin-ren,Qian-hu,Huang-qin".In terms of medication regularity in the remission stage,360 TCM prescriptions were included in this study with 155 kinds of medicinal involved.The frequencies of occurrence medicinal in the top three were Bai-zhu,Zhi Huang-qi,and Fang-feng.According to the statistics of medicinal attribute,it was found that more warm and flat among four qi,mostly sweet among five flavor,and the lung meridian was the most frequent meridian entry.The highest association frequency on tetravalent medicinal combination was " Bai-Zhu,Duan Mu-li+Duan Long-gu+Fang-feng ".By integrating the software methods and the clinical experience of Tutor,the obtained predominant prescription after analyzation was "Zhi Huang-qi,Bai-zhu,Fang-feng,Duan Long-gu,Duan Mu-li".Conclusion:The etiology and pathogenesis of children asthma was concluded by Tutor that the endowment of latent wind hidden internally is considered to be added as an etiology.The fundamental cause of recurrent attack of this disease is proposed to base on "the insufficience of lung,spleen,and kidney making the wind and phlegm hidden internally".In addition to the traditional identification of attack stage and remission stage,the prolonged stage should be added up to three stages with the application of syndrome differentiation.Generally speaking,the two methods of "regulating qi" and "dispelling wind" run through each stage.His medication characteristics are "to treat its tip in the emergency,to treat its root at no urgency,and to treat both the tip and root if the pathogen lingered and the healthy qi insufficient;to treat by syndrome differentiation with the medication at low dosage and flexible".However,asthma often has the coexistence of pathogenic factors excess and healthy qi deficiency,and its condition changes with the change of the degree of excessive pathogenic factors and deficient healthy qi.Therefore,the medicinal should be flexibly added and subtracted according to the concurrent symptoms.From this study,the TCM formula prescribed by Tutor WANG after syndrome differentiation on treating asthma can significantly improve the symptoms with no adverse reactions,which is safe and effective,and worthy of in-depth study and promotion.