Research On Knowledge Mining Of Exogenous Febrile Diseases In Works On Typhoid Fever In Song, Jin And Yuan Dynasties Based On Knowledge Meta-theor

Research backgroundAncient traditional Chinese medicine(TCM)books are important carriers for recording,preserving,and transmitting the knowledge of Chinese medicine,and they are rich in variety and connotation of knowledge.As an advantageous disease in TCM,many treatment experiences have been recorded in medical books for generations.Especially in the Song,Jin and Yuan dynasties,with the in-depth development of academic and clinical practice of febrile diseases,many works on febrile disease,called Shanghan works by TCM,were written,from which the essence of knowledge on exogenous fever diseases can be discovered,providing reference for disease prevention and treatment.Nowadays,various new epidemics and infectious diseases are frequent and the existing treatment methods are limited,so it is important to explore new treatment ideas and methods from ancient TCM books.Research objective(1)To analyze and index the representative Shanghan works in the Song,Jin and Yuan dynasties,and to excavate the knowledge on exogenous fever diseases,focusing on the analysis of the evolution law of the diseases.The new theory of the etiology and pathogenesis,the characteristics of the diagnosis and treatment,and the prescriptions will be mined in order to improve and the literature arrangement and to refine the study of academic thought on exogenous fever diseases in this period.(2)To deepen the application of knowledge element theory in the field of ancient TCM books and to explore the knowledge of exogenous fever diseases with the diagnosis and treatment thinking of "disease-pulse-syndrome combined treatment".It is to achieve the acquisition of explicit knowledge and the disclosure of tacit knowledge of ancient TCM books,and to explore a new way for the in-depth exploration and utilization of ancient TCM books,giving full play to the advantages of modern information technology.Research methods(1)In this study,12 representative Shanghan works of Song,Jin,and Yuan dynasties with important academic and clinical values in the history of the development of exogenous fever diseases were selected using TCM literature research methods.Then,information such as author,date of publication,and edition are determined,and the text of books is electronically uploaded to the indexing platform.(2)Based on the indexing rules,the knowledge element indexing method was used to index 12 Shanghan works at the levels of knowledge bodies,knowledge elements,semantics,and semantic relations to obtain structured data and multi-grained knowledge.It is to achieve reasonable organization and representation of ancient TCM knowledge,and to lay the foundation for knowledge mining of exogenous fever diseases.(3)The knowledge mining method of ancient TCM books was used to screen the knowledge bodies of cold damage,exogenous apoplexy,warm disease,epidemics and other exogenous fever diseases and the knowledge elements and semantics of disease,etiology,pathogenesis,symptom,pulse,treatment,prescription,etc.from the indexed data for statistical,categorization,comparison,and feature analysis.(4)In this study,the knowledge graph construction method was used,including four steps of knowledge extraction,knowledge fusion,knowledge processing,and knowledge graph construction:export XML format data from the indexing platform;extract entities and relationships to get itemized JSON format data;align entities,resolute coreference to get triplet data;import triplet data into Neo4j database to form knowledge graph.Research results(1)Features of academic development of exogenous fever diseases during the Song,Jin and Yuan dynasties:Government agencies and literati groups attached importance to the development of medicine,making Zhongjing’s scholarship widely disseminated and research on exogenous fever diseases more in-depth.In the Song Dynasty,the doctors based on clinical practice,wrote books extensively on exogenous fever diseases.During the Jin and Yuan Dynasties,the doctors merged the medical theories of several books and continuously innovated TCM theories and clinical treatments.In the late Song,Jin and Yuan dynasties,the study of exogenous fever diseases became more advanced,and the understanding of cold diseases and warm diseases was clearly differentiated.The focus of research gradually expanded from the narrow sense of febrile disease to the broad sense of febrile disease.During the Song,Jin,and Yuan dynasties,the doctors emerged with many new academic views and treatment ideas in the study of many types of exogenous fever diseases.(2)The indexing results of 12 Shanghan works:3652 knowledge bodies,involving 10 types,such as "disease-pulse-syndrome combined treatment" and "prescription";16,873 knowledge elements,involving 87 types,such as disease and symptom;40,816 semantic relations,involving 49 types,such as disease name and identifying syndromes;10,249 semantic relations,involving 29 types,such as the disease identification and treatment relation,and the herb-dosage-preparation relation.(3)Knowledge mining results of exogenous fever diseases:the main 8 types of diseases are cold damage,exogenous apoplexy,warm disease,epidemics,fever,summer-heat disease,wet disease,malaria and other diseases,including 112 specific diseases.For example,the diseases of cold damage includes cold damage by yin poisonous,cold damage by yang poisonous,cold damage with two infections,cold damage in winter,cold damage with food factor,cold damage with Shaoyin disease,severe cold damage,women’s cold damage,pregnancy cold damage,pediatric cold damage,cold damage by Shi qi,infectious cold damage,etc.The knowledge bodies of cold damage account for 50.41%of all knowledge bodies.The etiology involves cold evil,wind evil,summer heat evil,damp evil,warm evil,heat evil and other external evil,but not dry evil,of which cold evil accounts for 32.75%,and the special etiology includes poisonous qi,seasonal qi,obscene qi,surly qi,epidemic qi,etc.The pathogenesis involves 11 types:cold and heat pathogenesis,yin-yang pathogenesis,body fluid pathogenesis,six meridians pathogenesis,external and internal pathogenesis,exogenous pathogenesis,deficiency and excess pathogenesis,rong and wei pathogenesis,pathogenesis about five elements’ motion and six kinds of natural factors,qi and blood pathogenesis,and evil and positive pathogenesis,etc.,of which cold and heat pathogenesis accounts for 30.12%.The main pulse types are floating pulse,solid pulse,sinking pulse,deficient pulse,rapid pulse,and retarded pulse,of which floating pulse accounted for 23.34%;the top 5 symptoms are fever,sweating,headache,aversion to cold,and thirst,of which fever accounted for 14.10%.For example,the main pulse of cold damage is floating,sinking,and tight,and the main symptoms are fever,headache,and aversion to cold;the main pulse of exogenous apoplexy is floating,slow,and weak,and the main symptoms are spontaneous sweating,fever,and aversion to wind;the main pulse of warm disease is floating,replete,and large,and the main symptoms are fever,skin spots and rashes with veins,and spontaneous sweating.The rules of treatment are to harmonize yin and yang,consider seasonal,geographic,and human factors,Choose prescriptions according to climate and temperature;the treatment methods are diaphoresis,vomiting,catharsis,warm therapy,heat-clearing method,tonifying therapy,harmonizing method,detoxification of muscle,and,detoxification,etc..The methods of diaphoresis,vomiting,and catharsis are the most used,such as the diaphoresis method was used for exterior syndrome of cold damage,the method of laxative stool was used for internal syndrome of cold damage,the vomit method was used when the disease position was above.There are also external treatment methods such as acupuncture,moxibustion,nasal administration,water stains and water baths.Among the used formulas,Zhongjing’s formulae was often used,accounting for 26.88%,such as Mahuang Decoction,Guizhi Decoction,Chaihu Decoction,Baihu Decoction,Chengqi Decoction,etc.;the self-created formulas and other formulas,such as Yindu Gancao Decoction for cold damage by yin poisonous,Baidu Powder for exogenous apoplexy,Shengma Gegen Decoction for Spring fever disease,Zhimu Jieji Decoction for Fever.and Jiuzheng Huanglian Pill for summer-heat disease,account for 73.12%.(4)Knowledge graph:37,248 triples were extracted from the relational data,and a knowledge graph of 12 Shanghan works was constructed to present the dynamic diagnosis and treatment process of "identifying diseases→checking pulses→analyzing symptoms and syndromes→determining treatment",which simulates the clinical decision-making thinking of ancient doctors.The knowledge graph is centered on the core knowledge of exogenous fever diseases,and by correlating other treatment contents,it enables a comprehensive,dynamic and intelligent query of exogenous fever diseases knowledge and the discovery of innovative medical theories and hidden relationships.Research conclusion(1)Through literature research and academic combing,it is found that the doctors of the Song,Jin and Yuan dynasties expanded and analyzed the etiology and pathogenesis,clinical features and therapeutic methods of exogenous fever diseases based on Treatise on Febrile Diseases and broke through the diagnosis and treatment system of "cold damage to unify all exogenous fever diseases" to discuss different exogenous fever diseases.It laid a solid foundation for the breakthrough and development of cold damage,warm disease,and epidemics in later generations,and played an important role in the development of exogenous fever diseases in TCM.(2)The practice of indexing and knowledge mining for 12 Shanghan works revealed that the practitioners in the Song,Jin and Yuan dynasties added new diseases on the basis of"febrile diseases has five".Ancient TCM doctors attached importance to external causes of diseases,emphasized the combination of pulses and symptoms,followed the therapeutic principles of reconciling yin and yang and considering seasonal,geographic,and human factors,used various treatment methods.Then,they created new formulas with the ideas of Zhongjing,formed a clinical thinking of disease differentiation step by step and combination of disease and syndrome,and initially built a diagnosis and treatment system of "diseasepulse-syndrome combined treatment" for exogenous fever diseases.(3)Based on knowledge element theory and knowledge graph,we conducted a deep indexing practice and knowledge mining research on 12 Shanghan works in Song,Jin and Yuan to build a knowledge association network of ancient books and discover the tacit knowledge of exogenous fever diseases,which solved the problem of fragmented research due to the scattered academic thoughts of different dynasties and authors.This study provides a new path to discover the clinical knowledge of exogenous fever diseases from ancient TCM books.Research innovation and significance(1)This study has sorted out the thinking pattern and treatment system of the "combined treatment of disease,pulse,and evidence" of external fever,uncovered the theory of external fever and the content of treatment methods and prescriptions added and innovated by medical doctors in the Song,Jin,and Yuan dynasties,expanded the thinking of clinical evidence,improved the application value of ancient Chinese medical knowledge in the prevention and treatment of external fever,and has important significance for the scientific research of modern major diseases.(2)Based on knowledge element theory,we conducted knowledge indexing and knowledge mining of a dozen of ancient TCM books.This study combined with the knowledge expression characteristics of "disease-pulse-syndrome combined treatment" and followed the research idea of "identify different academic systems and examine their origins and spread" in ancient TCM literature.The research ideas and methods can provide reference for other types of ancient TCM books,which is innovative in terms of methodology.