Discussion And Application Of The Theory Of Gout "Phlegm And Blood Stasis Streamer" Based On Data Mining

GOUT is a kind of purine metabolic disorders and (or) uric acid excretion reduc ed disease,and has a relationship with blood uric acid.Clinical manifestations are acute inflammation of the joints,but often be neglected after pain relief,or have a strong i mpact on the quality of life.Gout belong to "bi" or "gout" or "lijie" in TCM.The TC M thinks that dampness,phlegm,heat and blood stasis are the main pathological factors. Modern medical research found that gout close contact with a variety of metabolic di seases and cardiovascular diseases.The key to improve the clinical curative effect of g out is combined with TCM and western medicine research progress.Based on the data mining technology,this study is to collect gout cases and to investigate the theory of "Phlegm and Blood Stasis" in diagnosis and treatment regularity and clinical appli cation of gout. Object:The objective of our study is applying datamining technology to the onset charact eristics and clinical features of gout,to find out Professor Yin’s administration features on the treatment,and to study the theory of "Phlegm and Blood Stasis"on the treatm ent and clinical thought of gout.Method:70 cases are collected by using the clinical questionnaires.We adopt Epidata3.1 so ftware for data management.The Epidata3.1 software can be directly used in reading a nd editing the basic information,the history traits,the clinical manifestation,tongue and pulse,the laboratory examination,the clinical stage,the TCM dialectical types,and medica tion.Then we use SPSS 18.0 statistical analysis software to carry on the frequency anal ysis and one-way ANOVA.Besides,we apply Complex Network to analyse related data.Result:1、Onset characteristics:In gout patients,the sex ratio(male to female) is 35:1.The average onset age is(37.69±3.75),and concentrates in 21-40 years old.The course of t his disease is focus on 0-5years(54.29%).The stages of gout is relatively balanced:the group of acute attack is38.57%,intermission group is 32.86%,the group of chronic pha se is 28.57%,and the group of renal disease stage is 42.86%.According to the results,t he frequency of gout is 24.29% in 1 times a year at most,and the 17.14% of patients attacks gout in less then two weeks.The 55.71% of patients have controlled high pur ine food and 57.14% have controlled alcohol (including beer,spirits,etc) before their fir st visiting hospital.2、Combined diseases and auxiliary examination:The highest frequency of combin ed diseases with gout is metabolism disorder of Lipid and Fatty Liver,their frequencie s is respectively29.59%,28.57%.The frequency of combined Hypertension and Kidney st one is respectively 12.76%,11.22%.The frequency of patients who are overweight and obesity is more than 80%,the same as central obesity.The urine PH under 6.0 about g out patients is 80.01%,among which 34.29% PH of the patients is 5.0.The average BI ood uric acid is (553.98±130.16) umol/L.About 87.14% of the patients are hyperurice mia.The abnormal rate of blood fat(TC、TG、HDL-C、LDL-C)and blood sugar is respec tively 15.71%,37.14%,38.57%,10.00%,and 17.14%.By using one-way ANOVA,BMI,wais t and TC have a significant difference in 5 groups of uric acid density(P<0.05),which points out that they are the independent risk factors of gout.There are 36.36% patien ts have tophus explored by dual-source computed tomography(DECT),and the tophus i s exployed most in the first metatarsophalangeal joint of both feet.3% Clinical features:The first metatarsophalangeal joint of both feet is the main pa in location of gout patients(28.32%).The frequency of the main clinical symptoms are arthralgia 70(20.65%),swelling 61(17.99%),burning 56(16.52%),tenderness 55(16.22%),re ddening of skin 50(14.75%),limited range of movement 29(8.55%),touchable tophus 18 (5.31%).The frequency of the main concomitant symptoms are purple or darkish lips 51(12.56%),shining and fat face 44(10.84%),snoring 44(10.84%),sweat 39(9.61%),shortn ess of breath and hypodynamia 27(6.65%),yellow urine 25(6.16%),tired of waist and k nee 19(4.68%),sinking limbs 17(4.19%),sticky stools 17(4.19%)and giddiness 16(3.9 4%).The highest frequency of tougue is red or crimson,thin and yellow fur.The pulse c ondition is heavy slipping.The core symptoms are:arthralgia,swelling, limited range of movement,burning,reddening of skin, tenderness, touchable tophus, purple or darkish lips, sticky stools, tired of waist and knee, sweat, snoring, shining and fat face, shor tness of breath and hypodynamia, yellow urine,red tongue,purplish red tongue,thin whit e fur of tongue,stringy pulse,veinlet pulse,heavy pulse,slipping pulse.4、Syndrome and traditional Chinese medicine:The distribution of gout syndrome i s:phlegm-stagnancy-type(45.59%),damp-heat retention-type(30.88%),spleen deficient-type (13.24%),liver and kidney Yin deficiency-type(10.29%).One of the most common comp lex syndrome is damp-heat retention-type with phlegm-stagnancy-type.Professor Yin’s c ore medication is:Atractylodes rhizome,Salvia miltiorrhiza,Plantain seed,Coix seed,Thun berbg fritillary bulb.Indian bread,Christina loosestrife,Cowherb seed,Liquorice root,Poiso n yam,Lightyellow sophora root,motherwort herb.5、The relationship between phlegm-stagnancy-type and disease-Syndrome-medicat ion:One of the most common syndromes is phlegm-stagnancy-type.The phlegm-stagna ncy-type can be found in every stage of gout by applying Complex Network.The core symptoms of this type are arthralgia,swelling,limited range of movement,burning,redde ning of skin,tenderness,touchable tophus,yellow urine,purple or darkish lips,shining and fat face,shortness of breath and hypodynamia,snoring,sweat,sticky stools,red or purplis h red tongue,heavy pulse,slipping pulse.What makes this type different from others is the unique symptoms:arthralgia,sticky stools, touchable tophus and purplish red tongu e.The phlegm-stagnancy-type also has a relationship with combined diseases,such as m etabolism disorder of Lipid,Fatty Liver,Hypertension,Kidney stone,prediabete,and especia lly,diabetes mellitus.Through analysis discovery,the common herbs of the phlegm-stagn ancy-typeused by Pro.Yin are: Atractylodes rhizome,Danshen root,Plantain seed,Indian br ead,Thunberbg fritillary bulb,Coix seed,Amur cork-tree,Cowherb seed,liquorice root,Alu m processed pinellia,Poison yam,Mustard,Zedoray rhizome,Milkvetch root,Lightyellow s ophora root,Peony root,Glabrous greenbrier rhizome,Sweet wormwood herb,Medicinal c yathula root,Southern fangchi root,Christina loosestrife,Motherwort herb.Compared with other types,this type has some special medicines:Medicinal cyathula root,Glabrous gree nbrier rhizome,Peony root,Milkvetch root,Zedoray rhizome,Mustard,Alum processed pin ellia.Conclusion:1、The formation of phlegm and blood stasis of gout,is associated with patients’ constitution,also closely associated with the high-energy diet.Phlegm and blood stasis i s the main pathological factors of gout form,progression and pathological outcomes.2、The most common syndrome is phlegm-stagnancy-type.The main clinical symp toms are arthralgia,swelling,limited range of movement,burning,reddening of skin,tender ness,touchable tophus,as well as yellow urine,purple or darkish lips,shining and fat fac e,shortness of breath and hypodynamia,snoring,sweat,sticky stools,red or purplish red to ngue,heavy pulse,slipping pulse,etc.3、Gout has a relationship with metabolism disorder of Lipid,Fatty Liver,Hyperte nsion,Kidney stone,prediabete,and especially,diabetes mellitus Combind with TCM treati ng method, we think that phlegm and blood stasis is the important factor of gout and related system diseases.Phlegm and blood stasis lingers in the joints, blood vessels, s kin, viscera,or accumulated in the kidney, or in subcutaneous lipoma, or change for e xcess blood sugar and blood fat in the blood vessels,and then it lead to diabetes,ather osclerosis,coronary heart disease,high blood pressure and so on.4、We emphasize the importance of the method of resolving phlegm to remove s tasis.Professor Yin avoid the production of phlegm and blood by eliminating dampness, huazhuo and transporting Middle-Jiao.According to the different course of the disease symptoms,flexiblely choosing different intensity of huayu,we treat the phlegm and bloo d by dredging urine and shit.Under the premise of TCM treating method.combined wi th the characteristics of different diseases with corresponding treatment respectively,phl egm and blood stasis should be the overall train of thought.