The Study On Regularity Of Treatment Based On Syndrome Differentiation Of Unit-combination Of Professor Shen Shaogong In The Treatment Of Essential Hypertension

Objective:In order to obtain the experience of professor shen shaogong in the treatment of Essential Hypertension by Text Mining of medical records,including prescription regularity, Syndrome combination regularity.The resulting rules can be used to enrich and improve the pattern of treatment based on syndrome differentiation.Collect the messages of Patients with hypertension by the four diagnostic methods and prescriptions of traditional Chinese Medicine,prescriptions of out-patient chinese patent medicine,and western medicine prescriptions. Observe the blood pressure values,heart rates,and symptoms of patients.Analyse the symptoms and treatments of patients in different hypertension grades.To explore and discuss clinical types, Syndrome differentiation regularity and treatments of Essential Hypertension,and find out the new methods to cure Essential Hypertension.Methods:Design data collection table of clinical records,collect the data of Patients with hypertension in syndrome differentiation and treatment,who were cured between Oct.2012and Oct.2013by professor Shen Shaogong.The course of treatment was3months. Gender, age, ethnicity,course of disease, Predisposing factors, Physical and chemical examination, Family history were needed.Then observe the changes of clinical symptoms,blood pressure values,heart rates before and after treatment.Using correlation analysis methods to give some related analysis and extract and mine regularities of Treatment Based on Syndrome Differentiation of Unit-combination of Professor Shen Shaogong in the treatment of Essential Hypertension.Results:1.In this research, there are100cases in total, with syndrome of intermingled phlegm and blood stasis35cases, syndrome of imbalance between yin and yang31cases, and syndrome of turbid phlegm accumulated internally24cases. Patients with syndrome of intermingled phlegm and blood stasis have higher ratio than syndrome of imbalance between yin and yang and syndrome of turbid phlegm accumulated internally respectively; specifically speaking, in male patients, there are syndrome of intermingled phlegm and blood stasis10cases, whose proportion is37.93%, and meanwhile patients with syndrome of imbalance between yin and yang7cases, accounting for24.14%; and syndrome of intermingled phlegm and blood stasis9cases, accounting for30.13%, syndrome of intermingled phlegm and blood stasis has higher proportion than syndrome of imbalance between yin and yang and syndrome of turbid phlegm accumulated internally respectively; In female patients, there are syndrome of intermingled phlegm and blood stasis25cases (35.21%), syndrome of imbalance between yin and yang24cases (33.80%),and syndrome of turbid phlegm accumulated internally15cases (18.31%).Syndrome of intermingled phlegm and blood stasis and syndrome of imbalance between yin and yang has the highest proportion, followed by syndrome of intermingled phlegm and blood stasis and syndrome of deficiency of both qi and yin.2.1n all the patients whose Age≤50, there are10cases of syndrome of intermingled phlegm and blood stasis(23.91%), syndrome of turbid phlegm accumulated internally23cases(50.00%), syndrome of imbalance between yin and yang has the highest proportion, followed by syndrome of intermingled phlegm and blood stasis and syndrome of turbid phlegm accumulated internally; meanwhile, in patients whose age>50, there are syndrome of intermingled phlegm and blood stasis25cases (46.30%), syndrome of turbid phlegm accumulated internally15cases (20.37%), syndrome of imbalance between yin and yang8cases (14.81%). Syndrome of intermingled phlegm and blood stasis has the highest ratio, then followed by syndrome of turbid phlegm accumulated internally, syndrome of imbalance between yin and yang, and syndrome of deficiency of both qi and yin。3. The "Treatment Based on Syndrome Differentiation-Syndrome Diagnosis-medication Rule" Pattern of Syndrome of Intermingled Phlegm and Blood StasisSyndrome of intermingled phlegm and blood stasis has dark red tongue, yellow greasy fur, stringy slippery pulse, with primary symptoms:vertigo, palpitation, chest congestion, tinnitus, thirst and dry mouth, shortness of breath, lumbago, etc have high frequency, and have strong relevance. Drugs like Zhuru (竹茹, BAMBUSAE CAULIS IN TAENIAS)、Fuling (茯苓,PORIA), Chenpi (陈皮, CITRI RETICULATAE PERICARPIUM), Zhiqiao (枳壳, AURANTII FRUCTUS), Gouteng (钩藤, UNCARIAE RAMULUS CUM UNCIS) have high frequency and strong relevance forms core drug combinations. Then syndrome of intermingled phlegm and blood stasis "the pattern of syndrome of "treatment based on syndrome differentiation-syndrome diagnosis-medication rule" intermingled phlegm and blood stasis" pattern forms.4. The "Treatment Based on Syndrome Differentiation-Syndrome Diagnosis-medication Rule" Pattern of Syndrome of Imbalance between Yin and Yang Syndrome of imbalance between yin and yang has thin fur, deep and thin pulse, its primary symptoms including vertigo, thirst, dry mouth, fatigue, weakness, palpitation, soreness of the loins, lumbago, etc has the highest frequency. Outcomes based on association rule analysis shows that vertigo, lumbago, shortness of breath, fatigue, weakness, etc has the strongest coorelationship. On drugs, Gouqizi,(枸杞, LYCII FRUCTUS)、 Juhua,(菊花, CHRYSANTHEMI FLOS)、 Dihuang,(地黄, REHMANNIAE RADIX)、Huangjing,(黄精, POLYGONATI RHIZOMA)、 Duzhong,(杜仲EUCOMMIAE CORTEX)、Sangjisheng,(桑寄生, TALXILLI HERBA) form core drug family. Then syndrome of deficiency of both liver and kidney the pattern of syndrome of "treatment based on syndrome differentiation-syndrome diagnosis-medication rule" pattern comes into existence.5. The "Treatment Based on Syndrome Differentiation-Syndrome Diagnosis-medication Rule" Pattern of Syndrome of Turbid Phlegm Accumulated InternallyDark red tongue, greasy fur, slippery pulse, with primary symptoms:vertigo, palpitation, chest congestion, hyperhidrosis and so on, which have the highest frequency and strong correlationship, forms into symptom families; composition rule of syndrome of turbid phlegm accumulated internally is obtained via association rules analysis, and the core drug combinations is composed of Zhuru (竹茹, BAMBUSAE CAULIS IN TAENIAS), Fuling(茯苓,PORIA), Chenpi (陈皮, CITRI RETICULATAE PERICARPIUM), Shichangpu (石菖蒲,ACORI TATARINOWII RHIZOMA), Yujin (郁金,CURCUMAE RADIX), etc.6. Course of Disease-efficacy RelationshipPatients with course of disease less than5year, after one course of treatment, outcomes are as follows:excellent10cases (19.61%), effective23cases(45.10%), total effective rate33cases (64.71%); after three courses of treatment, excellent14cases (27.45%), effective26cases (50.98%), total effective rate40cases (78.43%). Patients with course of disease more than10years, after one course of treatment, outcomes are below:excellent4cases (17.39%), effective7cases (30.43%), total effective rate11cases (47.82%); after three courses of treatment, excellent5cases (21.74%), effective7cases (30.43%), total effective rate12cases (52.17%).Therefore, the shorter the course of disease is, the more effective the medication becomes, the efficacy has reverse correlation with the course of disease.7. Relevance between Course of Disease and Efficacy.After a course of treatment, the outcomes are below:excellent19cases, effective ones40, total effective rate59.00%; after two course of treatment, total effective rate65.00%; after three course of treatment, total effective rate raises to70.00%. However, the inefficacy rate decreases from41.00%in the first course to30.00%in the third course of treatment.Thus, the total effective rate rise along with the prolonging treatment time, while inefficacy rate slow decrease, which means the longer the medication time is, the better efficacy will be achieved.8. Post-treatment condition (if the patients stop or reduce western medicine)After the treatment, there are10patients that stop taking west medicine, accounting for10%, while patients that reduce west medicine are14cases, with proportion10%.9. Blood pressure being normal After curementThere were17patients’blood pressure being nomal.The proportion was17.00%。Conclusions:Via primary processing the data that professor Shen Shaogong curing hypertension, syndrome and medication rules are dug out, and "treatment based on syndrome differentiation-syndrome diagnosis-medication rule"pattern, which could clarify the rules of prof. Shen’s treatment based on syndrome differentiation are obtained. It could objectively reflect prof. Shen’s academic idea of curing hypertension. However, due to limited cases, there are still some limitations, that need more research to better support the clinical use.