Based On The Auxiliary Platform Of Traditional Chinese Medicine Inheritance, The Law Of Compatibility Of Chinese Medicine For The Treatment Of Primary Dysmenorrhea By Professor Jing Yan Is Studied

Primary dysmenorrhea(PD)is a common disease in young and childless women,which seriously affects the quality of life of women.Combined with the latest international guidelines,consensus recommended first-line treatment is drug therapy and surgical treatment.Non-steroidal anti-inflammatory drugs and oral contraceptives can alleviate symptoms,but common gastrointestinal adverse reactions,so poor compliance;GnRHa or surgical treatment is not preferred for adolescent females with impaired reproductive function.The Chinese medical theory is rich,and the advantages in the treatment of functional dysmenorrhea and early secondary dysmenorrhea are prominent,among which acupuncture and traditional Chinese medicine are highly recognized.With nearly 40 years of clinical experience,Professor JingYan is one of the heirs of the academic experience of Professor XuRunSan,a master of traditional Chinese medicine.She inherits the treatment experience of gynecology of Professor Xu,and makes innovations based on his "Dysmenorrhea Prescription" from clinical practice.Data mining technology is an emerging technology in recent years.The technology is increasingly widely used in traditional Chinese medical research field and the inheritance of traditional Chinese medicine auxiliary platform(TCMISS V2.5)is widely used in the field of traditional Chinese medicine,auxiliary clinical large amounts of data management,query,output,and enhancement of traditional Chinese medicine data neatly,systematic,can better for Chinese medicine diagnosis and treatment.With the help of TCMISS,this study studied the compatibility rules of traditional Chinese medicine prescriptions in the medical records of primary dysmenorrhea in the outpatient department of professor Jing in recent 6 years,so as to enrich the clinical diagnosis and treatment ideas of this disease.ObjectiveTo study the medication law of Professor Jing in treating primary dysmenorrhea,and to explore the characteristics of drug compatibility and drug combination;According to patients’age and VAS score,the subgroups were excavated by stratification.Through association rule analysis,medication pattern analysis,cluster analysis,new prescription combination and visualized drug network display,the law of recessive prescription medication was obtained.MethodIn this study,a retrospective study was conducted to collect the prescription data of patients who were diagnosed with primary dysmenorrhea and given oral decoction of traditional Chinese medicine in the outpatient department in China Japan Friendship Hospital from January 2013 to January 2019.The medical record database of PD was established by using Excel.All the collected data were stratified according to age and VAS score.The drug frequency,the dominant law of traditional medicine,the invisible law of prescription association rule,cluster analysis,and the new prescription combination rule were counted.Finally,the statistical method was used to explore the potential relationship between age and drugs,VAS and drugs,and summarize the legislative characteristics,thinking track and prescription rules of treating primary dysmenorrhea with syndrome differentiation by professor Jing,so as to provide syndrome differentiation and medication ideas for clinical treatment of dysmenorrhea and improve the clinical treatment effect.ResultIn this study,104 outpatients diagnosed as primary dysmenorrhea by Professor Jing on January 1,2013 to January 31,2019,152 prescriptions included.Among them,the average number of treatment was 1.61,with the minimum of 1 visit and the maximum of 12 visits.The patients were divided into 4 groups(15-20 years old,21-25 years old,26-30 years old,31-35 years old).According to the times of diagnosis,the average age was 26.77 years old.The main population was 23-30 years old,accounting for 75.00%of the total population.According to the initial VAS cores of patients,the patients were divided into 3 groups(5-6 points in the moderate,7-9 points in the severe and 10 points in the extremely severe),and the VAS score was 6.35 on average,especially medium dysmenorrhea(VAS score 5-6)accounted for 62.5%.①General drug characteristics:159 drugs were included,2,737 drugs were Shared among all prescriptions,and 11.80 drugs were used per prescription on average.The frequency of drug use per prescription was calculated,and the top 3 high-frequency drugs were angelica sinensis(190 times,frequency 90.05%),rhizoma chuanxiong(140 times,frequency 66.35%),and paeony alba(127 times,frequency 60.19%).In terms of the characteristics of traditional drugs,the four qi drugs appeared most frequently in warm drugs,accounting for about 43%of all drugs,followed by cold drugs and flat drugs.Bitter herbs were the most common,accounting for 33%,followed by bitter and sweet.The frequency of meridians and liver meridians was much higher than other meridians,accounting for about 30%.In terms of drug efficacy,huoxue quyu medicine was the first,followed by kidney-tonifying medicine,qi-regulating medicine,clearing damp medicine and qi-tonifying medicine.②According to the age stratification,the four qi and five flavor patterns of stratified drugs of different ages are basically consistent with the general drugs.With the increase of age,the drugs for activating blood circulation and removing blood stasis show a decreasing trend,while the drugs for insects show an increasing trend.Kidney tonifying and qi tonifying drugs increased with age.Age was the correlative factor of dispelling pathogenic agents and strengthening agents.The specific rule is that the proportion of dispelling pathogenic drugs decreases with age,while the proportion of strengthening drugs increases.③VAS stratification showed that angelica sinensis,ligusticum chuanxiong,salvia miltiorrhiza,rhizoma bulbus,vinegar wulingzhi,radix paeoniae rubra,radix paeoniae alba,and radix bupleuri were all used in each pain rating group,and their distribution was relatively stable,so they were commonly used drugs for dysmenorrhea.With the increase of pain,the proportion of insect drugs(including leeches,worms and centipedes)increased significantly.Age is negatively correlated with VAS,and severe and extremely severe dysmenorrhea may occur more frequently in young women.④Drug use model:15 of the core drugs were analyzed and obtained(angelica sinensis,ligusticum,rhizoma cyperi,leonurus,salvia miltiorrhiza,radix paeoniae,radix bupleuri,poria cocos,frankincense,myrrh,corydalis,vinegar Wu Lingzhi,cattail pollen,artemisia).(5)Complex association rules:the number of support degree and the confidence degree were set as 46 and 0.6 respectively,including 108 pieces of data of 15 traditional Chinese medicines.The drug distribution was angelica sinensis,ligusticum chuanxiong,cattlewort,vinegar wuling lipid,processed myrrh,processed frankincense,rhizoma coryza,and artemisia argyi.⑥Cluster analysis:correlation degree 5 and penalty degree 2 were set,a total of 121 kinds of cluster analysis were obtained,and the first 10 kinds of 2 kinds of drugs,3 kinds of drugs and 1 kind of 4 kinds of drugs with correlation coefficient between 0.09 and 0.61 were extracted.The drugs were mainly divided into the group of promoting blood circulation and removing stasis,the group of warming meridians and promoting blood circulation and nourishing kidney.High frequency drugs were extracted from each group.The groups of activating blood and removing stasis were chuanxiong,salvia miltiorrhiza,sheng pu huang,vinegar wu ling zhi,making myrrh and making frankincense.Artemisia argyi;Dodder,ziheche and dipsacus in huoxue bushen group.⑦The new combination:a total of 4 groups,They are 1)raw cattail yellow,salvia miltiorrhiza,processed myrrh,vinegar wuling fat;2)vinegar,herba leonuri,dried ginger,radix cyathulae;3)scutellaria,angelica,radix pseudostellariae,pinellia ternata;4)dipsacus,dodder,ziheche,wine ligustrum,wolfberry.Among them,1 and 2 are the combination of new prescription before menstruation,3 and 4 are the combination of new prescription after menstruation.Among them,no.1 is the method of removing blood stasis and relieving pain,no.2 is the method of tongjinglishui,no.3 is the method of reducing adverse energy and stomach,and no.4 is the method of tonifying kidney and filling essence.ConclusionProfessor Jing discussed the treatment of PD from the adjustment the statement of deficiency and excess,and believed that the mixture of Xu and Shi were the basic pathogenesis,and the core was blood stasis.According to the principles of "urgent treatment for its symptoms,slow treatment for its origin"and "premenstrual and postmenstrual cycle therapy",blood-activating drugs,warm-menstrual drugs,regulating qi drugs and analgesic,tonifying kidney and spleen as the basic treatment,premenstrual urgent use of new dysmenorrhea prescription analgesic,after the treatment of syndrome differentiation.The core of professor Jing’s treatment for PD is the prescription for "New prescription for dysmenorrhea",which consists of angelica sinensis,chuanxiong,salvia miltiorrhiza,radix paeoniae,radix bupleurae,poria cocos,crude bulbus,vinegar Wu Lingzhi,frankincense,myrrh,red peony,artemisia argyi,cyperus acetate,herba kuncao and radix yuanhu.This study tried to verify the correlation between age and the severity of pain with two scientific research methods:statistics and data mining.It was found that in patients with primary dysmenorrhea,the younger the age,the more severe the pain might be.