Study On The Medication Rule Of Professor Ge Yan In Treating Chronic Atrophic Gastritis Based On Data Excavation

ObjectiveChronic atrophic gastritis is a precancerous lesion of the stomach.At present,Western medicine has no specific medicine for the treatment of CAG,but traditional Chinese medicine shows its unique advantages.This study uses statistical principles to conduct data mining on Professor Ge Yan’s prescriptions for the treatment of CAG,summarizes the rules of CAG’s syndromes and treatments and the experience of prescriptions and medications,and provides new ideas for the treatment of CAG by Chinese medicine,and provide the foundation for the next step of clinical research and experimental research.MethodsUsing the electronic information system of outpatient by Guangdong Second Hospital of Traditional Chinese Medicine,we searched for cases diagnosed with chronic atrophic gastritis from 2015 to 2020,and then screened them according to the inclusion and exclusion criteria,finally we obtained 306 medical records.Using Microsoft Excel 2019,SPSS Statistics 22.0,SPSS Modeler 18.0 statistical software to perform frequency analysis,cluster analysis,complex network analysis,association rule analysis basing on patients’information,syndrome types,prescription drugs,etc.Combine the statistical results with Professor Ge Yan’s opinions to summarize her academic thoughts on the treatment of CAG.Results1.Basic data analysis:Among the 306 patients in this study,149 were males and 157 were females.The ratios of males to females were 49%and 51%,respectively.The age distribution is between 17-86 years old,and the age groups with the largest number of cases are concentrated between 40-49 years old,50-59 years old,and 60-69 years old.2.Statistical analysis of symptoms,signs,and drugs:The top 5 common symptoms in order are upper abdominal distension,upper abdominal pain,belching,dry mouth,and poor mood.The top 5 of the high-frequency tongue picture were light red tongue,thin and white greasy coating,tortuous veins under the tongue,tooth marks on the sides,yellow and white coating.In the 306 prescriptions included in the study,the total number of types of Chinese medicine used was 203,and the total frequency was 4159 times.The average number of medicines used per prescription was 13.59±1.33.There are a total of 70 Chinese medicines used more than 10 times,accounting for 90,19%of the total frequency.The top ten medicines used are licorice,astragalus,turmeric,oldenlandia diffusa,atractylodes,codonopsis,panax notoginseng,barbata.Dendrobium and cuttlebone,the total frequency accounts for about 40%of the total frequency.The top 4 of the frequency distribution of four qi are warm,flat,slightly cold,and cold.The top 4 of the frequency distribution of five flavors are sweet,bitter,pungent,and slightly bitter.The top 3 of the distribution of return channels are the spleen,liver,and Stomach meridian is more common.The top 4 in the frequency of efficacy classification were tonic drugs,blood activating and removing blood stasis drugs,heatclearing drugs and qi regulating drugs.3.Statistical analysis of syndrome types:In this study,CAG is divided into 7 syndrome types.The weakened spleen and stomach(65 cases)are the most common,followed by the damp-heat type of the spleen and stomach(51 cases),the cold of the spleen and stomach(33 cases)is the least,and the liver and stomach qi are the least.There were 44 cases.42 cases,36 cases,and 35 cases of stagnation type,liver and stomach stagnation heat type,gastric collateral blood stasis type,and gastric yin deficiency type,respectively.The syndrome of stagnation of liver and stomach qi and damp-heat of the spleen and stomach are more common in young and middle-aged patients,and the syndrome of blood stasis in the stomach and collaterals is not seen.4.Systematic cluster analysis:Take the nine types of results of drugs with a frequency of more than 25 times(39 flavors in total)and extract the commonly used drug pairs:①Toxin pairs for strengthening the spleen and removing dampness,promoting blood circulation and removing blood stasis,and clearing blood stasis:licorice,astragalus,turmeric,white flower Oldenlandia diffusa,Atractylodes,Codonopsis,Panax notoginseng,Scutellaria barbata,Triangle,Coix seed,Leech,Shichangpu;②Yin-invigorating medicine pairs:Dendrobium,Taizishen,Salvia miltiorrhiza,Five-finger peach,Chinese yam;③Promoting muscle and relieving pain Medicine pair:cuttlefish.Baiji,Corydalis yanhusuo;④Relief liver and regulate qi,clear heat and remove dampness medicine pair:Bupleurum,Radix Paeoniae Rubra,Citrus aurantium,dandelion,Magnolia officinalis,Gardenia;⑤Disperse food and promote qi medicine pair:Amomum,Malt,dried tangerine peel,wood fragrance;⑥anti-blood medicine pairs:cat’s claw,Shenqu,Gallus gallus domesticus;⑦soothing and nourishing medicine:wild jujube seed;⑧anti-qi and anti-adverse medicine pairs:persimmon pedicle,ocher,coptis;⑨this Class drugs should not be a combination of drugs:Fructus Aurantii,Oryza sativa.5.Complex network analysis:The combination of drug pairs(excluding licorice)that appear more than 100 times in common are:Codonopsis,Astragalus,Atractylodes,Astragalus,Curcuma,Astragalus,Atractylodes.Codonopsis,Hedyotis diffusa,Zedoary,Hedyotis diffusa,Astragalus,Oldenlandia diffusa,Scutellaria barbata,Astragalus,Panax notoginseng,Oldenlandia diffusa,Panax notoginseng.Curcuma,Panax notoginseng,Codonopsis,Zedoaria,Atractylodes,Curcuma.6.Association rule analysis:use Apriori algorithm to model prescription drugs(with licorice removed),establish association rules with confidence greater than 90%and support greater than 15%as the benchmark,and combine the results of the maximum number of antecedents 2-5 to get the core drugs are Codonopsis,Atractylodes,Astragalus,Oldenlandia diffusa,Scutellaria barbata,Triangle,Curcuma,and Panax notoginseng.Except for the core drugs,common drug combinations include leech,Atractylodes macrocephala,Astragalus,Citrus aurantium,Radix Paeoniae Rubra,Bupleurum,Leech,Codonopsis,Astragalus.ConclusionProfessor Ge Yan believes that the pathogenesis of CAG is basically deficiency and blood stasis.Factors such as emotions,diet,and exogenous pathogens can cause liver depression and spleen deficiency,poor qi,water dampness,stagnation to reduce heat,and mutual dampness,heat,and stasis.Eventually lead to poison.The treatment should take dredging the liver and invigorating the spleen,promoting blood circulation to remove blood stasis,clearing heat and detoxification as methods.The core prescription drugs are Codonopsis,Atractylodes,Astragalus membranaceus,Rhizoma trifolium,Zedoary Rhizome,Panax notoginseng,Hedyotis diffusa,and Scutellaria semicolor.The prescription should be compatible with the certificate,and the application of insect drugs in blood stasis should be emphasized.At the same time,clarify the importance of mental conditioning,diet and daily routines in the CAG treatment process.