| Objective:The discovery of the rule of syndrome and treatment of Shang-xiao in TCM provides new ideas and basis for the clinical treatment of Shang-xiao.Methods:Through literature research methods,to comprehensively collected the implications,name evolution,etiology and pathogenesis,syndrome and treatment classification,clinical manifestations,treatment methods and prescriptions in ancient and modern Chinese medicine literature of Shang-xiao,and explored the academic ideas and research status of physicians in past dynasties on Shang-xiao through in-depth research on materials.Through collecting and sorting out the medical records and clinical studies of the ancient and modern treatment of Shang-xiao,collecting the basic information,symptoms,drugs,dosage forms and administration methods of patients recorded therein,standardizing the extracted data,importing them into Excel tables to establish a database,and using data mining technology and mathematical statistics methods to analyze the frequency,system clustering and association rules of drugs,In order to discover the law of syndrome and treatment of Shang-xiao prescription in ancient and modern times.Results:In this study,210 medical cases in ancient treatment,involving 84works of doctors and 88 medical cases in modern treatment,involving 77 works of doctors.The analysis results of the data are as follows:1.Symptom analysis results(1)Frequency analysis results.210 ancient medical records,with a total of 61 symptoms counted,and among these symptoms there are 27 high-frequency symptoms(n>3);116 symptoms were identified in 88 modern literature,and among these symptoms there are 50 high-frequency symptoms(n>3).The top 15 symptoms are as follows:Antiquity:Irritability,dry-mouthed,tongue red crack,polyuria,dry throat,oliguria,sensation of fullness in the chest,flushing,hunger with no desire to eat,urinary frequency,fatigue and lack of strength,fever,shortness of breath,emaciation.Modern:thirst with taking of fluids,red tongue,dry-mouthed,rapid pulse,yellow tongue fur,polyuria,constipation,fatigue and lack of strength,thin tongue fur,fine pulse,cough,Irritability,emaciation,fever,dry throat.(2)Correlation analysis results.The association rule analysis was carried out on the high frequency symptoms of the ancient and modern Shang-xiao,and the top 5 symptoms were ranked according to support as follows:Antiquity:thirst with taking of fluids+irritability,thirst with taking of fluids+dry-mouthed,thirst with taking of fluids+tongue red crack,red face+dry throat,thirst with taking of fluids+Polyuria.Modern:thirst with taking of fluids+rapid pulse,thirst with taking of fluids+yellow tongue,thirst with taking of fluids+Polyuria,thirst with taking of fluids+rapid pulse+dry-mouthed,thirst with taking of fluids+yellow tongue+red tongue.(3)Cluster analysis results.Hierarchical cluster analysis was carried out on the ancient and modern high frequency symptoms.The ancient high frequency symptoms were finally grouped into 8 categories,and the modern high frequency symptoms were finally grouped into 8 categories.The cluster results are as follows:(4)Antiquity:Clusterl:Cold waist and back,hypochondriac pain,Body and eye yellow,abdominal distention,Tongue hardnessand swelling and pain,Tooth numbness,fatigue and lack of strength,hunger without desire for food;Cluster2:cloudy urine,inhibited voidings of reddish urine;Cluster3:fever,red tongue;Cluster4:thirst with no desire to drink,polyuria;Cluster5:urinary frequency,tongue red crac,dry mouth;Cluster6:increased eating with rapid hungering,emaciation;Cluster7:thoracic fullness,shortness of breath,Irritability;Cluster8:dry throat,red face,coughing of phlegm.(5)Modern:Clusterl:spontaneous sweating and night sweat,palptation,shortness of breath and laziness to speak,vexing heat in the five hearts,fatigue and lack of strength,insomnia,coughing of phlegm,coughing of blood;Cluster2:tongue bearing dental impressions,deep pulse,tidal fever,headache,dizzy head and vision,enlarged tongue,white tongue fur,weak pulse;Cluster3:sticky phlegm,loss of appetite;Cluster4:stethalgia,thick yellow phlegm.slimy tongue fur,stringlike pulse;Cluster5:Irritability,fever with profuse sweating,flushed face;Cluster6:inhibited voidings of reddish urine,thirst with a liking for cool drinks,bitter taste in the mouth,bound stool,dry tongue fur,increased eating with rapid hungering;Cluster7:dry mouth,dry throat,rapid pulse,less fur or without fur,fine pulse,red tongue;Cluster8:red-tipped tongue,emaciation,polyuria,thirst with taking of fluids,thin yellow tongue fur,surging pulse,slippery pulse.2.Drug analysis results:(1)Frequency analysis results:Through frequency analysis of ancient and modern drugs for Shang-xiao,66 ancient high-frequency drugs(n>4)and 58 modern high-frequency drugs(n>3)were screened out.The top 15 drugs in frequency ranking are as follows:Antiquity:licorice,liriope,ginseng,trichosanthes root,anemarrhena,rehmanniae praeparatum,poria,kudzu,schisandra,gypsum fibrosum,coptis,membranaceus,skullcap,poria with hostwood,mix-fried licorice,amur corktree bark.Modern:liriope,rehmanniae praeparatum,anemarrhena,trichosanthes root,gypsum fibrosum,licorice,coptis,membranaceus,Chinese yam,kudzu,skullcap,scrophularia,pseudostellaria,asparagus,schisandra.Association analysis results:The association rules of high-frequency drugs used to treat Shang-xiao in ancient and modern times were analyzed,and the top 5 drugs were ranked according to their support,as follows:Antiquity:liriope+rehmanniae praeparatum+liriope,anemarrhena+gypsum fibrosum,licorice+anemarrhena+ginseng,ginseng+kudzu+liriop,licorice+membranaceus.Modern:liriope+rehmanniae praeparatum,rehmanniae praeparatum+membranaceus,liriope+membranaceus+rehmanniae praeparatum,liriope+trichosanthes root+rehmanniae praeparatum,anemarrhena+gypsum fibrosum+trichosanthes root.(3)Clustering analysis results:systematic Clustering analysis of high frequency drugs,including Cluster 1:safflower and peach kernel,Cluster 2:Stephania tetrandra,incised notopterygium;Cluster 3:forsythia,wood incense,ageratum;Cluster 4:turmeric,scorpion,piper cubeba,amomun kravanh,Angelica dahurica LanXiang leaf,Cluster 5:loquat leaves,Dendrobium,rhizoma alismatis;Cluster 6:bupleurum,rattletop,golden cypress,almond;Cluster 7:licorice,ginseng,lilyturf root,rhizoma anemarrhenae,radices rehmanniae,radices trichosanthis,the root of kudzu vine,chinensis,Poria,plaster,rhizoma coptidis,Astragalus,fushen,Scutellaria baicalensis;Cluster 8:kuh-seng,oyster.On modern of high frequency drugs,eventually gathered into 10 classes:Cluster 1:Metg kernel,Akebia quinata Decne,bamboo leaves,coix seed,pinellia,fructus aurantii,almond,Scutellaria baicalensis,Coptis,honeysuckle,forsythia;Cluster 2:Chuanxiong,radix bupleuri,the bulb of fritillary,platycodon grandiflorum,white peony root,Angelica;Cluster 3:pseudo-ginseng,the tuber of stemona,lily,the root of red-rooted salvia;Cluster 4:Ginseng,gardenia;Cluster 5:reed root,corn beard,lotus root juice,barbary wolfberry seed;Cluster 6:mulberry leaves,the rhizome of oriental water plantain;Cluster 7:red licorice,oyster;Cluster 8:Dendrobium,black plum,radices rehmanniae,ophiopogon,the root of straight ladybell,radix polygonati officinalis,radices trichosanthis,pueraria;Cluster 9:radix pseudostellariae,the fruit of Chinese magnoliavine,Atractylodes,Atractylodes,radix scrophulariae,fructus psoraleae,Semen Euryales,golden cypress,cypress,asparagus fern,winter,prepared rehmannia root,fructus corni,codonopsis,Poria,atractylodes,astragalus,Chinese yam;Cluster 10:gypsum,rhizoma anemarrhenae,licorice,ground bone skin.(4)Analysis of sexual taste:Analyze the nature and taste of high-frequency drugs used to treat Shangxiao in ancient and modern times,rank them according to the frequency of occurrence,and the analysis results are as follows:Antiquity:①Drug Property Analysis:cold(48.33%),warm(25.52%),flat(24.06%),cool(2.09%);②Taste analysis:Gan(43.08%),bitter(33.67%),Xin(12.20%),light(5.61%),acid(3.67%),salty(1.15%),astringent(0.62%);③Drug Meridian Analysis:lung(23.64%),heart(17.61%),stomach(17.40%),spleen(13.20%),kidney(12.66%),liver(7.36%),large intestine(4.39%),bladder(1.92%),bile(1.31%).Modern:① Drug Property Analysis:cold(60.98%),flat(20.67%),temperature(18.35%);②Taste analysis:Gan(43.08%),bitter(37.59%),Xin(10.89%),light(3.19%),acid(2.70%),salty(2.13%),astringent(0.41%);③Drug Meridian Analysis:lung(25.70%),stomach(14.23%),kidney(11.93%),liver(9.41%),large intestine(4.04%),bile(2.07%),bladder(1.24%),pericardium(0.69%).3.Dosage analysis:Through the frequency analysis of dosage forms used in ancient prescriptions,it was found that the frequency of dosage forms was mainly decoction was 143,accounting for68%of the total,followed by pills and powder,and the frequency was 37 and 20respectively,accounting for 28%of the total.Conclusion:Based on the ancient books of traditional Chinese medicine,by systematically combing the theoretical origin of Shang-xiao,and taking the ancient and modern medical records of traditional Chinese medicine for Shang-xiao as the entry point,the data mining method is used to study the disease name,syndrome classification and medication law of Shang-xiao,so as to find the syndrome and treatment law of traditional Chinese medicine for Shang-xiao,It provides a new idea and basis for clinical treatment of Shang-xiao.According to the principle of "prescription verification",combined with the statistical analysis results of ancient and modern treatment of Shang-xiao,it is concluded that Shang-xiao is characterized by "thirst and excessive drinking".Its main pathogenic factor is excessive heat.Phlegm dampness,body deficiency,exogenous and other pathogenic factors are also common.The main pathogenesis is lung dysfunction and abnormal body fluid metabolism caused by excessive heat in Shangjiao.Therefore,it is proposed to treat Shang-xiao with the method of Qing-xuan Run-fei,clear fire and nourish yin with cold medicine,intended to clear lung heat with cold,promote lung qi with Xin,and alleviate lung dryness with Gan..Through the discussion and analysis of the experience of ancient and modern physicians in treating Shang-xiao based on differentiation of symptoms and signs,this paper puts forward the diagnosis mode of combination of disease differentiation and syndrome differentiation,and the treatment idea of combination of special diseases,special prescriptions and special drugs. |
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