Analysis Of Syndrome And Treatment Rules Of Traditional Chinese Medicine Aphtha Based On Data Mining

Objective:Traditional Chinese medicine has rich experience in the treatment of aphtha and has remarkable curative effect,but modern Chinese medicine has no clear standard for its syndrome classification and clinical drug use,and the curative effect is uneven.In order to summarize its treatment experience and medication law,this study starts with TCM aphtha medical records through data mining technology,and studies the syndrome distribution,symptom and sign distribution,drug type distribution and drug combination distribution included in clinical medical records.Excavate its syndrome and treatment characteristics,summarize its inherent rules,and finally provide ideas and reference for clinical treatment,has a certain theoretical and clinical significance.Method:1.Medical record collection:using computer technology,log in to China knowledge Network,VIP Chinese Sci-tech periodical full-text Database and Wanfang data knowledge Service platform,and search the topic,title or key words as "Aphthous ulcer" OR "stomatitis" OR "recurrent oral ulcer"OR "mouth ulcers"AND("traditional Chinese medicine"OR "empirical prescription" OR "check the case" OR "academic thought").The search time range was set to 2013.01.012022.13.31,to find all the literature on the diagnosis and treatment of aphtha,and select and include the obtained literature according to the inclusion and exclusion criteria.2.Data mining:input the original medical record information into the Excel table,standardize the drug name,syndrome type,symptom and sign,establish the TCM oral ulcer medical record database,include the patient’s general information,syndrome,physical sign and prescription medication,analyze the medical record information through the traditional Chinese medicine data mining technology,and use the general statistical description to analyze the difference of the patient’s age,sex and onset time.The distribution of high frequency syndrome and symptoms and signs were analyzed,and the use frequency,efficacy attribute and odor meridian of single medicine were classified and statistically.Combined with hierarchical cluster analysis,association rule analysis,complex network analysis and other methods to summarize the compatibility of high-frequency traditional Chinese medicine,core prescriptions and other drugs to achieve the screening of efficient prescriptions.Results:A total of 117 articles were included,including 193 medical records,222 consultations and 222 prescriptions of traditional Chinese medicine.The following are the results of data mining.1.General data mining results of aphtha patients:among the 193 medical records included,there were 76 male patients,accounting for 39.38%,and 117 female patients,accounting for 60.62%.The incidence rate of female was higher than that of male.The age span of the patients is large,the youngest is 2 years old,the largest is 84 years old,and can be affected in all age groups.The sick people mainly concentrated in the range of 30 to 60 years old,and reached the peak at the age of 30 to 40 years old.aphtha can occur all the year round,among which the disease is most likely to be induced in spring and summer.2.Mining results of symptoms:A total of 16 high-frequency symptoms with a frequency of more than 10%were extracted from the medical records of aphtha.They were divided into 4 categories:pain,dry mouth,insomnia,fatigue,lack of appetite,constipation,loose stool,irritability,short yellow urination,bitter mouth,abdominal distension and fullness,bad breath,soft waist and knees,fear of cold,restlessness,difficulty in eating,and fidgeting.In the distribution of tongue quality,the frequency of red tongue was the highest,accounting for 60.45%,followed by light red tongue(17.73%),dark tongue(15.45%),fat tongue(15.45%),light tongue(15.00%)and toothed tongue(10.91%).The description of the moss elephant in the medical case focuses on the aspects of moss color,greasy,how much,dryness,etc.,such as white moss(41.55%),yellow moss(41.55%),thin moss(38.26%),thin moss(31.51%).There are a total of 17 kinds of pulse in medical records,the proportion of veinlets is the highest,reaching 53.24%,followed by number pulse(34.72%),string pulse(33.33%),sunken pulse(32.41%),slippery pulse(19.44%),weak pulse(14.81%).3.Mining results of aphtha syndrome:the top 10 aphtha syndromes are yin deficiency and fire syndrome(22.52%),spleen and kidney yang deficiency syndrome(15.77%),spleen deficiency and dampness stagnation syndrome(8.11%),heart and spleen heat accumulation syndrome(8.11%),liver depression and cremation syndrome(7.66%),spleen deficiency and volt fire syndrome(7.66%),dampness and heat trapped spleen syndrome(6.31%),qi and yin deficiency syndrome(4.25%),stomach heat blazing syndrome(2.25%),Liver depression and spleen deficiency syndrome(1.80%).4.Mining results of clinical drug use(1)Frequency analysis:273 flavors were used,and the drugs used more than 50 times were licorice,Coptis chinensis,Radix Rehmanniae,Poria,Ophiopogon,Atractylodes macrocephala,Scutellaria baicalensis,Radix angelicae Sinensis,Cortex Phellodendri,Radix Codonopsis,Radix Astragali and Cortex moutan.According to the analysis of the attributes of 273 drugs,they were divided into 18 categories.Heat-clearing drugs,deficiency-tonifying drugs,surface-relieving drugs and diuretic drugs were used frequently.From the point of view of nature and taste,the drugs were mainly cold,flat,warm,sweet,bitter and pungent,and the drugs were mainly lung,spleen,stomach,liver,heart and kidney.(2)Cluster analysis:based on the cluster analysis of 30 kinds of drugs with frequency>30,8 cluster combinations were obtained:C1:licorice,Ophiopogon,Radix Rehmanniae;C2:Coptis chinensis,Radix Scutellariae,Pinellia ternata,dried ginger and licorice;C3:Poria,Codonopsis pilosula,Atractylodes macrocephala,Radix Astragali,licorice;C4:Angelica sinensis,cohosh,white peony,Bupleurum,tangerine peel,licorice;C5:Amomum,Cortex Phellodendri,Cinnamomum,aconite,Achyranthes bidentata,Radix Achyranthis,Radix Rehmanniae;C6:Cortex moutan,Rhizoma Anemarrhenae,Gypsum.C7:Chinese yam,Coix seed;C8:forsythia,gardenia,Radix scrophulariae.(3)Correlation analysis:a total of 36 pairs of drugs were obtained,among which the top 10 pairs with strong correlation were Amomum-Phellodendron;gypsum-Anemarrhena;tangerine peel-licorice;Pinellia-Coptis;tangerine peel-Atractylodes macrocephala;Radix scrophulariae-Ophiopogon;aconite-licorice;Cortex moutan-Radix Rehmanniae;Atractylodes macrocephala-Poria;dried ginger-Coptis chinensis.(4)Complex network analysis:based on the complex network analysis of 273 drugs,it was found that the core prescriptions of aphtha were licorice,Coptis,Radix Rehmanniae,Scutellaria baicalensis,Cortex moutan,Poria,Ophiopogon,Angelica,Pinellia,Atractylodes,Radix Astragali,Codonopsis pilosula,plaster,Anemarrhena,Bupleurum and Cimicifu.a total of 18 drugs.Conclusion:1.Epidemiological characteristics of aphtha:the sex ratio of male to female patients was 1.54.This is basically consistent with the reports on the prevalence of aphtha in men and women in the relevant literature,suggesting that women may be more likely to suffer from aphtha.The disease can occur in all age groups,included in the medical records,more middle-aged patients,followed by elderly patients and children patients,suggesting that aphtha may be high in middle-aged and children.From the perspective of seasonal factors,it can occur all the year round,but the incidence of patients is higher in spring and summer.2.Symptomatic characteristics:from the point of view of symptom distribution,aphthous ulcer takes pain at the affected site as its primary symptom,in addition,according to the difference of etiology and pathogenesis in clinic.It is also often accompanied by eating disorders(lack of appetite,abdominal distension and fullness,difficulty in eating,bad breath and bitterness),dysuria(dry constipation,loose stools,short yellow urine),abnormal mood(irritability,restlessness),limb discomfort(softness of waist and knees,fear of cold,fidgeting heat)and other local or systemic symptoms.Although the symptoms of patients with aphtha are similar,but the pathogenesis is different,clinical diagnosis and treatment should be examined as a whole,through the comprehensive study of tongue,pulse and symptoms,can not be treated because of symptoms,so as to avoid mistreatment.3.Syndrome distribution:from the perspective of deficiency and excess,the causes of syndrome extracted are mostly yin deficiency,yang deficiency,qi and yin deficiency and other factors leading to the floating of fire,lack of fluid,burning mouth and tongue,erosion and sores.Deficiency aphtha is more common than positive aphtha in the included patients.At present,the syndrome of aphtha is complicated,and the classification standard is not unified.in most cases,it is classified according to the doctor’s own experience and the clinical manifestations of patients.in the naming,a variety of syndrome names can appear in the same pathogenesis,such as yin deficiency fire,kidney deficiency fire,yin deficiency fire floating and so on.Although the essence is the same,it is not conducive to the analysis and study of clinical data.At the same time,the syndrome of liver depression and fire does not belong to the common syndrome type in previous research,but accounts for a relatively high proportion in this study,which may be related to the current situation of great social pressure and high incidence of emotional diseases,liver depression and fire type of oral sores.it is often accompanied by irritability,dry mouth,distension pain,fullness and insomnia,which is more common in women or patients with serious emotional problems,which should be paid attention to.