A Comparative Study On The Patterns Of Medicine Used In The Treatment Of Spleen And Stomach Diseases By Medical Practitioners Representing The Hezhi School And The Yishui School During The Jin-Yuan Period

Objective:This book is a systematic collection of medical cases and prescriptions on the treatment of spleen and stomach diseases by medical practitioners of the Hejian School and the Yishui School during the Jin and Yuan dynasties,and uses data mining techniques to explore the characteristics of the medicine used by the two schools of medicine in treating spleen and stomach diseases and the rules of compounding.Methods:The nine works of Liu Wansu,Zhang Congzheng and Zhu Zhenheng,the representative doctors of the Jin-Yuan period of the Hejian school,and the nine works of Zhang Yuansu,Li Gao,Wang Haogu and Luo Tianyi,the representative doctors of the Jin-Yuan period of the Yishui school,were selected and the prescriptions for the treatment of seven diseases of the spleen and stomach(stomach pain,fullness,vomiting,abdominal pain,diarrhoea,dysentery and constipation)were extracted from their works,and the names of the diseases,prescriptions,decoction methods and drug combinations were recorded.The prescription databases of the two schools of medicine were established separately.The prescriptions were analysed using Microsoft Excel software for frequency,four qi,five tastes,attribution and efficacy,and IBM SPSS Modeler 18.0 and SPSS Statistics 25.0 software for correlation rules,cluster analysis and factor analysis.The results of the analysis were used to explore the patterns of medication used in the treatment of spleen and stomach diseases by the Hejian school and the Yishui school,and to summarize the empirical ideas of the two schools of thought.Results:1.244 prescriptions for the treatment of diseases of the spleen and stomach,including 24 for stomach pain,25 for abdominal pain,54 for diarrhoea,19 for fullness,24 for vomiting,80 for dysentery and 18 for constipation,were compiled and collected from healers representing the Jin-Yuan Hejian school;226 prescriptions for the treatment of diseases of the spleen and stomach,including 10 for stomach pain,38 for abdominal pain,28 for diarrhoea,37 for fullness,38 for vomiting,39 for dysentery and 36 for constipation,were compiled and collected from healers representing the Yi Shui school.36 for constipation.2.Treatment of diseases of the spleen and stomach by the representatives of the Hejian school:244 prescriptions were recorded,involving 186 drugs,22 of which were used more than 20 times,in descending order:Atractylodes macrocephala,Glycyrrhiza glabra,Chen Pi,Poria,Paeonia lactiflora,Radix et Rhizoma pinnatifida,Radix Angelicae Sinensis,Radix et Rhizoma ginseng,Mu Xiang,Rhubarb,Radix et Rhizoma ginger,Radix et Rhizoma Huanglian,Radix et Rhizoma caozhi,Atractylodes macrocephala,Hou Pu,Cinnamon,Betel nut,Slippery Rock,Radix et Rhizoma ginger,Scutellariae scutellariae,Radix et Rhizoma lucidum,Radix et Rhizoma marimo.Among them,Atractylodes macrocephala was used most frequently,with 72 times.The results of the taste and ascription of drugs show that the four gases are dominated by warming drugs,which are used the most frequently at 716 times,followed by cold drugs at 359 times,flat drugs at 229 times,hot drugs at 125 times and cool drugs at the least frequently at 7 times.The five flavours are mainly bitter and pungent,used 745 and 729 times respectively;the drug’s meridians are mainly the spleen and stomach meridians,followed by the lung and liver meridians.The top 5 drugs in terms of efficacy were deficiency tonics,qi tonics,heat tonics,heat tonics and dampness tonics,with deficiency tonics being the most frequently used,with 342 times.The drug association rule analysis yielded 11 results,and the top 5 drug combinations with strong associations were Poria and Atractylodes macrocephala,Angelica and Paeonia,Atractylodes and Paeonia,Atractylodes and Ginseng,and Betel nut and Mu Xiang.Cluster analysis yielded 5 sets of clustering results and factor analysis yielded 9 common factors.3.A total of 226 prescriptions,involving 150 drugs,were recorded for the treatment of diseases of the spleen and stomach,and 27 drugs were used more frequently than 20 times,In descending order,they are Chen Pi,Roasted Licorice,Ginseng,Atractylodes Macrocephala,Ginger,Radix Angelicae Sinensis,Radix et Rhizoma Glycyrrhizae,Cinnamon,Radix et Rhizoma,Poria,Muxiang,Chai Hu,Bai Shao,Da Huang,Scutellaria,Hou Pu,Radix et Rhizoma,Huang Lian,Atractylodes Macrocephala,Qing Pi,Citrus Aurantium,Scutellaria,Liu Shen Qu,Herba Cardamom,Clove and Ginger,with Chen Pi being used most frequently,up to 79 times.The results of the taste and ascription of drugs show that the four gases are dominated by warming drugs,which are used the most frequently at 876 times,followed by cold drugs at 320 times,flat drugs at 224 times,hot drugs at 190 times and cool drugs at a minimum of 6 times.The five flavours are predominantly pungent and bitter and are used 887 and 745 times respectively.The main channels of the drug are the spleen and stomach channels,followed by the lung and heart channels.The top 5 drugs in terms of efficacy were deficiency tonics,qi tonics,warming herbs,relieving the symptoms and clearing heat,with deficiency tonics being used the most frequently,451 times.The drug association rule analysis yielded 20 results,and the top 5 drug combinations with strong associations were Ginseng and Roasted Licorice,Atractylodes and Ginseng,Roasted Licorice and Angelica,Roasted Licorice and Atractylodes+Ginseng,and Huangqi and Shengma.Cluster analysis yielded 6 sets of clustering results and factor analysis yielded 10 common factors.Conclusion:1.The Hejian school is centred on the elaboration of the fire-heat disease mechanism,and its representatives treat spleen and stomach diseases mostly from the two spleen and stomach organs,taking into account the lung,liver,pungent and kidney organs.Most of the medicines used in the formula are for tonifying deficiency,regulating qi,clearing heat,warming the lining,inducing diuresis and diuresis,the use of hard,sweet and warm medicines is advocated.On the basis of tonifying the qi of the spleen and stomach and harmonizing the qi of the spleen and stomach,the heat theory is mostly used to treat spleen and stomach disorders,and the method of clearing heat and dipping fire is also an important rule of treatment.2.The Yi Shui school focuses on the study of the internal organs,and its representatives focus on the two organs of the spleen and stomach,taking into account the lungs,heart,kidneys,liver and other internal organs.Most of the medicines used in the formula are for nourishing deficiency,regulating qi,warming the lining,relieving symptoms,clearing heat and resolving dampness,the treatment is based on the principles of benefiting qi and strengthening the spleen,regulating qi and drying dampness,and caring for the spleen and stomach,and is used in conjunction with the methods of warming,opening,tonifying and drying dampness.3.The Hejian School and the Yishui School have their own distinctive features in the treatment of spleen and stomach diseases,while reflecting the holistic approach to prescriptions and medicines of the schools.However,both schools of thought attached great importance to the spleen and stomach,and were adept at using medicines to regulate them.This is a great reference for future clinical use.