The Research Of Medicine Experience Of Professor Shui Diankui Treating Gastric Precancerous Lesions Based On Data Mining

Objective: Through data mining technology,this paper analyzes professor Shui I Diankui’s experience in the treatment of gastric precancerous lesions and the core prescription,in order to inherit and develop his tutor’s thought and academic experience of syndrome differentiation and treatment,and provide experience reference for the treatment of spleen and stomach diseases by traditional Chinese medicine.Methods: By collecting the clinical medical records of patients with precancerous lesions of gastric cancer who met the inclusion criteria for outpatient diagnosis and treatment by Professor Shui Diankui from January 2021 to December 2022,the case data information meeting the inclusion criteria were uniformly entered into Microsoft Office Excel tables to establish a case data information database.The use of "traditional Chinese medicine inheritance support system(V3.0)" software to conduct statistical analysis on the four properties,five flavors,meridian tropism,drug category and efficacy of drugs,summarize the core drugs and commonly used drugs of Professor Shui Diankui in treating PLGC,obtain the internal relations among traditional Chinese medicines by using the data analysis and mining methods such as association rule analysis and cluster analysis built in the software,explore the matching relationship among drugs,and analyze and summarize the medication rules and academic thoughts of Professor Shui Diankui in treating precancerous lesions of gastric cancer.Results:1.Basic information: Among the 268 medical records collected,109 were male and 159 were female,with the ratio of male to female being1:1.46.The age range was 19-88 years,with an average age of 50.83 years.The patients aged 41-60 years were the most,accounting for 57.5% of the total.The patients with different pathological degrees were mostly aged 41-60 years old,and the total proportion of mild,moderate and severe pathology was 58.4%,46.8% and 83.3% respectively.The most common pathological degree was mild,accounting for 77.99%.2.Frequency statistics of clinical symptoms and syndromes:In this study,there were 52 symptoms.Among the symptoms with frequency ≥ 10%,it can be seen that the symptoms of digestive system are:epigastric distending pain(48.13%),epigastric dull pain(20.90%),epigastric fullness(15.30%),loose stool(33.96%),constipation(11.57%),heartburn(21.27%),acid regurgitation(17.91%)and belching(12.31%).Clinical symptoms that present as systemic manifestations include:fatigue(51.12%),dry mouth(36.19%),bitter taste in the mouth(30.22%),cold body and limbs(33.21%),insomnia(29.10%).There was no significant correlation between clinical symptoms and endoscopic findings or histopathological grading of gastric mucosa.According to the classification of TCM syndrome types,the most common syndrome is spleen and stomach deficiency,followed by spleen deficiency and qi stagnation syndrome,with dampness,heat,blood stasis and phlegm.From the pathological point of view,it is also based on the spleen and stomach deficiency syndrome,but there is a certain emphasis on the syndrome.3.Medication analysis:In this study,268 prescriptions were included,involving 178 kinds of traditional Chinese medicines.The drugs with cumulative frequency of more than 134 were Poria cocos,Pericarpium Citri Reticulatae,Fructus Amomi,Cortex Magnoliae Officinalis,Rhizoma Pinelliae,Rhizoma Atractylodis,Rhizoma Atractylodis Macrocephalae,Radix Glycyrrhizae,Herba Agastaches and Codonopsis pilosula.The most common drugs were warm,pungent and sweet.The 178 kinds of traditional Chinese medicines were classified into 17 categories according to their efficacy.The top 5 categories were tonifying deficiency,eliminating dampness,regulating qi,resolving phlegm,relieving cough and asthma,and relieving exterior syndrome.4.By using the association rules and cluster analysis provided by the data analysis section of TCM inheritance auxiliary platform,when the support degree is set to 70% and the confidence degree is set to 1,there are 5 core traditional Chinese medicines in the prescription,26 pairs of core combinations of medicines and 3 core prescriptions by cluster analysis.According to the analysis of the prescription of high frequency drugs and different syndrome types and different pathological degrees,it was found that the prescription rule of precancerous lesions of gastric cancer was based on Sijunzi Decoction,according to the different clinical symptoms,combined with drugs for promoting blood circulation and removing blood stasis,such as Chuanxiong,Angelica sinensis,Zanthoxylum nitidum,Salvia miltiorrhiza;qi-regulating herbs such as Pericarpium Citri Reticulatae,Rhizoma Pinelliae,Radix Et Rhizoma Nardostachyos,and Radix Aucklandiae;yin nourishing herbs such as Radix Ophiopogonis,Fructus Schisandrae Chinensis,and Herba Dendrobii;interior-warming herb such as radix Aconiti lateralis Preparata,rhizoma Zingiberis Preparata,fructus Evodiae;Yang tonifying herbs,such as Fructus Alpiniae Oxyphyllae,Semen Cuscutae,Rhizoma Curculiginis,and Fructus Psoraleae.Conclusion(s):1.Professor Shui Diankui believes that the location of precancerous lesions of gastric cancer is in the stomach,closely related to the spleen,liver and kidney."Spleen and stomach weakness" is the basic pathogenesis and the core pathogenesis throughout the disease.2.Professor Shui Diankui,based on the theory of "Qi circulating," started from the pathogenic mechanism of "spleen deficiency,toxin invasion and blood stasis," modified the formula based on Lizhong Tongluo Huazhuo Decoction,and treated it mainly by strengthening the middle and earth and re-transportation and transformation.In the early stage of gastric precancerous lesions,the qi of the spleen and stomach is consumed,the dampness is accumulated inside,and the middle yang is damaged,so he focuses on warming the middle and dampness.In the middle stage of the disease,qi stagnation due to spleen deficiency,yin injury due to pathogenic heat,internal accumulation of cold and dampness,and phlegm retention caused by toxic invasion of "qi,dampness,heat and phlegm" are mixed with various pathogenic factors.It is mainly used to treat the symptoms such as invigorating spleen,clearing heat,eliminating dampness and resolving phlegm.In the later stage of the disease,the spleen and stomach are weak and the blood is astringent and stagnant,so as to focus on tonifying qi,dredging collaterals,promoting blood circulation and removing blood stasis.