Research On The Law Of Medication In The Treatment Of Insomnia Based On Data Mining Analysis Of Medical Records In Ming And Qing Dynasties

Objective: By collecting and sorting out the medical records of insomnia treated by physicians in the Ming and Qing Dynasties,and using the method of data mining,this study analyzed the law of syndrome differentiation and medication of insomnia treated by physicians in the Ming and Qing Dynasties,in order to provide reference for the treatment of insomnia with traditional Chinese medicine.Methods: The medical records of the fifth edition of the Chinese Medical Code were selected as the retrieval data,and the information such as the doctor’s name,Dynasty,literature source,patient’s name,sex,age,symptom,tongue,pulse,syndrome elements of disease location,syndrome elements of disease nature and composition of traditional Chinese medicine were input into the Excel table,and each information point was standardized according to the corresponding standards of traditional Chinese medicine.Establish the database of medical cases of insomnia in Ming and Qing Dynasties.The software Excel,SPSS 25.0 and SPSS Modeler 18.0 were used to statistically analyze the distribution of symptoms,syndrome elements,tongue and pulse,and to explore the potential association between symptoms,syndrome elements and traditional Chinese medicine.Result:1.Collection of medical records: a total of 235 medical records of insomnia in the Ming and Qing Dynasties were obtained,from 66 ancient books of the Ming and Qing Dynasties,a total of 60 physicians.2.Symptom analysis: Frequency analysis: 132 kinds of symptoms were involved in all 235 medical records,and 722 symptoms occurred accumulatively.There were 26 kinds of high frequency symptoms,with a cumulative frequency of 76.73%,including insomnia,palpitation,vexation,loss of appetite,abdominal distension,dizziness,pale mouth,fright,constipation,fatigue,loose stool,cough,noisy,chest tightness,nausea,tinnitus,vomiting,emaciation,spermatorrhea,abdominal distension,dreaminess,spontaneous perspiration,belching,shortness of breath,fever and asthma.Cluster analysis: Three groups of results were obtained by cluster analysis of high-frequency symptoms:(1)pale mouth,fever,loose stool,chest distress,vomiting,abdominal distension,cough,abdominal distension,belching,constipation,asthma,fatigue,shortness of breath,inappetence,emaciation and insomnia;(2)fright,spontaneous perspiration and vexation;(3)palpitation,dizziness,noise,nausea,spermatorrhea,dreaminess and tinnitus.Association rules: By analyzing the association rules of the symptoms except insomnia,it was found that palpitation,vexation,loss of appetite,abdominal distension and light mouth were closely related.3.Analysis of tongue and pulse: Frequency analysis of tongue picture:Only 32 medical records recorded 16 kinds of tongue pictures,with a total frequency of 45.High-frequency tongue pictures included pale tongue,greasy tongue coating,red tongue and thick tongue coating.A total of 106 medical records recorded pulse conditions,a total of 24 kinds of pulse conditions,the total frequency of 222 times.High-frequency pulse conditions include thin pulse,rapid pulse,slippery pulse,wiry pulse and weak pulse.4.The result of syndrome element analysis: Frequency analysis: There were 215 syndrome elements of disease location in 235 medical records,13 kinds of syndrome elements of disease location were extracted,the total frequency was 412 times,and the high-frequency syndrome elements were heart,spleen,kidney,liver and stomach.The disease nature syndrome elements were recorded in 210 medical records in 235 medical records,and 22 kinds of disease nature syndrome elements were extracted,the total frequency was 376 times,and the high frequency disease nature syndromes elements were yin deficiency,phlegm,qi deficiency,fire and qi stagnation.Association rules: Through the association analysis of disease location and disease nature,it was found that the heart was closely related to blood deficiency,fire,phlegm,dampness,yin deficiency and Yang deficiency.Spleen is closely related to dampness,qi deficiency,phlegm,yin deficiency and qi stagnation.Kidney is closely related to essence deficiency,qi deficiency,yin deficiency and Yang deficiency.Liver is closely related to qi stagnation,fire,yin deficiency,wind and adverse flow of qi.Stomach is closely related to qi deficiency,phlegm,qi stagnation,fire and adverse flow of qi.5.Medication analysis: Frequency analysis: 235 medical records included 265 kinds of traditional Chinese medicine,the cumulative frequency of use was 2254 times,and there were 25 kinds of high-frequency traditional Chinese medicine.Comprises spina date seed,Poria with hostwood,liquorice,Pinellia tuber,tuckahoe,thinleaf milkwort root-bark,tangerine peel,Chinese angelica,bamboo shavings,dwarf lilyturf tuber,Radix Rehmanniae Preparata,ginseng,golden thread,dried rehmannia root,immature bitter orange,ginger,Chinese date,largehead Atractylodes rhizome,membranous milkvetch root,husked millet,dens draconis,tree peony bark,platycladi.Classification of efficacy of traditional Chinese medicines: all 265 kinds of traditional Chinese medicines,a total of 20 categories.Comprises tonifying medicine,tranquilizing medicine,heat-clearing medicine,phlegm-resolving and cough-relieving medicine,diuretic and dampness-eliminating medicine,qi-regulating medicine,exterior-relieving medicine,liver-calming and wind-calming medicine,astringent medicine,blood-activating and stasis-resolving medicine,dampness-resolving medicine,interior-warming medicine,digestion-promoting medicine,resuscitation-inducing drug,purgative drug,wind-dampness-dispelling drug,hemostatic drug,toxin-removing and necrosis-removing and muscle.Four qi,five flavors,and channel tropism: the four qi are both cold and warm,the five flavors are mainly sweet,supplemented by bitter and pungent,and the channel tropism is mainly the heart meridian.Cluster analysis: The high-frequency traditional Chinese medicines were divided into four groups: T1: Rhizoma Zingiberis Recens,Fructus Jujubae,Radix Glycyrrhizae,Rhizoma Atractylodis Macrocephalae,Radix Astragali,Radix Angelicae Sinensis,Radix Ginseng,Radix Polygalae,and Arillus Longan;T2: Poria,Cortex Moutan,and Radix Rehmanniae Preparata;T3: Rhizoma Pinelliae,Semen Sorbi Chinensis,Caulis Bambusae In Taenia,Fructus Aurantii T4: Rhizoma Coptidis,concha Haliotidis,Radix Ophiopogonis,Radix Rehmanniae,semen Ziziphi Spinosae,Poria,dens Draconis,and semen Platycladi.Association rules: Through the association analysis of traditional Chinese medicine,it can be found that the relationship between Semen Ziziphi Spinosae,Radix Polygalae,Radix Angelicae Sinensis,Poria,Poria,Radix Glycyrrhizae,Caulis Bambusae in Taenia,Rhizoma Pinelliae and Pericarpium Citri Reticulatae is relatively close.6.Association rule between symptoms,syndrome elements and TCM:TCM → symptom association: TCM associated with palpitation includes Colla Corii Asini,Concha Ostreae,Semen Nelumbinis,Semen Ziziphi Spinosae,Radix Polygalae,Rhizoma Alismatis,Rhizoma Coptidis,Semen Platycladi,Radix Panacis Quinquefolii,Poria,Radix Salviae Miltiorrhizae,Rhizoma Pinelliae,and Caulis Bambusae in Taenia;Traditional Chinese medicines associated with vexation include Rhizoma Polygonati,Radix Asparagi,Carapax et Plastrum Testudinis,Radix Rehmanniae Preparata,and Poria;Traditional Chinese medicines associated with inappetence include Rhizoma Cimicifugae,Radix Bupleuri,and Radix Astragali;Traditional Chinese medicines associated with fatigue include yam and Ophiopogon root;Traditional Chinese medicines associated with chest distress include Fructus Aurantii and Radix Scutellariae;The traditional Chinese medicine associated with the big constipation comprises white peony root,Chinese yam,medlar,rhubarb and immature bitter orange;Traditional Chinese medicines associated with thirst include japonica rice,gypsum,Rhizoma anemarrhenae,lophatherum gracile,and licorice.Symptoms → Traditional Chinese Medicine Association: Symptoms associated with Semen Ziziphi Spinosae include fright,vexation,dizziness,palpitation,and loss of appetite;Symptoms associated with Poria include irritability,chest pain,delirium,sore throat,weight loss,loss of appetite,spontaneous sweating,and palpitation.Symptoms associated with licorice include fever,thirst,and fear;Symptoms associated with Rhizoma Pinelliae,Poria,Pericarpium Citri Reticulatae,Caulis Bambusae In Taenia,Fructus Aurantii Immaturus,Fructus Jujubae,Rhizoma Zingiberis Recens,and Radix Glycyrrhizae include phobia;Symptoms associated with Caulis Bambusae in Taenia include phobia and delirium;Symptoms associated with white peony include hypochondriac pain;Symptoms associated with Radix Ophiopogonis and Radix Rehmanniae include sore throat;Symptoms associated with Coptis include delirium and hypochondriac pain.Traditional Chinese medicines associated with Radix Rehmanniae Preparata include good suspicion,good surprise,and lumbago;Symptoms associated with Fructus Aurantii and Radix Scutellariae include chest tightness and thirst;Symptoms associated with Eucommia include low back pain;Traditional Chinese medicines associated with Radix Scutellariae and Radix Bupleuri include fever and thirst;Symptoms associated with Astragalus include spontaneous sweating and palpitations.The association rules between syndrome elements of disease location and traditional Chinese medicines: the traditional Chinese medicines associated with heart include lotus seed,Poria cocos,longan pulp,Coptis root,Ophiopogon root,etc.Traditional Chinese medicines associated with the spleen include Atractylodes macrocephala,Coptis chinensis,Pericarpium Citri Reticulatae,Arillus longan,Poria cocos,etc.The traditional Chinese medicines related to kidney include yam,asparagus,prepared rehmannia root,flatstem milkvetch seed,oriental waterplantain rhizome,etc.Traditional Chinese medicines associated with liver include Tribulus terrestris,Fructus Ligustri Lucidi,Concha Margaritifera,Dens Draconis,Rhizoma Pinelliae,etc.Traditional Chinese medicines associated with the stomach include Dendrobium,Pinellia,Fructus Aurantii,Pericarpium Citri Reticulatae,and Rhizoma Anemarrhenae.The association rules between the syndrome elements of disease nature and the traditional Chinese medicines: the traditional Chinese medicines associated with yin deficiency include turtle shell,donkey-hide gelatin,tortoise shell,dogwood,Schisandra fruit,etc.Traditional Chinese medicines associated with phlegm include tabasheer,Poria with hostwood,exocarpium citri rubrum,ginger,and Arisaema cum bile;Traditional Chinese medicines associated with qi deficiency include Atractylodes macrocephala,Ophiopogon japonicus,Cimicifuga foetida,Ginseng,Codonopsis pilosula,etc.The traditional Chinese medicines associated with fire include Uncaria rhynchophylla,tabasheer,Arisaema cum Bile,Gardenia jasminoides Ellis,Exocarpium Citri Reticulatae,etc.Traditional Chinese medicines associated with qi stagnation include Fructus Toosendan,Semen Ziziphi Spinosae,Rhizoma Cyperi,Radix Paeoniae Alba,Poria,etc.Traditional Chinese medicines associated with heat include gypsum,Rhizoma anemarrhenae,Radix Scutellariae,Radix Paeoniae alba,semen sojae praeparatum,etc.Conclusion: Based on the statistical analysis of 235 cases of insomnia in Ming and Qing Dynasties,the characteristics of insomnia in Ming and Qing Dynasties are as follows:(1)The pathogenesis mainly includes deficiency of spleen and stomach qi,deficiency of heart and gallbladder qi,disharmony between heart and kidney,etc.,mainly due to dysfunction of viscera,accompanied by disorder of qi and blood.(2)The location of disease mainly includes heart,spleen,kidney,liver,stomach and so on,mainly the five viscera,which is most closely related to the heart.(3)The disease mainly includes yin deficiency,phlegm,qi deficiency,fire,qi stagnation,etc.,and the deficiency and excess are mixed,with yin deficiency as the primary cause.(4)The medication is mainly to tonify deficiency and tranquilize the mind,clear heat and resolve phlegm;It is also used to promote diuresis and eliminate dampness,regulate qi and remove depression.