Analysis Of Professor Hong Minli Treating Chronic Obstructive Pulmonary Disease In Stable Phase Based On The Traditional Chinese Medicine Inheritance Support System

Objective: Based on the "Traditional Chinese Medicine Inheritance Assistance platform(V2.5)",this study analyzed and mined the medical records of Professor Hong Minli in the treatment of chronic obstructive pulmonary disease(COPD)in stable phase,explored the syndrome differentiation thinking and medication rules of Professor Hong Minli in the treatment of COPD in stable phase,and finally summarized her experience in the treatment of COPD in stable phase.Methods: The medical records of COPD in stable phase diagnosed and treated by Professor Hong Minli in the Department of Pulmonary Disease,Zhangzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine from December 2021 to February 2023 were collected.The clinical medical records that met the inclusion criteria and exclusion criteria were included in this study.The clinical medical records included in this study were standardized and entered into the "Traditional Chinese Medicine Inheritance Auxiliary Platform(V2.5)" to form the "medical record database" and "prescription database".The "statistical report" and "data analysis" were used for statistics and clustering.The basic information and Traditional Chinese Medicine(TCM)syndrome,symptoms,prescriptions and drugs of Master Hong’s treatment of COPD in stable phase were summarized to find out potential new prescription combinations.Then,Professor Hong Minli’s clinical experiences in the treatment of COPD in stable period were extracted.Results:1.Basic information,course of disease analysis: A total of 84 patients with COPD in stable phase were included in this study,with a total of 367 visits,including 74 male and 10 female patients.The ratio of male to female patients was 7.4:1.In terms of age of onset,patients were mainly aged 60-79 years old.The course of disease,more than 10 years patients accounted for 69.05% of the total;It was known that most of the patients with COPD in stable phase in Professor Hong Minli’s clinic were the elderly with a long course of disease.2.Four diagnostic information analysis: According to the analysis of the symptoms,tongue and pulse of 367 medical records,cough,shortness of breath and white sputum rank the top three,and the rest were a little amount sputum,chest tightness,sticky sputum,weak and sore loins and knees,dry mouth,fatigue and weakness,frequent urination at night,anorexia,etc.Among them,characteristics of expectoration were white sputum,sticky sputum,and a little amount sputum.Tongue nature were mainly light-reddish tongue,red tongue,dark red tongue.In addition to the normal tongue shape,tooth-marked tongue,bulgy tongue,thin tongue were also seen.The tongue fur were mostly white with thick in the middle,thin white and white thick,and the pulse were mainly sunken,deep and thready,string and slippery pulse.3.The TCM syndrome analysis: The TCM syndrome in this study included syndrome of lung and spleen qi deficiency,phlegm-dampness blocking in the lung;syndrome of lung and kidney Yin deficiency combined with phlegm turbidity retention;syndrome of lung and kidney Yang deficiency with retained water-fliud;phlegm-heat accumulating in the lung.Among them,the syndrome of lung and spleen qi deficiency,phlegm-dampness blocking in the lung,lung and kidney Yin deficiency combined with phlegm turbidity retention were the most common.4.Prescription analysis: In this study,there were 49 commonly used formulas for Dr.Hong,among which Liuwei Dihuang Wan,Liujunzi Decoction,Xiaochaihu Decoction,Jinshui Liujun Decoction,Buqi Jianpi Huatan Decoction and so on were frequently used;A total of 139 traditional Chinese medicines were involved,among which the frequency of use was more than 100 times,and the top 10 traditional Chinese medicines were: Poria Cocos,Rhizoma Pinelliae,Liquorice,White Atractylodes Rhizome,Pericarpium Citri Reticulatae,Dangshen,Radix Rehmanniae Praeparata,Fructus Corni,Rhizoma Dioscoreae,Radix Astragali;The catalogue of the drugs most belong to Tonic Drugs;Antiphlegm,Antitussive and antiasthmatic Drugs;Damp-clearing Drugs.The Chinese medicinal natures were mainly warm,followed by mild and cold.The Chinese medicinal flavors were mainly sweet,followed by spicy and bitter taste.5.New formula analysis: Based on the entropy hierarchical clustering algorithm,10 groups of new formula were evolved,which were:(1)Pericarpium Citri Reticulatae＿White Atractylodes Rhizome＿Poria Cocos＿Radix Rehmanniae Praeparata＿Cortex Moutan Radicis;(2)Radix Ophiopogonis＿Fructus Schisandrae＿Radix＿Rubiae＿Radix Ginseng;(3)Almond＿Herba Ephedrae＿Cortex Mori＿Magnolia Officinalis＿Gypsum Fibrosum＿Rhizoma Zingiberis;(4)Dangshen＿Radix Rehmanniae Praeparata＿Rhizoma Alismatis＿White Atractylodes Rhizome;(5)Angelica Sinensis＿Eucommia Ulmoides＿Semen Cuscutae＿Radix Astragali＿Radix Saposhnikoviae;(6)Angelica Sinensis＿Radix Astragali＿Semen Cuscutae＿Fructus Forsythiae＿Massa Medicata Fermentata＿Radix Saposhnikoviae(7)Fructus Alpiniae Oxyphyllae＿Radix Linderae＿Raspberry＿Os Draconis;(8)Radix Rehmanniae Praeparata＿Fructus Corni＿Cortex Moutan Radicis＿White Atractylodes Rhizome＿Rhizoma Dioscoreae＿Rhizoma Alismatis;(9)Radix Scutellariae＿Radix Bupleuri＿Radix Pseudostellariae＿Poria Cocos;(10)Licorice＿Rhizoma Pinelliae＿Rhizoma Alismatis＿Cortex Moutan Radicis＿Fructus Corni.Conclusion:1.According to the data of the medical records included in this study,it showed that COPD patients in stable stage tended to have a long course of disease and were older.In addition to the main symptoms of cough,expectoration and shortness of breath,and other systemic symptoms were chest tightness,waist and knee sore and weak,dry mouth,fatigue,frequent nocturnal urination,anorexia,etc.Combined with tongue and pulse signs,professor Hong believed that the main pathogenesis of COPD in stable stage were the Lung,spleen,kidney and other viscera function deficiency,mean while the accumulation of phlegm,rheum,heat and blood stasis.which led to lung qi obstructed and could not be accumulated and decreased,reflecting the pathogenesis characteristics of stable COPD with essential empty and out solid,mixture of deficiency and excess.2.In clinical practice,professor Hong payed attention to the collection of medical history,comprehensive analysis by the four examination methods,especially the inquiry.She kept close to the pathogenesis of COPD and treatment both of deficiency and excess.In the treatment,professor Hong mainly used sweet flavors and warm in nature of Chinese medicine herbs,followed by spicy and bitter flavors,mild and cold in nature.The cold and warm in nature of Chinese medicine herbs were used in the same time,tonification and purgation in combination.The spleen meridian and the lung meridian were the main meridians of drugs,followed by the stomach meridian,the heart meridian and the kidney meridian.This reflected that professor Hong’s treatment of COPD in the stable phase mainly focused on tonifying deficiency,being good at treating from the spleen,reinforcing earth to generate metal and also paying attention to tonifying the lung and the kidney,taking into consideration phlegm,rheum,heat and blood stasis,total for combining essential empty and out solid,adjusting the origin and superficiality.and paying attention to regulating qi activity at the same time.