| OBJECTIVE:This study used a combination of literature research and data mining methods to sort out the ancient Chinese classical medical texts and medical scholars on the name,classification,etiology,treatment rules and methods of knee paralysis,and discussed the close connection between the five viscera and knee paralysis in their development and treatment.We also used data mining and machine learning methods to analyze the patterns of medication for each type of knee paralysis and analyze the similarities and differences between the treatments of each type of knee paralysis.METHODS:In this study,the method of literature research and data mining combining qualitative and quantitative analysis was chosen to study knee paralysis from both macroscopic qualitative and objective quantitative aspects.In the literature study,based on the inductive and logical analysis methods in the literature study,we researched the relevant medical treatises in the past dynasties,collated the knowledge of the medical books and medical practitioners on knee paralysis in different periods,explored the correlation between the five organs and knee paralysis,and summarized the theoretical basis for the treatment of knee paralysis on the basis of the theory of the "integral view of the five organs".In the aspect of data mining,by referring to the "General Catalogue of Chinese Ancient Books of Traditional Chinese Medicine","Abstract of Chinese Medical Books","Dictionary of Chinese Medical Books" and other cataloguing monographs,we chose to take the medical cases about knee paralysis recorded in "Chinese Medical Dictionary",China Knowledge Network,Wanfang Database,Wipu Database and some supplemental books as the main object of research,and reviewed,screened,sorted out,standardized and so on,to form a database of medical cases of knee paralysis.The results of the search were reviewed,screened,organized and standardized to form a database of knee paralysis medical cases.Based on this database,we analyzed the medication pattern of each type of knee paralysis and constructed an intelligent treatment model of knee paralysis by applying pytorch fully connected neural network.RESULTS:In terms of literature research,the name "knee paralysis" appeared in the modern era and was clearly proposed by Lou Duofeng in "Lou Duofeng on the Essence of Paralysis".However,according to the characteristics and symptoms of this disease,it is different from the "joint wind","white tiger disease","crane knee wind","inib paralysis","gout" and"flowing injection" proposed by medical practitioners in the past.”,"gout","flow injection","tendon paralysis","bone paralysis" "kidney paralysis," "pain paralysis," and so on.The Huangdi Neijing laid the theoretical foundation for paralysis,including knee paralysis,and in the Eastern Han Dynasty,the treatise on typhoid fever,the Jin Kou essentials,and the Zhong Zang Jing expanded on the name,etiology,and treatment of knee paralysis,and in the Jin,Sui,and Tang Dynasties,it was further inherited and improved.In addition,there were many schools of thought and academic contention during this period,and the views of various schools of medicine differed,even from the same school of medicine,complementing and improving each other’s theories of Chinese medicine.Throughout the ancient texts of Chinese medicine,the common understanding of the etiology of knee paralysis includes feeling external evil,weakness of positive energy,deficiency of endowment,diet,internal injuries,trauma and fall,stasis of blood and phlegm,etc.,which can be summarized as positive deficiency and evil reality.The positive deficiency is mostly due to liver and kidney yin deficiency,coup deficiency,and lack of solidity of the body surface,while the evil is mostly due to wind,cold,heat,moisture,and other pathological products such as blood stasis and phlegm.Knee paralysis is caused by deficiency of kidney essence,lack of bone marrow,or loss of harmony between liver qi and blood,and lack of tendons and tendons,or loss of spleen health,and lack of use of the limbs,or loss of lung publicity and purification,and lack of consolidation of the exterior of the body,or deficiency of heart qi and blood,and loss of nourishment of the meridians,or depression of liver qi and stagnation of blood,or loss of lung qi publicity,loss of spleen health,and deficiency of kidney qi,or deficiency of heart,liver,and kidney yin,and deficiency of internal heat,and decoction of blood,and stagnation of paralysis,so the treatment should focus on the five organs and the five related organs.The treatment of knee paralysis should focus on the five viscera and the five organs,such as from the spleen and the kidney to benefit the qi and nourish the blood,from the same source of yin and fill the essence and marrow,from the lung and the kidney to benefit the vital energy,from the heart and the kidney to balance the yin and yang,from the heart,liver and kidney to regulate the flow of qi and blood,move the qi and remove stasis,from the lung,spleen and kidney to regulate the metabolism of water and liquid,dispel phlegm and dampness,from the liver,spleen and kidney to support the righteousness and dispel the evil,and to pass the channels and dispel cold,forming a "five viscera-centered,mutually synergistic and cooperative The theoretical system of treating knee paralysis was formed with a holistic view of "five organs as one".In terms of data mining,this study included 168 ancient medical cases and 278 modern medical cases for the treatment of knee paralysis,totaling 446 cases.The clinical symptoms with high frequency included:knee pain,knee enlargement,unfavorable knee flexion and extension,difficulty in walking,bone pain,weakness,dullness,insomnia,and low back pain.The most frequent symptom was knee pain,with 361 cases(18.51%);the most frequent tongue symptom was light red tongue,with 222 cases(69.38%);the most frequent moss symptom was thin white moss,with 129 cases(39.81%);the most frequent pulse symptom was thin pulse and string pulse,both with 126 cases(18.37%).Liver and kidney deficiency type,damp-heat paralysis type,qi-blood weakness type,cold-damp paralysis type,and qi-stagnation and blood stasis type,which occurred 127,118,85,77,and 39 times,respectively,accounting for 28.48%,26.46%,19.06%,17.26%,and 8.74%,respectively.In this study,we analyzed the medication pattern of different types of knee paralysis and compared the similarities and differences of the medication pattern of different types of knee paralysis.Among them,the high-frequency drugs used in the type of knee paralysis with deficiency of liver and kidney were niu-knee,angelica,dulcimer,licorice,and white peony,etc.The most used drugs were warm and sweet,mainly attributed to liver,kidney,spleen,lung,and heart meridians,with the main effects of strengthening tendons and bones,tonifying liver and kidney,and dispelling wind and dampness.Damp-heat paralysis type knee paralysis high-frequency use of drugs such as Phellodendron,Achyranthes bidentata,Radix Angelicae Sinensis,Glycyrrhiza glabra,Atractylodes macrocephala,etc.,of which Phellodendron has the highest frequency of 50 times,with a frequency of 42.37%;the use of drugs with warm,flat,bitter and sweet taste is most frequent,and the main meridians are the liver,spleen,lung,stomach and kidney meridians,with effects mainly involving dispelling wind-dampness,dispelling wind-dampness,clearing heat and detoxifying drugs,with the core drug pair being Atractylodes bidentatae.The high-frequency drugs used in knee paralysis with weakness of qi and blood are Angelica sinensis,Radix Astragali,Radix Paeoniae Alba,Atractylodes Macrocephala and Glycyrrhiza glabra,among which Angelica sinensis is the most frequent,appearing 58 times with a frequency of 68.24%;the drugs used are mainly warm,flat,sweet and pungent,and the meridians are mainly to the liver,spleen,lung,heart and kidney meridians,with effects mainly involving diuresis and swelling,regulating menstruation and relieving pain,and dispelling wind and dampness,with the core drug pair being Radix Astragali-Angelica.The high-frequency drugs used for cold-damp paralysis type of knee paralysis are Gui Zhi,Radix Angelicae Sinensis,Radix et Rhizoma Pinelliae,Glycyrrhiza Glabra,Poria,etc.,of which Gui Zhi is the most frequent,with a frequency of 42 and 54.55%;the drugs used are mainly warm,flat,pungent,and sweet,and are mainly attributed to the spleen,liver,lung,kidney,and heart meridians,with efficacy mostly involving drugs to dispel wind and dampness,dispel wind-dampness,and warm the meridians,and the core drug pair is Angelicae Sinensis-Dou Hua.High-frequency drugs for knee paralysis with Qi stagnation and blood stasis are licorice,angelica,hyssop,Chuanxiong,and frankincense;the drugs used are mainly warm,flat,pungent,and bitter,and the main meridians are liver,spleen,heart,kidney,and lung meridians,with effects on strengthening tendons and bones,dispelling wind-dampness,and dispelling wind-dampness.In addition,we compared the patterns of medication for different types of knee paralysis.Firstly,the treatment of knee paralysis of all the different types of knee paralysis takes care of the vital energy of the five viscera,restores the function of the five viscera,helps the righteous and dispels the evil,dispels the evil and helps the righteous,the five flavors of medicine are mainly sweet,pungent and bitter,and the effects are all related to nourishing the liver and kidney and dispelling wind-dampness.Third,the treatment of each type of knee paralysis is based on the "five viscera as a whole" concept,and the medicine used is based on the liver,kidney,spleen,heart,and lung meridians.The difference in the use of medicine for each type of knee paralysis lies in the use of medicine according to the evidence,and the fundamental basis for the use of medicine according to the evidence lies in the difference in the nature of the disease mechanism.In the case of liver and kidney deficiency,the main treatment is to tonify the liver and kidneys,dispel dampness,and open the ligaments,with Radix Aconiti as the core medicine;in the case of damp-heat paralysis,the main treatment is to clear heat and relieve symptoms,benefit qi and remove dampness,with Phellodendron Bark as the core medicine;in the case of qi and blood weakness,the main treatment is to tonify blood and move blood,benefit qi and consolidate the essence,with Radix Angelicae Sinensis and Radix Astragali as the core medicines;in the case of cold-damp paralysis,the main treatment is to relieve symptoms from the lungs,liver,spleen and kidneys.The treatment of cold and damp paralysis in the knee mainly focuses on the lung,liver,spleen,and kidney to dispel the cold and dispel dampness,with Gui Zhi as the core herb;the treatment of qi stagnation and blood stasis in the knee mainly focuses on the heart,liver,spleen,and kidney to move the qi,invigorate blood circulation,and remove blood stasis,with Angelica sinensis and Chuanxiong as the core herbs.The final F1 composite score of the knee paralysis model constructed in this study was 68.91%.Combining F1 with the confusion matrix evaluation index,the accuracy rates of cold-damp paralysis and qi-blood weakness types were higher,both at 70%-80%,and the misclassification rates of qi-blood weakness type and liver-kidney deficiency type were lower.The model is more sensitive to the sample data of liver-kidney deficiency type,cold-damp paralysis type,and qi-blood weakness type,and can predict them well for classification,while the misclassification rate of qi-stagnation and blood stasis type is higher.CONCLUSION:1:The literature studies knee paralysis and the five viscera,which are closely related to knee paralysis,and the "five viscera in one view" has an important role in the treatment of knee paralysis that cannot be ignored.The Five Organs coordinate with each other to fulfill the functions of water and fluid metabolism,maintenance of the body’s vital energy,transportation of water and grain,and production of Qi and blood,which are the basis for the normal activities of the knee joint and its surrounding tissues.2:The treatment of each type of knee paralysis focuses on tonifying the liver and kidneys,restoring the functions of the five organs,and taking into account the need to support the positive and eliminate the evil.The main treatment for the liver-kidney deficiency type of knee paralysis is to tonify the liver and kidneys and dispel dampness;for the damp-heat paralysis type of knee paralysis,the main treatment is to clear heat and remove heat,benefit qi and eliminate dampness;for the qi-blood weakness type of knee paralysis,the main treatment is to tonify blood and move blood,benefit qi and consolidate the essence;for the cold-damp paralysis type of knee paralysis,the main treatment is to dispel cold and dispel dampness,and to warm the middle of the body from the lungs,liver,spleen and kidneys;for the qi-stagnation and blood-stasis type of knee paralysis,the main treatment is to move qi from the heart,liver,spleen and kidneys,The treatment of the knee paralysis with qi stagnation and blood stasis is mainly based on the heart,liver,spleen and kidney to move the qi,open the channels and invigorate the blood.3:The pytorch fully connected neural network-based intelligent treatment model for knee paralysis has a higher accuracy rate for the cold-damp paralysis type and the qi-blood weakness type,and is more sensitive to the data of patients with these two types of symptoms. |
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