| ObjectiveBy analyzing the medication patterns of traditional Chinese medicine in the treatment of vascular dementia in the real world,this study explores the characteristics of traditional Chinese medicine in the treatment of vascular dementia,providing certain reference for clinical prevention and treatment of this disease,and laying the foundation for formulating a unified diagnosis and treatment plan for traditional Chinese medicine in the treatment of vascular dementia.MethodCollect data from the electronic medical record system of patients who were hospitalized in 13 tertiary hospitals of the Brain Disease Project Group from January 1,2015 to December 31,2019,and were diagnosed with vascular dementia as the first time discharged.Integrate the data into the "China Traditional Chinese Medicine Evidence Based Medicine Center Brain Disease Project Group Vascular Dementia Data Warehouse".Using a cross-sectional study method,based on a real-world electronic medical record system,a VD medical record database was constructed using Microsoft Excel 2019 software.Two researchers independently extracted information to ensure data accuracy.Patients with vascular dementia who met the inclusion and exclusion criteria were included and the data was standardized and cleared.With the help of the traditional Chinese medicine inheritance assistance platform(V3.0)software,the database data was statistically analyzed and mined.The "statistical analysis","prescription analysis" and other functions in the "data analysis" module of the software were used to analyze the frequency of drug use,the four qi and five flavors,the efficacy of meridians,association rules and cluster analysis,and other aspects,so as to analyze the regularity of Chinese medicine in the treatment of vascular dementia.ResultThis study ultimately included 888 patients with VD and 888 prescriptions.Among the included patients,the majority were women,with 572 female patients(64.41%)and 316 male patients(35.59%),with a male to female ratio of approximately 1:2;Among the included patients,the youngest is 38 years old,the oldest is 103 years old,and there are the most patients aged 70 to 89 years old,with a total of 583 cases,accounting for 65.65%.The frequency analysis of single traditional Chinese medicine revealed 382 herbs,with a cumulative frequency of 11744 times.Among them,27 herbs had a cumulative frequency more than 100 times.The top ten herbs with the highest frequency of use were Chuanxiong,Poria cocos,Licorice,Angelica sinensis,Acorus tatarinowii,Pinellia ternata,Atractylodes macrocephala,Chenpi,Astragalus membranaceus,and Peach kernel.The statistical results of the Four Qi show that the main properties of traditional Chinese medicine for treating vascular dementia are warm,cold,and mild drugs.The frequency order of the Four Qi is warm drugs(5041 times),cold drugs(2898 times),mild drugs(2810 times),cool drugs(315 times),and hot drugs(206 times);The statistical results of the five flavors show that the main flavors of traditional Chinese medicine for treating vascular dementia are sweet,bitter,and pungent.The frequency order of the five flavors is sweet drugs(5772 times),bitter drugs(5414 times),pungent drugs(4394 times),sour drugs(914 times),and salty drugs(692 times).The statistical results of meridian tropism show that the top three meridian tropisms are the spleen meridian,liver meridian,and lung meridian,with 5225,5207,and 4703 times respectively.The frequency order is the spleen meridian,liver meridian,lung meridian,heart meridian,stomach meridian,kidney meridian,gallbladder meridian,large intestine meridian,bladder meridian,small intestine meridian,pericardial meridian,and triple jiao meridian.The results of efficacy statistics show that the first four types of efficacy are tonifying deficiency,promoting blood circulation and resolving stasis,clearing heat,and resolving phlegm,relieving cough,and asthma,with frequencies of 2837,1843,942,and 894,respectively.The analysis results of association rules show that when the support level is 133 and the confidence level is 0.8,75 commonly used drug combinations with a frequency greater than 133 are obtained,and 19 corresponding association rules are obtained.The drug association network graph shows 17 traditional Chinese medicines;When the support level is 178 and the confidence level is 0.7,24 groups of commonly used drug combinations with a frequency greater than 178 were obtained,and 11 corresponding association rules were obtained.The figure shows a total of 13 traditional Chinese medicines,including Acorus tatarinowii,Peach kernel,Poria cocos,Licorice,Citrus reticulata,Pinellia ternata,Atractylodes macrocephala,Chuanxiong,Red peony,Angelica sinensis,Astragalus membranaceus,Safflower,and Earthly dragon;When the support level is 222 and the confidence level is 0.6,10 commonly used drug combinations with a frequency greater than 222 were obtained,including Poria cocos and Pinellia ternata,Poria cocos and Atractylodes macrocephala,Poria cocos and licorice,Poria cocos and Chuanxiong,Chuanxiong and Angelica sinensis,Chuanxiong and Huangqi,Chuanxiong and Red peony,Pinellia ternata and tangerine peel,Pinellia ternata and licorice,Angelica sinensis and Huangqi.11 corresponding association rules were obtained.The figure shows Red peony,Chuanxiong,Angelica,Huangqi,tangerine peel,Pinellia ternata,Poria cocos,licorice,and Huangqi Atractylodes macrocephala has a total of 9 traditional Chinese medicines.Six clustering combinations were obtained through cluster analysis.The first type:licorice,Chuanxiong,white peony,Poria cocos,Angelica sinensis,Astragalus membranaceus,Acorus tatarinowii,malt,with 236 similar formulas mainly composed of them;The second type:Atractylodes macrocephala,licorice,Chuanxiong,Angelica sinensis,Astragalus membranaceus,Codonopsis pilosula,Acorus calamus,Pinellia ternata,with 121 similar formulas mainly composed of them;The third category:Pinellia ternata,licorice,Scutellaria baicalensis,Poria cocos,Atractylodes macrocephala,Acorus tatarinowii,Gastrodia elata,and Chuanxiong,with 152 similar formulas mainly composed of them;The fourth category:Platycodon grandiflorum,tangerine peel,Poria cocos,Pinellia ternata,licorice,Angelica sinensis,Chuanxiong,and Fritillaria thunbergii.There are 137 similar formulas mainly based on them;The fifth category:Poria cocos,Acorus tatarinowii,Glycyrrhiza uralensis,Pinellia ternata,Ligusticum chuanxiong,Atractylodes macrocephala,tangerine peel,and Angelica sinensis.There are 95 similar formulas mainly based on them;Category 6:Ligusticum chuanxiong,Angelica sinensis,safflower,red peony,astragalus membranaceus,earthworm,peach kernel,and achyranthes bidentata.There are 147 similar formulas mainly based on them.ConclusionThe results showed that the most frequently used single herbs in the treatment of vascular dementia with traditional Chinese medicine were Chuanxiong,Poria cocos,licorice,Angelica sinensis,Acorus tatarinowii,Pinellia ternata,Atractylodes macrocephala,tangerine peel,Astragalus membranaceus,and Peach kernel.The medicinal properties were mainly warm,cold,and mild,with sweet,bitter,and pungent flavors.The main meridians were spleen,liver,and lung meridians,and the main effects were tonifying deficiency,promoting blood circulation and resolving stasis,clearing heat,and resolving phlegm,relieving cough,and asthma.Through association rule analysis,it can be found that commonly used drugs are Liujunzi Tang and Siwu Tang plus or minus.According to cluster analysis,the core drug combinations are mainly divided into three categories:tonifying deficiency,dispelling dampness and resolving phlegm,and promoting blood circulation and resolving stasis.The treatment of vascular dementia with traditional Chinese medicine mainly focuses on supplementing qi and blood,dispelling dampness and resolving phlegm,promoting qi and blood circulation,removing blood stasis and unblocking collaterals,emphasizing the tonifying of spleen and kidney qi deficiency,and insufficient essence and blood.At the same time,it is combined with products that dispel dampness and resolving phlegm,promote blood circulation and resolving blood stasis,achieving the goal of both attacking and tonifying,and treating both symptoms and symptoms.The research results are basically consistent with the current theories of traditional Chinese medicine on the etiology and pathogenesis of vascular dementia,and can provide reference for the selection of prescriptions and development of new drugs for the clinical treatment of this disease in traditional Chinese medicine. |
PDF Full Text Request