Research On Syndrome Key Factor In Chronic Hepatitis B Based On Various Data Analysis Methods

The syndrome is generalization to whole response of disease pathology andphysiology change of human body, which is result of syndrome differentiation,the basis of therapy and the foundation of diagnosis and treatment of TraditionalChinese Medicine(TCM). In view of significance of standardization of syndromeand study of syndrome key factors and many questions in the fields of syndromeof TCM, this study which was following the evidence-based medicine thought andthe DME method developed chronic hepatitis B(CHB) through literature, big sampleclinic epidemiology investigation and the non-surveillance mathematicalstatistic methods to find the character of symptom, syndrome, syndrome keyfactors of CHB and their relationship in order to afford reliable foundationfor the establishment of the new system of syndrome differentiation which iscentered on syndrome key factors.This paper includes literature study, clinic study and the study of syndromekey factor of CHB based on various data analysis methods.Part1 Literature study of symptom, syndrome and the syndrome key factor in CHBObjectiveTo analysis the symptom, syndrome and the syndrome key factor in CHB fromthe point of view of Literature and to afford foundation for the establishmentof the questionnaire of clinical symptoms of CHB.Methods1 Search the related literature of CHB from a great deal of publishedmagazines.2 Standardize the name of general symptoms of CHB and uniform the differentname of the same symptom.3 Establish the literature database CHB.4 Classify the the syndrome key factor in Literatures according to thedefinition of syndrome key factors and the principle of classifying.5 Summarize the common symptom, syndrome and the syndrome key factor in CHBin literature.Results 1 Common symptoms: Based on standardization of the symptoms of CHB on modernpublished magazines, we summarized the common symptoms of CHB were anorexia,weakness,loose stool,hypochondriac pain,dry mouth,bitter mouth,nausea,vague pain in hypochondrium,distention and fullness, the common tonguemanifestation were greasy fur,red tongue,yellow fur,white fur,pale tongue,ecchymosis on tongue,less fur,purplish tongue,plump tongue, the common pulsemanifestation were stringy pulse,thready pulse,deep pulse,slippery pulse,hesitant pulse.2 Common syndrome: There are 79 types of syndromes appeared in the literatureafter standardized 197 the syndromes. The syndromes which frequence is more than1ï¼…were syndrome of dampness-heat,syndrome of stagnation of liver qi and spleendeficiency,syndrome of yin deficiency of liver and kidney,syndrome of yangdeficiency of spleen and kidney,syndrome of static blood blocking collaterals,syndrome of qi stagnation and blood stasis,syndrome of stagnation of liver qi,syndrome of stagnation of liver qi and blood stasis,syndrome of blood stasis. Thecommen symptoms of syndromes were extracted through the frequency analysis.3 Common syndrome key factor: 19 syndrome key factors interrelated with CHBwere found, the 12 syndrome key factors which frequence is more than 1ï¼…were:the liver,the spleen, Stagnation ofr qi,the kidney,the dampness,the heat,the yin deficiency,the blood stasis,the yang deficiency,the collaterals,the gallbladder,deficiency of qi, they were commen syndrome key factors, maycover 97ï¼…cases.Application of the binary Logistic regression model to confirm the relationof syndrome key factor and its related symptoms, when the related symptoms appear,the possibility of the syndrome key factor occurring is biggerPart2 Clinical study of symptom, syndrome and the syndrome key factors of CHBObjectiveThrough the investigation of clinical symptoms of CHB to discuss the symptom,syndrome and the syndrome key factors of CHB and provide epidemic foundationto the perfect of syndrome units differentiation system.Methods1 Based on the literature study, after the symptom standard and the symptomquantification graduation, with experts proving, the questionnaire of clinicalsymptoms of CHB and its handbook were established,2 Through reliability investigation to evaluate the quality of questionnaire so as to amend and consummate the questionnaire of CHB.3 The national multi-centers and big sample clinical epidemiologyinvestigation was developed on strict quality control.4 Established the database of clinical epidemiology investigation of CHB.5 Through methods of frequence, correlation and Binary logistic to analyzethe symptom, syndrome and the syndrome key factors of CHB by SPSS13.0.ResultsThrough 582 CHB patient's clinical materials from national six centers, thesymptom, the symptom, syndrome and the syndrome key factors were studed.Basing on analyse of the syndrome key factors of the clinical expert'sconclusion about syndrome, we summarized the rule of combination of syndromekey factors and discovered that two-two combination of syndrome key factorswere commen, such as liver and qi stagnation, liver and spleen, spleen and qideficiency, liver and qi deficiency, spleen and qi stagnation, liver and heat,liver and dampness, spleen and dampness, spleen and heat, liver and blood stasis.Main three-three combination of syndrome key factors were liver and spleen andkidney, liver and spleen and collaterals, liver and gallbladder and spleen. Weused the binary Logistic regression model to confirm the relation of syndromekey factor and its related Symptoms.Part3 Research of the characteristic of syndrome key factorsof chronichepatitis B based on many math and statistics methodsObjectiveApplying the non-surveillance analysis method, we analyzed the CHB clinicalepidemiology investigation materials through various data analysis methods andanalyzed the characteristics and combination rules of symptoms and syndrome keyfactors.MethodsThe methods included Factor analysis strategy, Structural equation modeling,Relational grades analyzing,Non-negative matrix factorization,Latent structuremodels.Results1 Through the factor analysis, 24 factors were extracted which accumulativecontribution percentage was 63.110ï¼…. The content of 24 factor covered most clinicsyndromes. The result of factor analysis pointed out that the syndrome keyfactors of CHB included liver, spleen, kidney, gallbladder, stomach, heart, qi stagnation, qi deficiency, dampness, heat, blood stasis, yin deficiency, yangdeficiency, hyperactivity of yang.2 Structural equation modeling analysis showed that the fitting effect ofthe simplified model was good and it was good for explain. The 15 symptoms groupsmay cover the basic syndromes of CHB. The result of structural equation modelingpointed out that the syndrome key factors of CHB included liver, spleen, kidney,stomach, heart, qi stagnation, qi deficiency, dampness, heat, blood stasis, yindeficiency, yang deficiency.3 Using Relational grades analyzing we supposed the symptoms groups whichrelationship were most, and the syndrome key factors of CHB included liver, spleen,kidney, gallbladder, stomach, heart, qi stagnation, qi deficiency, dampness, heat,blood stasis, yin deficiency, yang deficiency.4 Using Non-negative matrix factorization we extracted enough simple butrepresentative for characteristic of disease, the advantage of the method wasthat it could differentiate the force and provide rich information for thejudgement of location and quality of syndromes, we supposed that the syndromekey factors of CHB included liver, spleen, kidney, gallbladder, stomach, heart, qistagnation, qi deficiency, dampness, heat, blood stasis, yin deficiency, yangdeficiency, hyperactivity of yang.5 Through Latent structure models We supposed the whole characteristic ofdata of sample of CHB and tried to explain the rules of syndromes and syndromeswith latent class. Using Latent structure models was able to discover the hidedrelations between the symptom and the syndromes and may grasp the data on thewhole.Conclusions1 We integrated the results of literature study, clinic study and the studyof syndrome key factor of CHB based on various data analysis methods, and supposedcommon symptoms, Common syndrome and commen syndrome key factor.Common symptoms: weakness, deep-colored urine, hypochondriac discomfort,dry mouth, dim complexion, spiritlessness, distention and fullness, bitter tastein mouth, hypochondriac distention, insomnia, abdomen distention, loose stool;Commen tongue manifestation: greasy fur, red tongue, yellow fur, white fur, plumptongue, dark tongue, sublingual vessel.Commen pulse manifestation: stringy pulse, slippery pulse, thready pulse,deep pulse, rapid pulse. Common syndrome: syndrome of dampness-heat, syndrome of stagnation of liverqi and spleen deficiency, syndrome of yin deficiency of liver and kidney, syndromeof yang deficiency of spleen and kidney; syndrome of static blood blockingcollaterals, syndrome of qi stagnation and blood stasis, syndrome of stagnationof liver qi, syndrome of stagnation of liver qi and blood stasis, syndrome ofblood stasis.Commen syndrome key factor: liver, spleen, kidney, gallbladder, stomach, qistagnation, qi deficiency, dampness, heat, blood stasis, yin deficiency, yangdeficiency2 The results showed that through union application of kinds of mathematicalstatistics method we can find out many characters of syndrome key factors ofCHB from different aspects, It is important that developing clinical epidemiologyinvestigation and data analysis without expert experience at first time for therealy characteristic of syndrome.3 The results showed that syndrome is a complex system, study from the pointof view of syndrome key factor can represent the complexity of syndrome and affordreliable foundation for the standardization of syndrome of TCM and perfect thesyndrome system...