| Objective:In order to find out the rule of differentiation and treatment of LN, we investigated the clinical experience of tutor and aided by computer Data Mining technology and modern epidemiology statistical methods. In addition, with the herbal formula extracting from the Data Mining of the research, a clinical research was performed in LN patients, aiming at supporting the effectiveness and safety of the treatment of LN with Chinese Traditional Medicine.Method:We Collect the clinical LN cases of tutor in recent years, First of all, the information of the clinical cases that met the inclusion criteria should to be saved.then the information is preprocessed and database was established with Excel software. By the use of statistical methods such as frequency analysis was applied to find the commonly used medicines, symptom frequency, Differentiation type frequency, Prescription frequency and The pharmacologic properties of frequency Association rules was applied to summarize the law of Clinical drug law of the tutor and the Close relationship Drug combinations that treated the LN were learned from clusteringA clinical research is performed with the herbal formula extracting from the Data Mining of the research,40cases of the patients were treated with YiQi ZiShen Tang on the basis of routine therapy as treatment group and37cases of patients were treated with routine therapy as control group. observing of the clinical efficacy and side effects and adverse reactions of Western medicine.Result:1. Data Mining results:(1) Frequency Analysis results:The symptoms of which the frequency is more than20%in this study are in order:fatigue, be prone to catch cold, sallow complexion, joint pains, tinnitus, thirsty, anxiety, insomnia, edema, back soreness, back pain, dizziness, palpitation, sweating, pick tongue and fatness (or with teeth mark), thin pulse, small and wiry pulse. As with TCM syndrome types criteria of LN, dual deficiency of qi and yin is the most common in the main syndromes, up to67.71%, followed by46.29%for liver and kidney yin deficiency. Liver-Qi stagnation is the most common in the accompany syndrome, accounting for40.86%, followed by blood stasis25.43%, exopathy accounting for20.86%, Dampness19.14%, dampness-heat11.71%, rare cold-dampness and phlegm-heat. We collected223cases,350prescriptions and got172drugs. The total frequency was6708times. There are30kinds medicine that common used, cumulative frequency up to69.84%. The first23kinds of drugs which frequency is all over100times, cumulative frequency up to61.42%, which are the primary drugs for treating LN. The prescriptions of which the frequency is more than20%in this study are in order:Yiqi Zishen decoction (33.43%), Erzhi decoction(23.71%), Shengmai Drink(20.29%), Sijunzi decoction (18.57%), Xianzao decoction (14.86%); As for drug meridian, spleen (20.54%), lung (16.52%), kidney (16.07%) are common; For distribution of property of medical drugs:warm nature (38.30%) and cold nature eveness(29.79%); for medicine category:tonifying (39.42%), heat-clearing(17.26%), promoting blood circulation and removing blood stasis (11.60%); for distribution of flavor of herbs:bitter (24.11%), sweet (41.13%).(2) Cluster analysis results:Cluster analysis was carried out within the81drugs that frequency is more than10times and the accumulative frequency up to95.61%. Through cluster analysis, we obtained14drug pairs、10combinations with3drugs and8drug combinations with over3drugs, which embodied the clinical prescription principles of tutor and the pathogenesis of the disease.(3) Association rules analysis results:The association rules analysis were carried out mainly between symptoms and herbs formulas, symptoms and herbs, herbs and herbs. Then I concluded the experience of my tutor in treating LN:①According to the pathogenesis of LN, we choose different treatment means in different stages. In the first stage, we should control the symptoms of LN, and locating emphasis on complementing kidney; In the middle stage, yin deficiency with internal heat, locating emphasis on the liver and kidney, combined with eliminating pathogen; later warmly invigorating spleen and kidney and regulating, restore balance of yin and Yang.②With spleen and kidney as the root, the treatment is overall. To treat kidney, modified Liuwei Dihuang decoction is commonly used. Regulation of spleen and stomach is payed attention to, avoiding hurting spleen and stomach and influencing the absorption of decoction.③Agile method and prescription, exquisite herb compatibility. Relationship between qi, blood, yin and yang is payed attention to. Tonifying is combined with dredging and eliminating the Pathogen, with no stagnation.④Herb modification with symptoms, calm, light and agile, which avoids too hot and fragrant to damage fluid and too bitter and cold to hurt spleen and stomach, all for the clinical effect. By the use of association rules to analyze the law of syndrome differentiation and Prescription of my supervisor will help to found the law of clinical treatment and to promote effective herbs. That will help to conclude the experience of old famous TCM doctors further scientifically and systematically, then to inherit and carry forward.2. Clinical research results:with respect to the treatment efficacy, the improvement of treatment group is better than the control group in the aspects of reducing urine protein, rising complement and lowering triglyceride, and statistics difference is on significant level(P<0.01); as with side effects and the adverse reaction, after the treatment, treatment group had improved more significantly than control group in the aspects of such symptoms as:blood pressure、lipemia、blood glucose and liver function ect (P<0.05), as so as compared with itself (P<0.05). Moreover, there was significant difference between treatment group and control group in the aspects of insomnia、following infection digestive discomfort and menstrual disorder (P<0.01).Conclusion:1. Aided by the Data Mining technology, the herbal prescription law therapeutic principles and methods of tutor treating LN could be summarized. Through frequency analysis, most commonly used drugs included the following kinds:drus for tonifying, for clearing away heat, and for promoting blood circulation and removing blood stasis. With the help of association rules analysis, compatibility law of Chinese herbal drugs for Professor Ai Rudi treating LN could be concluded. By using of cluster analysis, commonly used drug combinations for treating LN could be concluded.2. Data mining is an effective way for summarizing and inheritance of traditional Chinese medicine. Aided by Data Mining, valuable experience became visual and easy to understand, at the same time it became verifiable. All of these had played a very important role for the inheritance and Innovation of traditional Chinese medicine.3. Data mining is the way to the modernization of Chinese traditional medicine. Aided by the Data Mining, the mass of TCM diagnosis and treatment could be analyzed. By the analysis, some implied key association and law among syndrome differentiation of traditional Chinese medicine, prescription drugs, thus could promote the development and innovation of traditional Chinese Medicine, also accelerate the process of modernization of traditional Chinese Medicine. In sum, Using Data mining technology, old Chinese medical cases and prescriptions can be analyzed objectively on a multi-dimensional and multi-perspective level, some objective and referential conclusions for clinical work can also be obtained. Clinical studies have found that the clinical efficacy of LN with Chinese Traditional Medicine is definite, not only can the occurrence and development of LN be prohibited, but also the drug side effects of western medicine and adverse reactions can be avoided. |
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