| ObjectiveExpert in the field of "Treatise on Febrile Diseases" Professor Li Saimei, apprenticed from Diabetes Mellitus specialist xiong man qi, not only well-versed in the knowledge of both Chinese and Western medicine theories, but also masters the theories of exogenous and seasonal febrile disease. She has been working hard on promotion and education of bringing the traditional Chinese medicine theories and thinking back into clinical practices, lectures and researches, thankfully, the outcomes of the hard work are satisfied, which are overwhelmingly praised and applauded by colleagues among her profession.Professor Li Saimei is experienced in using traditional Chinese medicine prescription and theories in treating endocrine disorder, especially specific to the Diabetes Mellitus and hyperthyroidism.Throughout the treatment, patients benefited from her view of the concept of holism and the superior syndrome differentiation which are features in Traditional Chinese Medicine, offered them a well-directed and highly individualized treatments in different stages of the disease depending on their body situation. Professor Li Saimei proposed several guidelines and theories which are helpful in clinical practice diagnosing and treating endocrine disorders, such as "Nine steps to use Traditional Chinese Medicine prescription in clinical practice ", "How to diagnosis and reach a decision about syndrome differentiation on Diabetes Mellitus" and "The methods of using six meridians theory to treat Diabetes Mellitus". All these guidelines and theories originated from "Treatise on Febrile Diseases" are very practical and have curative effects in clinical practice. Therefore, the clinical experience and thinking of Professor Li Saimei in treating endocrine disorders specific to Diabetes Mellitus are valuable to dig up and sorted out by new data mining technique and methods, and then being shared and passed down to the offspring and benefit the afterworld.Data mining methods and technique nowadays are passing through from the original obtaining experience from one private teacher to computers handling and analyzing massive information and data. Though there are already big progresses in the methods and techniques of the data mining, for those that are suitable to be used in the field of Chinese medicine are seldom. The main reason is that Chinese Medicine is famous for its integrated and complicated network thinking which is difficult for most data mining methods and techniques to explain the all-round aspects and reflect the truth of the observed objects. As a result, making the wishes of systemization and inheritance of the clinical experiences from famous Chinese Medicine specialists poorly could not come true within a short period.Therefore, this thesis will co-operation with professor Hong Wenxue and his research team, aims to use a newly-found data mining method:under the guidance of formal concept analysis, drawing a structural partial-ordered diagram where the popularity and specialty of the researched objects are directly perceived, to dig up and sort out the clinical experience of Professor Li Saimei in using Bupleurum and Cinnamon Combination in daily clinical practices, hoping objectively showing the thinking and knowledge of Professor Li Saimei, also making some efforts to the works and studies of the inheritance from famous Chinese Medicine specialist.MethodsCollection of Professor Li Saimei’s clinical history records including prescription Bupleurum and Cinnamon Combination from outpatient service of endocrine division,in No.1 Affiliated Hospital, Guangzhou University of Chinese medicine.After related screening, using frequency analysis to obtain preliminary results such as age groups, sex.western medicine diagnosis, Chinese medicine differentiation of symptoms, herbs’ dosages, and finally find out the designated prescription of Bupleurum and Cinnamon Combination whose herbs and dosage are normally used by Professor LI Saimei in daily clinical practices.Then we process the newly-found data by using the structural partial-ordered diagrams guided by the formal concept analysis. Through directly observation of combined frequency, cluster and association analysis in the diagram, the popularity and specialty of the observed objects could be found out,exposing the hidden facts and knowledge from the researched objects, as a result studies the clinical experience and thinking of Professor Li Saimei in using Bupleurum and Cinnamon CombinationResultsAfter frequency analysis of the clinical history records including prescription Bupleurum and Cinnamon Combination, the preliminary result shows that the designated prescription and herbs’dosages areRadix bupleuri 10g, Cassia twiglOg, Radices paeoniae alba10g, Scutellaria baicalensislOg, Pinellia ternata10g, Codonopsis pilosula 30g, Liquorice10g, Da Zao 10g respectively. It mainly used in endocrine disorder in middle-aged and elderly patients, especially for those who suffered from Diabetes Mellitus and hyperthyroidism.Besides, it also used to treat a varieties of other diseases, such as Neurological disorders, Gynecology disorders, Orthopedics and Traumatology disorders, Dermatology disorders, Gastroenterology disorders, Respiratory disorders, Cardio-cerebral-vascular disorders, and Rheumatism immunity disorder, some incurable diseases, for examples, Effort syndrome, Fever NOS, etc. The differential syndrome primarily is Shaoyang syndrome, Taiyang syndrome comes second. The third one is the cold and heat complex syndrome and stagnation of liver-qi with deficiency of the spleen.The extra added herbs covers a wide aspects, involving different functional herbs. Among them the enriching herbs is the most commonly used herbs, herbs for relieving cold comes second, the third one are clearing damp and promoting diuresis herbs, resolving dampness herbs and promoting blood circulation and removing blood stasis herbs.According the using frequency in proper sequence are Ceranthus sagittatus S. et Z.15g, Fructus amomi 6g, Radix scrophulariae 15g, the root of Kudzu vine 60g, Poria cocos20g, Chinese angelica 15g, Forsythia suspensa Vahl20g, Dried Rehamnnia root 20g, Purple perilla15g, Oyster 30g.The designated Bupleurum and Cinnamon Combination is analyzed by using structural partial-ordered diagrams guided by the formal concept analysis, the results show that the prescription is mainly targeted on endocrine disorder patients, especially those who suffered from Diabetes Mellitus and Hyperthyroidism, who got the dry mouths as their main symptom. Besides this, they may also have fatigue, sleep disorder, bitter taste in their mouths.dizziness.sweating, chillness, etc. All these symptoms related to multiple visceral functions and meridian systems, co-exist exterior and interior, hot and cold, deficiency and excess characteristics in one case.Generally speaking,the symptoms can be grouped into two differential symptoms, one is Diabetes Mellitus symptoms, the other one is flu symptoms, implies professor Li Saimei uses the designated Bupleurum and Cinnamon Combination to treat Diabetes Mellitus patients mainly, for some may also suffered from flu at the same time. Those patients usually have dry mouth, bitter taste in their mouths, fatigue, dizziness and sleep disordersThe extra added herbs in those cases mostly divided into two big groups, one group is mainly target on warming the kidney and strengthening the spleen with Aceranthus sagittatus S. et Z.15g and Fructus amomi 6g as the chief extra added herbs. The other group is mainly target on nourishing yin and clearing heat with Radix scrophulariae 15g as the chief extra added herbs. From the results we can note that the extra added herbs in the two groups seldom existed in one case, which means these two groups belongs to two trains of thought.The extra added herbs of the warming kidney and strengthening the spleen group, besides Aceranthus sagittatus S. et Z.15g and Fructus amomi 6g, may also have Poria cocos 20g, Rhizoma Atractylodis 30g, Rhizoma Atractylodis 30g, Chinese angelica 9g, Rhizoma Atractylodis Macrocephalael5-30g, Radices rehmanniae 20-50g, Ligusticum wallichii 10-15g, Rhizoma coptidis 5-20g, Fossil fragments 30g, Oyster 30g, the root of Kudzu vine 60g, Radix curcumae 60g, Radix curcumae lOg, Endothelium corneum gigeriae galli 10g, Radix aconiti carmichaeli 10g, Radix aconiti carmichaeli 5-10g and Rhizoma zingiberis 6-10g.If examined carefully, Fuzilizhong Decoction and bazhen decoction are embedded, all herbs’functions are major warming kidney, strengthening spleen and nourishing the liver. When Aceranthus sagittatus S. et Z.15g are not in use with Fructus amomi 6g, it mostly used with Fructus psoraleae 15g, Semen Cuscutae 15g, the fruit of Chinese wolfberry 15g, Chrysanthemum10g, in order to enhance the warming kidney effectiveness. While treating Diabetes Mellitus in clinical practice.Professor Li Saimei likes to use Aceranthus sagittatus S. et Z.15g and Fructus amomi 6g with Rhizoma Atractylodis 30g and Coptis chinensis 15-20g together carry out the warming kidney and strengthening spleen effect.For the nourishing yin and clearing heat group, she prefer to use Oyster 30g, Forsythia suspensa Vahl15-30g, Fritillaria thunbergii Miq 10-15g, Fried silkworm 10g, Radix Rehmanniae Recens 20g and Radix Ophiopogonis 20-30g,which embedded Fluid-increasing Decoction.major nourishing yin and clearing heat, resolving hard lump and relieving sore throat. While treating Diabetes Mellitus in clinical practice, Professor Li Saimei likes to use Radix scrophulariael5g with radices rehmanniae 15-20g, Radix Ophiopogonis 20-30g, Fritillaria thunbergii Miq.10-15g, Fried silkworm 10g and Forsythia suspensa Vahl 15-30g, enhancing the nourishing yin and clearing heat effect.ConelusionAccording to the result, under the guidance of six meridians theory, differentiation of diseases, syndromes and symptoms and emphasis on insufficiency of the spleen in treating Diabetes Mellitus proposed by Professor Li Saimei, are suitable to use for those middle-aged and elderly patients. There are two types of differential syndromes, one is deficiency of spleen and kidney with Aceranthus sagittatus S. et Z.15g and Fructus amomi 6g as chief extra added herbs, while the other is the exterior evil entering into Shaoyan with Radix scrophulariae 15g as chief extra added herbs. They both have dry mouths,bitter tastes in their mouth,itchy feeling in the throat, dizziness, fatigue, diarrhea, sleeping disorders and some may got other symptoms, such as frequent drinking, visual dizziness, night urination, chillness,cough with sputum, Limb arthralgia, frequent sweating, chest dullness feeling, yellow urine or tinnitus. In conclusion, the Bupleurum and Cinnamon Combination of ProfessorLi Saimei can be used in two differential syndromes after appropriate herbs adjustment throughout the whole treating process of Diabetes Mellitus, which is an intelligible, smart idea and thinking. |
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