| ObjectiveCollect the medicine cases of pro wang and establish a database through standardized and structured data collection platform. To make conclusions in syndrome types of gynecological pain, feature and regular in drugs with relevance principle and mining subject for pro wang in treating gynecological pain syndrome. With document research and expert interviews, extract academic thoughts of pro wang in treating gynecological pain syndrome, so as to provide new ideas for treatment in gynecological pain.MethodsThe patient accept the TCM treatment basing on syndrome differentiation by pro wang during sep 2013 to mar 2016, who were inaccordance with the inclusive criteria. There are general information, medical history by four diagnostic methods of TCM, type of syndrome and drugs. Collect medicine cases of pro wang and establish a database through standardized and structured data collection platform. Analyze the frequency ofsingle Chinese medicine, relevancy of Chinese medicine and LDA topic model by big data of Chinese medicine service platform of guangdong province hospital of TCM. Explore feature and regular in gynecological pain with data mining method in big data of Chinese medicine service platform. Make a summing up of the experience and way in gynecological pain treatment after confirm the result with pro wang.Results1. General conditions(1) 137 patients were included in the standard. The total times in treatment was 316.The top three diseases of gynecological pains is sequelae of pelvic inflammatory disease(PID), adenomyosis and endometriosis. The proportion of the common diseases was 44.3%,33.5% and 22.2%. The top three syndrome of TCM is qi stagnation and blood stasis syndrome, damp-stasis accumulation syndrome, blood stasis due to cold accumulation, damp-heat retention and blood stasis and deficiency of kidney with blood stasis. The proportion of above syndromes was 24.05%,18.67%,13.29%,11.07% and 10.76%.(2) The common syndromes of PID were damp-stasis accumulation syndrome, qi stagnation and blood stasis syndrome and damp-heat retention and blood stasis. The common syndromes of adenomyosis and endometriosis were qi stagnation and blood stasis syndrome, blood stasis due to cold accumulation and damp-stasis accumulation syndrome.2. Research on drug law of pro wang in treating gynecological pain basing on association rule(1)Most of gynecological pain was sthenia syndrome. Stagnation, blood stasis, cold was the main cause of gynecological pain:The cause of the gynecological pain includes sthenia syndrome and deficient syndrome. From this study we found that sthenia syndromewas more than deficient syndrome of gynecological pains, which caused by stagnation, blood stasis, cold. Excessive syndromeof TCM includedQi stagnation and blood stasis, dampness and blood stasis, blood stasis due to cold, syndrome of stagnant dampness-heat. The proportion of excessive syndrome was 67.08%. Intermingled deficiency and excess was less than excessive syndrome. The least was deficient syndromeaccounting, it was about 6%. Above all,most of gynecological pain was sthenia syndrome. Cold was the main cause, The pathogenesis of gynecological pain is that it is obstruction that causes the pain.(2) QI-Regulating was the focus of pro wang’s treatment of gynecological pain syndrome:The effect of qi-regulating drug were regulating qi-activity and removing qi depression. Most of qi-regulating drug were bitterness and spice. Most of them were belonged to spleen, stomach, lung,and livermeridian. The ratio of spleen, stomach, lung, and livermeridian in prescriptions of pro wang was 22%,14.57%,14.3% and 13.8%. The ratio of bitterness and spice drugs was 26.4% and 24.4%. Pro wang was good at use qi-regulating drugs, such as, RAdix Linderae, cyperus rotundus, Radix Aucklandiae, immature bitter orange, pericarpium arecae, Radix peucedani platycodon, grandiflorus and almond.(3)Stagnation-Regulatingwas an important mothod of treatment of pro wang’s treatment for gynecological pain syndrome:Stagnation included qi stagnation, dampnessstagnation, food stagnation, blood stasis. And the first three could cause stagnation of blood and qi stasis, which may bring about pain, so pro wangpayed attention toStagnation-Regulating in clinical treatment. For qi stagnation, pro wang commonly used bitter orange, cyperus rotundus and szechwan chinaberry fruit to regulate qi. For dampnessstagnation, pro wang through movement and transformation of spleen and stomach, aromatic to remove dampness, or clearing away heat and light leakage, or eliminatingdampness, to the purpose of dispel wet and stagnationdisappear. At the same time, pro wang pay attention to let pathogen have a way out, or through burp or farting, or sweating, or Stool and urine.(4)Remove blood stasis was the root of the treatment for gynecological pain:Pro wang believed that if dampness and blood stasis, the treatment was firstly to treat damp and then to cure the blood stasis. Even if treating damp and blood stasis at the same time, still to treat wet medicine mainly and add one or two kinds of Huayu drugs on action. This often accede to Dansen, Chishao, Maodongqing.For Qi-stagnancy and blood stasis, pro wang combine regulating qi-flowing to dispersing blood stasis, such as, Chishao, Danggui, Taoren, Honghua, Zhike and so on. For cold dampness and blood stasis, pro wang thought cold stasis and governance should treating at the same time, drugs commonly used with cinnamon, dried ginger, fennel, angelica, chuanxiong, Chishao, red peony root;if pelvic has mass formation, add to Sparganium, Curcuma zedoary, to break blood disease; such as endometriosis or adenomyosis rectum fossa and tenderness nodules, add to Rhubarb, Citrus aurantium to dampness of blood stasis.(5) Driving out cold was the common way of pro wang for gynecological pain:The study indicated thatblood stasis due to cold accumulation was common in adenomyosis and endometriosis. The immediate cause of blood stasis was cold, so that driving out cold can be conducive to removing blood stasis. Cinnamon, ginger carbo, fennel, dried ginger and Folium Artemisiae argyi were very common in prescription of pro wang. Cinnamon could be fire tonification and Yang invigoration, warm uterus and relieve pain. Evodia rutaecarpa could drive cold and sooth the liver. Fennel and dried ginger could warm spleen and stomach for dispelling cold and invigorate the spleen. Folium Artemisiae argyi could warm channel for arresting bleeding,specially for menorrhagia.(6)Light spirit, less drug dosage, more superior effect:This study showed that, a total of 316 cases of traditional Chinese medicine prescriptions in the treatment of gynecological pain with pro wang, least among themwas 6 herbs, most was 9 herbs.7 or 8 herbs taken part in 89.5%. Drugs so little, but the effect was so significant. Pro wang said that we must to seize the cause of disease, the drug should be targeted.3. Summary the essence of academic thought of pro wang for the TCM treatment of gynecological pain:(1) Regulating qi-flowing for activating stagnancy, promoting blood circulation, driving cold and relieving painwas the main method for the treatment of gynecological pain.(2) Be good at grasping the master card, step by step.(3) Drug fast, direct access to disease.ConclusionPro wang Xiaoyun had a wealth of experience in the treatment of gynecological pain, through the statistics and analysis about the gynecological pain syndrome cases of Pro Wang based on association rules. After the analysis and data mining of the successful cases, we could get the conclusions:gynecological pains caused by stagnation, blood stasis, cold. Common syndrome types includedQi stagnation and blood stasis, Dampness and blood stasis, Accumulation and stasis of damp-heat type, Blood stasis due to cold, Kidney Deficiency and blood stasis. And in the three causes of gynecological pain, Dampness and blood stasis, Accumulation and stasis of damp-heat type was the most common types in sequelae of PID. And Qi stagnation and blood stasis and Blood stasis due to coldwas the most common types in endometriosis or adenomyosis rectum fossa. Pro Wang pay attention to egulate qi-flowing for activating stagnancy, promoting circulation and removing stasis, drive cold and relieve pain, and make evil way. Essentials of therapy was regulating qi-activity to smooth. Pro Wang is good at grasping the master card, step by step, and used drug fast, direct access to disease. That indicated study of data mining based on association rules analysis method can objectively reflect the famous veteran doctors of TCM clinical characteristic and experience of disease, preliminary summarize their dialectical thinking mode and discover some new knowledge. |
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