The Study Of The Contemporary Chinese Herbal Treatment Of Acne Which Based On Data Mining

PURPOSEDisease-Syndrome Integration is the main clinical model in the contemporary Chinese medicine. Pathogenesis revealed by Syndrome is the key in Holistic Diagnosis and Treatment. By clarifying the basic clinical features of acne, and also its theories, therapeutic principles, formulae and herbal medicines, could be an effective way to increase the efficacy of acne. Literature study discovered that the viewpoints of both ancient and contemporary practitioners were similar, of which Lung, Spleen and Kidney were related mostly to acne, followed by heart and liver. However, there are still discrepancies in symptom descriptions, controversies in therapeutic principle selections and preferences in prescriptions. Therefore, in this research, validated medical records by the contemporary renowned Chinese medicine practitioners were collected and then FP-Growth Association Rule Analysis was undergone in order to reveal effective herbal combinations, and to discover new knowledge, such that a step forward in clinical and research field can be made.METHODSMedical records of acne treatment were first collected then organized from database CNKI (from February 1988 to November 2014), and a database was established with all records selected under the inclusive and exclusive criteria. Prior to data mining and statistical analysis, data pre-handling such as herbal name standardization, correction of words, medical terms standardization, verification of original texts were proceeded. 448 qualified medical records of acne treatment were collected and saved in Medcase V3.2 Software. Further standardizations and data-washing procedures were repeatedly run. Medical Record Data Mining Platform composed of strategic templates was established after 361 clinical symptoms were standardized with accumulated 2699 times of standardization, and was featured in multiple data mining methods, with functions of collecting, storing, organizing and analyzing. By using Medcase V3.2 Software, FP-Growth Association Rule Analaysis Model, Medcase Record Mining System, Association Rule Analysis Platform, Xminer Operation Tool and FP-Growth Association Rule Analysis were performed. According to the statistical results, empirical conclusions which explained by Chinese medicine theory were drawn in terms of coated tongue condition, pulse condition, therapeutic principle, and also herbal medicine.RESULTSIn f.requency analysis,high-frequency symptoms occurred in the medical records included mainly thirst,greasy face,agitated,hard stool and itch.Types of lesion in descending order were papilar,pustule,nodule, scar, hyperpigmentation. Parts of lesion were most-likely appearing on the face,the cheek,the forehead,the neck,the chest and then the back.Colours of lesion were red,light red,dark red in descending order.High-frequency tongue conditions occurred were red,red at the tip,light red, pale,dark red,dark,red in the edge,then wavy markings in the edge.High-frequency pulse conditions occurred were taut(弦),smooth(滑),thin(细),rapid(数),deep(沉), moderate(缓),small(小),floating(浮),soggy(濡),weak(弱),unsmooth(涩),large(大), excess(实),empty(虚),abrupt(促),surging(洪).The top fifteen high-frequency therapeutic principles occurred in the medical records included mainly clearing away heat(清热),detoxicating(解毒),activating blood(活 血),dispersing focal distention(散结),removing stasis(化瘀),cooling blood(凉血), clearing the lung(清肺),strengthening spleen(健脾),dispersing stagnant liver qi(疏 肝),eliminating phlegm(化痰),disinhibiting dampness(利湿),dispelling dampness (祛湿),nourishing yin(滋阴),clearing the stomach(清胃),relieving Fu-organs(通 腑).After integration and standardization,the above-mentioned therapeutic principles were basically aligned with the textbook of Zhong Yi Wai Ke Xue,written by D.M. LU,published by Shanghai Scientific and Technical Publishers,explained that lung clearing(清肺),wind dispersing(散风),heat clearing(清热),dampness eliminating 化湿,phlegm eliminating化痰,spleen strengthening(健脾),dampness percolating渗 湿were the main therapeutic principles.The research found that flexible therapeutic principles were applied by the contemporary practitioners to cope with complicated situation in treating acne.The top fifteen high-frequency herbal medicines occurred in the medical records were Moutan Radicis Cortex(牡丹皮),Forsythiae Suspensae Fructus(连翘),Glycyrrhiizae Radix(甘草),Paeoniae Rubra Radix(赤芍),Salviae Miltiorrhizae Radix(丹参), Angelicae Sinensis Radix(当归),Scutellariae Baicalensis Radix(黄芩),Poria(茯苓), Rehmanniae Radix(生地黄),Coicis Semen(薏苡仁),Taraxaci Mongolici Herba(蒲 公英),Atractylodis Macrocephalae Rhizoma(白术),Bupleuri Chinensis Radix(柴 胡),Hedyotidis Herba(白花蛇舌草),Citri Reticulatae Pericarpium(陈皮).High frequency herbal medicine could be categorized in several types,namely blood-cooling medicine (凉血药), blood-activating medicine (活血药), heat-clearing detoxicating medicine(清热解毒药),heat-clearing dampness-drying medicine (清热燥湿药),spleen-tonifying dampness-percolating medicine(健脾渗湿药),liver-coursing medicine(疏肝药),phlegm-eliminating medicine(化痰药),heat-clearing medicine(清热药),pus-clearing medicine(排脓药),according to the classification mentioned in the textbook of Chinese Material Medica written by Z.Q. LEI, published by Shanghai Scientific and Technical Publishers.In the Medicine Internal Association Rule, Pairing use like Forsythiae Suspensae Fructus and Salviae Miltiorrhizae Radix(连翘与丹参),Lonicerae Flos and Forsythiae Suspensae Fructus(金银花与连翘),Moutan Radicis Cortex and Poria(牡丹皮与茯苓),Atractylodis Macrocephalae Rhizoma and Poria(白术与茯苓)were found. Further discovery of four-drug combination including Moutan Radicis Cortex, Paeoniae Rubra Radix, Glycyrrhiizae Radix, Forsythiae Suspensae Fructus(牡丹皮,赤芍,甘草,连翘)and Moutan Radicis Cortex, Scutellariae Baicalensis Radix, Forsythiae Suspensae Fructus, Glycyrrhiizae Radix(牡丹皮,黄芩,连翘,甘草)were significantly identified, while three-drug combination including Rehmanniae Radix, Moutan Radicis Cortex, Paeoniae Rubra Radix(生地黄,牡丹皮,赤芍)and Lonicerae Flos, Forsythiae Suspensae Fructus, Salviae Miltiorrhizae Radix(金银花,连翘,丹参)were seen.In the External Association Rule between medicine and therapeutic principle, dispersing stagnant liver qi (疏肝) has a higher confidence with Bupleuri Chinensis Radix (柴胡) and Moutan Radicis Cortex (牡丹). Clearing the stomach (清胃) has a higher confidence with with Mori Albae Radicis Cortex (桑白皮) and Eriobotryae Japonicae Folium (枇杷叶). Detoxicating (解毒) has a higher confidence with Rehmanniae Radix(生地黄),Lonicerae Flos (金银花) and Artemisiae Capillaris Herba (茵陈). Both stasis-removing (化瘀), blood-activating (活血) have a higher confidence with Cinnamomi Ramulus (桂枝). Both warming yang 温阳 and storing yang (潜阳) have a higher confidence with Aconiti Lateralis Preparata Radix (制附 子). Nourishing yin(滋阴、养阴)has a higher confidence with Scutellariae Baicalensis Radix (黄苓); regulating liver(调和清木)、resolving depression (解郁) have a higher confidence with Bupleuri Chinensis Radix (柴胡). Lung clearing (清肺) has a higher confidence with Mori Albae Radicis Cortex(桑白皮).Heat clearing (清 热) has a higher confidence with Scutellariae Baicalensis Radix (黄芩). Disinhibiting dampness (利湿) has a higher confidence with Artemisiae Capillaris Herba(茵陈). Spleen strengthening (健脾) has a higher confidence with Codonopsis Radix(党参).Wind dispersing(疏风)has a higher confidence with Schizonepetae Tenuifoliae Herba(荆芥).CONCLUSIONBy performing statistical analysis and association rule analysis of those selected medical records of contemporary renowned Chinese medicine practitioners, the results were aligned with both the traditional knowledge and current clinical practice, proving that applying data mining in medical records is effective amd realistic. Commonly used herbal medicines in treating acne could be found out by focusing on the frequency and combinations of the herbal medicine. By association rule analysis, relationship among therapeutic principle, herbal medicine and symptoms can be described quantitatively. By connecting symptom-therapeutic principle-herbal medicine, the results can be a reference for clinical practice. Furthermore, by distinguishing the mining results with traditional Chinese medicine knowledge, new discovery and new scope of views were found, which could be made use by clinical practitioners. This explains data mining and FP-Growth Association Rule Analysis is practical and useful in applying to medical records in Chinese medicine.