A Study On Regularity Between The Disease Chronic Glomerulonephritis CGN And The Treatment Based On Data Mining

Profession:Traditional Chinese Internal Medicine Author:Sin Ch i u Hung, Nast Tutor:Li S MChronic Glomerulonephritis CGN, which is also known as Chronic Nephritis, has various causes. Composed of multiple pathological types, CGN is primarily caused by a group of immune diseases of the glomerulus. There are various kinds of pathological types and their expected consequences are different as well. Clinically the main symptoms are edema, hematuresis, albuminuria, lumbago and lacking in strength. There is no disease named Chronic Glomerulonephritis in traditional Chinese medical documents. However, according to its different clinical manifestations, CGN is quite similar to dropsy, blood urine, renal wind syndrome and turbid urine in symptoms. It was also spotted in such categories as weakness, backache and faint. Traditional Chinese Medicine (TCM) has accumulated thousands of years’abundant experience on healing CGN, bearing an advantage of being highly curative and with fewer side effects. This study mainly covers the following:Purpose:(1) The cognition of CGN from the perspective of TCM1.1 Pathogenesis of CGN:During the period between the founding of New China and the 1960s, TCM held that the main internal cause of this disease was vacuity and dysfunction of the lung, spleen and kidney, and the external cause was the externally contracted wind evil. Until mid-1980s, medical scientists also noticed that yin vacuity, damp-heat and blood stasis has are a close relationship with the cause of the disease. Since the end of last century, it has been found that the use of hormones and cytotoxic drugs in curing the disease would produce toxic side-effects that weaken the patients’ immune system, which renders the patient vulnerable to attacks by external evil. This leads to unstable course of CGN refractory to treatment.1.2 Pathogenic factors:CGN’s pathogenic factors are wind evil, dampness and blood stasis. Deficiency in origin basically accounts for the pathological changes in CGN. Damp-heat is the key pathogenic factor. As damp-heat is stuck inside the body, it would damage right qi. Insufficiency of right qi would hamper the flow of blood, which eventually leads to blood stasis. At the same time,when damp-heat is accumulated, it becomes heat that would burn the vessel network. Again this leads to blood stasis. As time passes, dampness and stasis intertwine and they are hard to remove. Eventually they breeds urine toxin. When the evil of damp-heat gathers at triple burner and qi dynamic is in disorder, water-damp would flood the skin and cause puffy swelling. If damp-heat stagnates at the kidney, it causes damp-heat lumbar pain. While dampness at the center burner disables the spleen in upbearing the clear, the stream sore in the lower burner would lead to leakage of essential qi from the kidney, thus causing albuminuria. If the blood vessel network is also damaged, hematuria results.1.3 Diagnostic classification:In the past decade, the disease was mainly classified into the following patterns:I) pattern of lung (spleen) kidney qi vacuity; Ⅱ) pattern of spleen-kidney yang vacuity; Ⅲ) pattern of liver-kidney yin vacuity; Ⅳ) basic pattern of dual vacuity of qi and yin; V) with external contraction; Ⅵ) with water-damp;Ⅶ) with damp-heat; Ⅷ) with blood stasis and Ⅸ) with damp turbidity. Although medical practitioners have insights slightly different from each other on pattern identification, basically they still process their diagnosis of the disease based on the two aspects---deficiency of life essence and clinical symptoms, and execute treatment with the concept of ’same treatment for different diseases’. This brings very desirable results.(2) Data MiningIn order to grasp a further systematic understanding on the relationship between the diagnosis and the treatment of CGN, data mining method has been applied on sorting empirical documents about treatments on CGN such as ancient Chinese medicine literatures and documents written by Chinese medicine masters. The study aims to summarize and highlight the regularity found in the causes of disease, the trigger point of the disease, symptoms, the disease itself, prescriptions and medicines in the healing process, which provides an essential schema of thoughts for clinical treatments on CGN, in its diagnosis and therapy.2.1 Method1. Building lexicons-Building up main lexicon, synonym lexicon, implication lexicon etc. as a tool for title extracting, summary, keywords, heading words and full text.2. Uniting the computer searching method and manual searching method to collect modern national Chinese medicine masters’ prescriptions and articles published by my research advisor Professor Li Shun Min on CGN and combining the results of the relevant documents to ensure the data are comprehensive and accurate.3. Integrating data and statistics collected and encoding them in ANSI format. Then conducting information extraction on unconstructed TXT text data downloaded with specific text extractor. Saving the result in Access and SQL format, the next step is to analyze each text individually. After setting up the rules, subsequent data filtering is proceeded according to the rules.4. The data is then processed into an ocular network diagram with the software Cytoscape3.1. The final Visualized diagram is output after denoising.5. The diagram shows the count frequency of the target Chinese medicine masters in the CGN data bank and the correlative relationship between their count frequencies. It works to establish the regularity of the different aspects more objectively.2.2 ResultData mining method is applied to 680 documents of Chinese treatment on GNC. After sorting the data, the following results are drawn:2.2.1 Causes of the disease:107 types of causes in total and the total frequency is 5461.41 single causes (around 38% of the identified causes) appear over 10 times, among which the highest is "damp-heat" with a frequency of 1111, making up 20.3% of the total. The combo of the two causes of damp-heat and static blood appear most often, with the highest count of 182.2.2.2 Locations of disease:71 types in total and the total frequency is 3388. Spleen and kidney appear most frequently among the data, with 414 times (12.22%). The combination of spleen, kidney and zangfu appear the most, with 69 times.2.2.3 Major Symptoms:125 types with 5340 times in total. Dropsy carries the highest frequency with 2353 times (44.06%). This indicates dropsy is the main symptom of CGN. Dropsy and hematuria appear together 217 times, with the highest frequency for combined main symptons.2.2.4 Tongue and Pulse:2.2.4.1 Tongue Condition:There are 39 types of tongue conditions. The frequency is 1450 times. Red tongue is seen most often, with 17.97%. Following next is "plain tongue", with 13.38%.2.2.4.2 Pulse Presentation:62 types are identified in total and the total frequency is 1043 times. Deep and thin pulse presentations appear most frequently with 177 times, about 16.77%. In the combination of the tongue and pulse, the combination of deep and thin pulse presentation and red tongue appear the most, for totally 57 times.2.2.5 Diagnosis:There are totally 139 diagnoses from the mining result. The total frequency is 4260 times. Qi yin asthenia appears the most with 744 times (about 17.46%). For combinations, liver kidney yin insufficiency and qi yin asthenia appear the most, with 122 times.2.2.6 Treatment:Totally 242 methods are identified. The total frequency is 5650 times. Among all, the one appears the most is "activating blood circulation to dissipate blood stasis", with the ratio is 13.519%. The most common combination of treatments is supporting healthy qi and activating blood circulation to dissipate blood stasis, carries a total of180 times.2.2.7 Prescription:156 prescriptions are found and the frequency of it is 1491.The use/application of liuweidihuangtang is most common with 136 times (about 9.121%). The compound formula, wupiyin complementing to zhenwutang has the highest frequency of 17 times.2.2.8 Chinese Medicine:From the 680 documents,586 Chinese medicines in use are identified and the total frequency is 28261 times. Among all, huangqi is the most used one, about 5.54%. Followed closely are fuling, danshen, baizhu, yimucao, shanyao, zexie, baimaogen, dihuang and dangshen. Different Chinese medicines have been used together to treat CGN. In the use of two Chinese medicines, the combination of fu ling matching with huang qi appears the most, with 343 times.In the category of using three Chinese medicines, bai zhu matching with fu ling and huang qi appears the most, with 260 times. For four medicine combination, salvia matching with bai zhu, fu ling and huang qi appears the most, with 182 times. The most frequent five-medicine combination belongs to dioscorea, bai zhu, white atractylodes, fu ling, salvia and huang qi. This reflects that to a certain extent these medicines are the common chosen ones in combination treatment for CGN.2.2.9 Proprietary Chinese Medicines:104 types of proprietary Chinese medicines are identified. The frequency of the use of Six-Ingredient Rehmannia Pill is the highest, with 96 times (9.55%). The next is Lei Gong Teng Duodai Pian, with 87 times (8.66%). The most frequently used propriety Chinese medicine combination is Shenling Baizhu Wan matching with Six-Ingredient Rehmannia Pill, with 14 times in total.Achievement:The study has been successful in establishing the regularity between CGN and its treatment in a statistical way, as well as analyzing the full text of documents on the disease systemically. A conclusion on the regularity of the causes of disease, the trigger point of the disease, symptoms, the disease itself, symptoms, prescriptions and medicines in the healing process has been realized, which complements former studies merely focused on sorting the summary data in the past. And a more comprehensive, stereoscopic and authentic regularity in the therapeutic treatments on CGN has been established.