| ObjectiveTo explore the rule of Chinese medicine in treating dysentery in Ming and Qing dynasty by data mining technology and literature research methods.The TCM case record data were collected based on the characteristics of its entirety and complexity of the real world TCM pattern.MethodsPerforming a systematic search on Encylopaedia Of Traditional Chinese Medicine with the keywords "Li-ji","Li""Zhi-xia"and"Chang-pi" for Chinese medical literatures of dysentery in Ming and Qing dynasty,extracting TCM clinical information of medical cases including name,gender,age,past-history,TCM constitution,hobby,diet,mental health,symptoms,syndrome elements,prescription medication,etc.TCM database was formed after standardization.Use various statistical methods to statistics analysis.This important factor of different courses and special populations have been considered as well in the research.Results1.Patient's general condition1040 medical cases were included.The medical cases of the acute phase are 345(33.2%),the chronic phase 582(56%)and the after-treatment phase 113(10.9%).Of 473 medical cases,there are 346 males and 127 females,and their proportion is 2.72:1;171 medical cases record information about season,autumn and summer accounting for 88.3%.Of 136 medical cases,the most common causes are unhealthy diet,excessive fatigue,negative emotional stimuli,heat evil,etc.Of unhealthy diet,unclean fruits,greasy food,excessive alcohol are more important,same as overwork and excessive sex of excessive fatigue,and anger of negative emotional stimuli.Excessive smoking,alcohol and greasy food are higher in frequency of unhealthy lifestyle.23 medical cases record information about past medical history,involving 19 diseases such as asthma,jaundice and stomachache,etc.27 medical cases record information about physical health,and poor-health is higher in frequency.Of 36 medical cases,yin-deficiency constitution and damp-heat constitution are the main TCM constitutions.For distribution of special populations,the medical cases number of older patients is 97,children is 50,pregnancy is 27,postpartum is 25.317 medical cases record informations about course of the treatment.The average treatment time is 5.79d,the longest is 90d and the shortest is 1d.And the acute phase is 3.5d in average,the chronic phase is 7.04d and the after-treatment phase is 10.2d.176 medical cases of Mistreatment account for 16.92%of all.The mistreatment percentage in older patients is 27%,young adults is 26%,children is 26%.Mistreatment can always lead to exacerbate the disease.Incorrect subjective judgments and TCM theory is the main reasons for mistreatment;Incorrect deficiency and excess is the common form of mistreatment.2.Diagnosis and treatment Rule of the whole medical cases of dysenteryThe most common gastrointestinal symptoms are abdominal pain,tenesmus,stool frequently,pus and blood stool.The most common types of abnormal stool are stool frequently,pus and bloody stool.Abdominal pain and abnormal stool are the most two common symptoms.The most common symptoms of tongue images are yellow,white and greasy.The most common symptoms of pulse conditions are stringy,rapid and thready.The most important rule by association rule mining is tenesmus.The most associated-symptoms are abdominal pain,rapid pulse and dry mouth.The most common sorts of Chinese medicines are drugs of nourishing qi,enriching the blood,clearing heat and dampness.The most common herbs are white peony root,poria cocos,pericarpium citri reticulatae,bighead atractylodes rhizome and coptidis rhizome,etc.Factor analysis and cluster analysis shows that "white peony root","ginseng,bighead atractylodes rhizome,poria cocos,prepared radix licorice" are the main types.Association rules mining shows that the important rules are "angelica pubescens,radix peucedani","radix peucedani,angelica pubescens","notopterygium incisum,angelica pubescens","rhizoma chuanxiong,radix peucedani","chinese pulsatilla,the bark of ash".Multilayer network analysis shows that core prescription are white peony root,coptidis rhizome,radix scutellariae,radix aucklandiae,chinese angelica,radix liquiritiae,ginseng,bighead atractylodes rhizome,poria cocos and prepared radix licorice.By ? correlation analysis between symptom and herbs,below are specific herbs for important symptoms.Abdominal pain:mirabilite,wine processing rhubarb and coptidis rhizome,etc;Hou-zhong:areca nut,rheum officinale and liquorice,etc;Fever:periostracum cicadae,soybean germinated and mulberry leaf,etc;Nothing-eating:rhizoma acori talarinowii,chinese waxgourd peel and nelumbo nucifera gaerth,etc;Tenesmus:rheum officinale,areca nut and radix glycyrrhizae,etc;Vomit:pinellia ternate,flos rosae rugosae and bamboo shavings,etc;Abdominal Distension:cortex magnoliae officinalis,star anise and atractylodes,etc;Emaciation:adenophora tetraphylla,charcoal of ginger and folium eriobotryae,etc;Unconsciousness:rhinoceros horn,jellyfish and concha ostreae,etc;Hiccup:semen canavaliae,kaki calyx and ginseng,etc;Abdominal painless:fructus ziziphi jujubae,soybean germinated and sanguisorba officinalis,etc.Below are specific herbs for abnormal stool.Stool frequently:rheum officinale,musk and platycodon grandiflorum,etc;Pus and bloody stool:charred crataegus,medicated leaven and coptidis rhizoma,etc;Bloody stool:Sanguisorba officinalis,sophora japonica and watermelon's peel,etc;Red jelly-like stool:amomum tsao-ko,radix aucklandiae and radix scrophulariae,etc;White jelly-like stool:piperis longi,endothelium corneum gigeriae galli and monkshood,etc;Sticky and greasy stool:fructus amomi,medicine terminalia fruit and flos rosae rugosae,etc;Thin sloppy stool:semen euryales,alpinia oxyphylla and lotus petiole,etc;Purple-black stool:rubia cordifolia,peach seed and olibanum;Discomforting evacuation:betel nut,flos rosae rugosae and asarum,etc;Variegated stool:antelope's horn,rhinoceros horn and turtle shell,etc;Fish brain jelly-like stool:monkshood,fructus psoraleae,nutmeg,cinnamon and roasted ginger,etc.Below are specific herbs for important pulse conditions.Wiry pulse:rhizoma cyperi,the root of Chinese pulsatilla and honeysuckle,etc;Rapid pulse:gypsum,honeysuckle and the root of chinese pulsatilla,etc;Thready pulse:dendrobium,kaki calyx and monkshood,etc;Slippery pulse:coptidis rhizoma,radix scutellariae and snakegourd fruit,etc;Large pulse:ginseng,cinnamon and dried ginger,etc;Deep pulse:chinese mosla herb,wine processing rhubarb and flos carthami,etc;Moisten pulse:ailanthus altissima,lotus leaf base and rice sprout,etc;Weak pulse:cordyceps sinensis,yam and cornu cervi degelatinatum,etc;Powerless pulse:maize,xin-huibai and cinnamon,etc;Floating pulse:fistular onion bulb,notopterygium root and chinese mosla herb,etc;Weak cubit pulse:ginseng,dried ginger,sophora japonica and monkshood,etc.Below are specific herbs for important tongue images.Yellow tongue coating:radix scutellariae,honeysuckle and red peony root,etc;White tongue coating:medicated leaven,wineprocessing rhubarb and atractylodes,etc;Greasy tongue coating:old black tea,semen sojae praeparatum and pogostemon cablin,etc;Red tongue coating:rhinoceros horn,dendrobium and american ginseng,etc;Peeling tongue coating:rhizoma bolbostemma,codonopsis pilosula and leaf of rice,etc;Grey black tongue coating:rice,mirabilite and the bark of ash,etc;Light white tongue coating:cortex magnoliae officinalis,white hyacinth bean and mulberry leaf,etc;Thick tongue coating:pericarpium citri reticulatae viride,pogostemon cablin and semen raphani,etc.3.Syndrome factors researchSyndrome factors were extracted from 730 medical cases.The syndrome elements of disease location were extracted from 555 medical cases.The main common types are spleen,intestine,stomach,kindey and liver.The most associated syndrome elements of disease location are spleen and intestine.The syndrome elements of the nature of disease were extracted from 725 medical cases.The main common types are damp,heat,qi-deficiency,and yin-deficiency;The most associated syndrome elements of the nature of disease are damp and heat.By association rules mining between syndrome elements of disease location and nature,the most associated syndrome elements are damp,heat,spleen and intestine.By ? correlation analysis between syndrome factors and symptoms,below are specific symptoms for syndrome elements of disease location.Spleen:eat-less,loose stool pond and weak pulse,etc;Intestine:yellow tongue coating,tenesmus and rapid pulse,etc;Stomach:noneating,rapid pulse,and nausea,etc;Kindey:high fever,powerless pulse and clear abundant urine,etc;Liver:wiry pulse,dizziness and rough coating,etc;Lung:cough,asthma and spitting,etc;Exterior:fear of cold,fever and headache,etc.Below are Specific Symptoms for syndrome elements of disease nature.Damp:discomforting evacuation,greasy coating and abdominal pain,etc;Heat:rapid pulse,yellow tongue coating,pus and bloody stool,etc;Qi-deficiency:weak pulse,spiritlessness and qi-insufficiency constitution,etc;Yin-deficiency:red tongue,yin-deficiency constitution and dry tongue,etc;Summer heat:greasy coating,yellow tongue coating,sweating,etc;Yang-deficiency:limb reversal,yang-deficiency constitution and cold lower limbs,etc;Agitating-bleeding:bloody stool,purple-black stool,etc;Toxin:tongue born with bur,involuntary movements with coma,colic,etc.By ? correlation analysis between syndrome factors and herbs,below are specific herbs for syndrome elements of disease location.Spleen:bighead atractylodes rhizome,ginseng and prepared licorice,etc;Intestine:radix glycyrrhizae,radix platycodi and red paeony root,etc;Stomach:fingered citron,american ginseng and caulis bambusae in taeniam,etc;Kidney:prepared rehmannia root,fructus psoraleae and monkshood,etc;Liver:white peony root,the bark of ash and platycladi seed,etc;Lung:semen armeniacae amarum,sugarcane and concha meretricis sea cyclinae,etc;Exterior:saposhnicovia divaricata,notopterygium root and semen sojae praeparatum,etc.Below are specific herbs for syndrome elements of disease nature.Damp:pogostemon cablin,cortex magnoliae officinalis and charred crataegus,etc;Heat:rhizoma coptidis,radix scutellariae and chinese bulbul,etc;Qi-deficiency:ginseng,bighead atractylodes rhizome and radix astragali,etc;Yin-deficiency:dendrobium,colla corii asini and prepared rehmannia root,etc;Summer heat:pogostemon cablin,talc and fingered citron,etc;Yang-deficiency:monkshood,bighead atractylodes rhizome and fructus psoraleae,etc;Agitating-bleeding:ailanthus altissima,fulonggan and carbonized catnip,etc;Toxin:gypsum,cyrtomium rhizome and fortune eupatorium herb,etc.4.Multi-dimensional research on medical cases of dysentery345 medical cases of acute dysentery were included in the reseach.The main common symptoms are abdominal pain,tenesmus,rapid pulse,etc;the most associated symptoms are pain,rapid pulse,greasy tongue fur,tenesmus,fever.The main common syndrome elements are heat,damp,intestines,summer heat and spleen;The most associated syndrome elements are spleen,liver,intestines,heat,damp and qi-stagnation.The most common sorts of Chinese medicines are drugs of restoring vital energy,heat-clearing and qi-regulating.The most common herbs are rhizoma coptidis,white peony root,radix scutellariae,radix aucklandiae and pericarpium citri reticulatae,etc.Factor analysis and cluster analysis shows that"rhizoma coptidis,radix scutellariae,white peony root","pericarpium citri reticulatae,cortex magnoliae officinalis and radix aucklandiae" are the main types.Multilayer network analysis shows that core prescription are white peony root,rhizoma coptidis,radix scutellariae,radix aucklandiae,angelica sinensis,radix glycyrrhizae,pericarpium citri reticulatae,poria cocos,prepared radix licorice,cortex magnoliae officinalis and betel nut.582 medical cases of chronic dysentery were included in the reseach.The main common symptoms are abdominal pain,thready pulse and string pulse,etc;the most associated symptoms are rapid pulse,thready pulse and dry mouth.The main common syndrome elements are spleen,damp,heat,stomach and qi-deficiency;the most associated syndrome elements are spleen,stomach intestines,heat,damp,qi stagnation and fluid-deficiency.The most common sorts of Chinese medicines are drugs of restoring vital energy,heat-clearing and qi-regulating.The most common herbs are white peony root,poria cocos,bighead atractylodes thizome and angelica sinensis,etc.Factor analysis and cluster analysis show that "poria cocos","hite peony root,angelica sinensis" are the main types.Multilayer network analysis show that core prescription are ginseng,poria cocos,bighead atractylodes rhizome,prepared radix licorice,white peony root,coptidis rhizome,angelica sinensis,radix aucklandiae,pericarpium citri reticulatae,radix astragali and roasted ginger.113 medical cases of after-treatment-phase dysentery were included in the reseach.The main common symptoms are thready pulse,rapid pulse and abdominal pain,etc;The main common syndrome elements are spleen,qi-deficiency,damp and stomach;the most associated syndrome elements are spleen,stomach,damp,qi deficiency and fluid-deficiency.The most common sorts of Chinese medicines are drugs of restoring vital energy,qi-regulating and heat-clearing.The most common herbs are white peony root,poria cocos,bighead atractylodes rhizome and pericarpium citri reticulatae,etc.Factor analysis and cluster analysis show that "white peony root","ginseng,bighead atractylodes rhizome,poria cocos,prepared radix licorice" are the main types.Multilayer network analysis show that core prescription are ginseng,bighead atractylodes rhizome,poria cocos,prepared radix licorice,pericarpium citri reticulatae,angelica sinensis and white peony root.97 medical cases of dysentery of older patients were included in the reseach.The main common symptoms are abdominal pain,tenesmus,stool frequently and string pulse,etc;the most associated symptoms are abdominal pain,tenesmus,slippery pulse and fever.The main common syndrome elements are heat,damp,intestines,spleen and qi-deficiency;the most associated syndrome elements are intestines,spleen,liver,damp and heat,secondly are stomach and yin-deficiency.The most common sorts of Chinese medicines are drugs of restoring vital energy,heat-clearing and qi-regulating.The most common herbs are white peony root,ginseng,poria cocos and coptidis rhizomaare,etc.Multilayer network analysis shows that core prescription are ginseng,bighead atractylodes rhizome,poria cocos,pericarpium citri reticulatae,prepared radix licorice,white peony root,coptidis rhizomaare,radix scutellariae and angelica sinensis.50 medical cases of dysentery of children patients were included in the reseach.The main common symptoms are abdominal pain,fever and stool frequently etc;the most associated symptoms are abdominal pain,fever,stool frequently,tenesmus,dry mouth and rapid pulse.The main common syndrome elements are spleen,intestines,heat,stomach and damp;the most associated syndrome elements are spleen,intestines,stomach and heat,secondly are lung,damp and qi-deficiency.The most common sorts of Chinese medicines are drugs of restoring vital energy,heat-clearing and qi-regulating.The most common herbs are white peony root,prepared radix licorice,coptidis rhizoma and bighead atractylodes rhizome,etc.Multilayer network analysis show that core prescription are ginseng,bighead atractylodes rhizome,poria cocos,prepared radix licorice,white peony root,coptidis rhizomaare,radix scutellariae,radix aucklandiae,angelica sinensis,pericarpium citri reticulatae and cortex magnoliae officinalis.27 medical cases of dysentery of pregnancy patients were included in the reseach.The main common symptoms are abdominal pain,tenesmus,rapid pulse,stool frequently and slippery pulse etc;The main common syndrome elements are uterus,stomach,yin-deficiency,spleen,kidney and damp;the most common sorts of Chinese medicines are drugs of restoring vital energy,heat-clearing and qi-regulating.The most common herbs are white peony root,bighead atractylodes rhizome,pericarpium citri reticulatae and coptidis rhizoma,etc.Multilayer network analysis show that core prescription are ginseng,bighead atractylodes rhizome,poria cocos,prepared radix licorice,bupleunum,rhizoma cimicifugae,white peony root,coptidis rhizomaare,radix scutellariae,radix aucklandiae,pericarpium citri reticulatae,angelica sinensis and radix glycyrrhizae.25 medical cases of dysentery of postpartum patients were included in the reseach.The main common symptoms are abdominal pain,tenesmus,stool frequently and large pulse etc;The main common syndrome elements are heat,intestines,spleen,qi-deficiency,qi-stagnation and damp.The most common sorts of Chinese medicines are drugs of restoring vital energy,heat-clearing and qi-regulating.The most common herbs are angelica sinensis,white peony root,pericarpium citri reticulatae,and poria cocos,etc.Multilayer network analysis show that core prescription are ginseng,bighead atractylodes rhizome,poria cocos,prepared radix licorice,white peony root,coptidis rhizomaare,radix scutellariae,angelica sinensis,radix glycyrrhizae and pericarpium citri reticulatae.Conclusion1.patient's general conditionDysentery mostly happened among men during summer and fall months.Unhealthy diet,heat evil and wind-cold evil can be the direct causes and excessive fatigue,negative emotional stimuli can be the internal causes.Also,unhealthy diet,excessive fatigue and negative emotional can be long-term adverse factors for human body susceptible to infections.Yin-deficiency constitution and damp-heat constitution are the main TCM constitutions.Dysentery is so complex that it should be treated carefully to avoid mistreatment.2.Diagnosis and treatment Rule of the whole medical cases of dysenteryThe most common gastrointestinal symptoms are abdominal pain,tenesmus,stool frequently,pus and blood stool,that can be as specific diagnostic symptoms for dysentery;Abdominal pain and stool abnormity are the most two common symptoms and are important to syndrome differentiation.Abdominal pain,rapid pulse nad dry mouth are the core and key symptoms.The core herbs of prescription for eliminating excess are white paeony root,coptidis rhizome,radix scutellariae,radix aucklandiae,chinese angelica and radix glycyrrhizae,especially white paeony root as the key herbs.The core herbs of prescription for reinforcing deficiency are ginseng,bighead atractylodes rhizome,poria cocos and prepared licoriceare,especially preserving stomach-qi as the key therapeutic principles.In conclusion,Valuing yin-fluid and stomach-qi is the key therapeutic principles throughout treatment.This research give a definition of specific herbs for important symptoms that can have great clinical significance.3.Syndrome factors researchThe syndrome elements of disease location of dysentery is intestines directly,involving spleen,stomach,liver and kidney,and the spleen is the key one.The syndrome elements of the nature of disease were damp,heat,qi-deficiency,yin deficiency,and damp and heat are the key.This research give a definition of specific herbs and symptoms for important syndrome elements that can have great clinical significance.4.Multi-dimensional research on medical cases of dysenteryThe Core symptoms of acute dysentery are abdominal pain,rapid pulse,greasy tongue fur,tenesmus,fever;the Core syndrome elements are spleen,liver,intestinal,heat,damp,and qi-stagnation,and especially qi-stagnation is prominent;11 core combinations were mined,and especially "rhizoma coptidis,radix scutellariae,white peony root","pericarpium citri reticulatae,cortex magnoliae officinalis and radix aucklandiae" are the key herbsSymptoms of chronic dysentery are complex and dispersive in distribution.The core symptoms is abdominal pain.The core syndrome elements are spleen,stomach and intestines,heat,damp,qi-stagnation and fluid-deficiency.11 core combinations were mined,and especially "poria cocos","hite peony root,angelica sinensis" are the key herbsSymptoms of after-treatment dysentery are dispersive in distribution,the main common symptoms were non-gastrointestinal symptoms such as thready pulse,rapid pulse,abdominal pain,string pulse and spiritlessness;Pulse conditions can be the important basis for diagnosis and treatment;the core syndrome elements are spleen,stomach,damp,qi-deficiency and fluid-deficiency,and especially qi-deficiency and fluid-deficiency are prominent;8 core combinations were mined,and especially"white peony root","ginseng,bighead atractylodes rhizome,poria cocos,prepared radix licorice" are the key herbs.The core symptoms of dysentery of older patients are abdominal pain,tenesmus,slippery pulse and fever;the core syndrome elements are intestines,spleen,liver,damp and heat.8 core combinations were mined,and tonifying spleen is important.The core symptoms of dysentery of children patients are abdominal pain,fever,stool frequently,tenesmus,dry mouth and rapid pulse.The core syndrome elements are spleen,intestines,stomach and heat.Dysentery of children patients has characteristics of complicated with dyspepsia and being easy to change.The main common symptoms of dysentery of pregnancy patients are abdominal pain,tenesmus,rapid pulse,stool frequently and slippery pulse etc;The main common syndrome elements are uterus,stomach,yin-deficiency,spleen,kidney and damp;Medicine for pregnant dysentery conforms to the general rule,and benefiting qi and elevating yang should be valued.The main common symptoms of dysentery of postpartum patients are abdominal pain,tenesmus,stool frequently and large pulse etc;The main common syndrome elements are heat,intestines,spleen,qi-deficiency,qi-stagnation and damp.8 core combinations were mined.Dysentery of children patients has characteristics of blood-deficiency and qi blood stasis. |
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