The Study Of The Relationship Between The Prenatal TCM Constitution Distribution Of Hong Kong Females And Their Relevant Postnatal Condition

Objective We try to investigate the distribution of the prenatal TCM constitution distribution of Hong Kong females,their health condition and relative factors through this study.By using Decision Tree model of Data Mining to analyze and categorize the relationship and classification rules among the prenatal TCM constitution and different postnatal TCM symptoms of the females.Further statistical analysis of the distribution of these postnatal symptoms would also be done.Methods 200 Hong Kong females,who were after their delivery within 100 days,had been invited to join the survey from May 2013 to May 2017.Incomplete questionnaire,samples who were lost in contact before completing the two parts of the questionnaire,or not giving birth of the babies before March 2017 have been all excluded from the study.This study has been divided into 2 parts;1)the standardized Constitution Chinese Medicine Questionaire(CCMQ),which was developed by Prof.Wand Qi and declared by the Association of Chinese Medicine,has been conducted by the recruited females before or after their delivery,2)Self-designed questionnaire about postnatal condition in TCM.Analyze the results of the appearance of the postnatal TCM symptoms,distribution of TCM constitution,the condtion during pregnancy and after childbirth,the correlation between the TCM constitution and postnatal TCM symptoms.All the standards of diagnosis have been based on different Gynaecological textbook and relative journals.After the investigation,all the raw data were entered into the Google Form,and then were exported to Excel.Conduct preprocessing of the data: Data cleaning,Data integration,Data reduction,and Data transformation.Encoded the data,then processed statistical analysis of the data.Executing the Classification Tree Algorithm of the Orange software for mining the data.Developing classification rules among the different types of TCM constitution and postnatal symptoms by classification through building decision tree model.Results There were 200 questionnaire sending out to the females who had fulfilled the inclusion criteria.Finally,there are 132 samples successfully collected,they are aged from 17 to 42.Age group 31-35 got the highest percentage among the others(n=73,55.3%).Then followed by age group 36-40 and 26-30,which shared 18.2% and 16.7% respectively.Among the different creers,females who worked in office were the majority(56.8%),then came to the full-time mother(16.7%)and shift duty(12.9%).Most of the investigated population lived in crowd urban area(49.2%),then was those lived at submontane(22.7%)and coastal area(21.1%).For the blood type distribution: Type AB was 9.1%,Type O was 34.8%,Type A was 23.5% and Type B was 21.2%.Over half of the females were first pregnancy.From the research,multifetal pregnancy(6.1%)was not common.69.7% of the females suffered different kinds of discomfort during pregnancy.62.9% of them had not used Chinese medicine for prevention of abortion.It was the same common for the pregnant females to take Chinese and Western medicine when they felt sick.88.6% of the females took supplements during their pregnancy.The expected date of delivery was mosly in Winter,while the Summer was the least.91.6% females delivered in full-term pregnancy.Natural childbirth was still the mainstream type of childbirth in Hong Kong.72.7% females were willing to follow the traditional rituals during postnatal period.In this research,females generally would not stay in the hospital more than 4 days.Nearly 90% females gave breast milk feeding.The satisfaction of the rest for postnatal recovery was highly depending on the support of the new mother.The number of days of the lochia clearance were relatively long for the females in this research,67.4% whose lochia had been last more than 21 days.40.2% was diagnosed as Postpartum prolonged lochia,9.8% was diagnosed with Postpartum pain,22.0% was diagnosed as both above diseases,3.0% wasdiagnosed as Postpartum prolonged lochia with others postpartum diseases/ non-postpartum diseases,1.5% was diagnosed as Postpartum pain with others postpartum diseases/ non-postpartum diseases,1.5% was diagnosed as Postpartum prolonged lochia and Postpartum pain with either others postpartum diseases or non-postpartum diseases,13.6% was diagnosed with only either others postpartum diseases or non-postpartum diseases,8.3% was healthy females.Among the population who has been diagnosed as Postpartum prolonged lochia,the most common symptoms type was Qi deficiency type(n=58),then was Stagnant blood type(n=34);but if we grouped the subtype with the main type together and counted again,the most common symptoms type would change from Qi deficiency type(n=72)to Stagnant blood type(n=75).For the population with Postpartum pain,the most common symptoms type were Wind and cold type(n=20)and Stagnant blood with meridian blocked type(n=15).The TCM constitution types distribution were shown below in decending order: Yin deficiency(37.1%),Yang deficiency and Blood stasis(35.6%),Qi deficiency(33.3%),Phlegm-dampness and Special diathesis(22.0%),Damp-heat(21.2%),Qi stagnation(19.7%),Gentleness(6.8%).With only one single TCM constitution type were 31.1%,while those with a complex TCM constitution type were listed out: more than 1 type were 15.2%,more than 2 type were 6.8%,more than 3 type were 15.2%,more than 4 type were 3.0%,more than 5 type were 4.5%,more than 6 type were 6.1%,more than 7 type were 0.8%,without any significant TCM constitution type were 17.4%.Among all the Postnatal TCM symptoms,prolonged lochia were the most common(67.42%),tiredness has come next(56.06%),then abnormal sweating and(39.39%)?feeling annoyed(39.39%),dry mouth(37.88%),Postnatal body pain(36.36%),feeling anger(31.06%).Diagnosed as Postpartum Prolonged Lochia was 40.2%,Postpartum pain 9.8%,both 22.0%.Classification rules for tiredness=Yes: R1:IF Yin deficiency=tends to Yes AND Qi deficiency=No AND Blood stasis=No THEN tiredness=Yes R2:IF Yin deficiency=No AND Qi deficiency=No AND Blood stasis=No ANDGentleness=Basically Yes THEN tiredness=Yes R3:IF Qi deficiency=No AND Blood stasis=Yes THEN tiredness=Yes R4:IF Qi deficiency=tends to Yes THEN tiredness=Yes R5:IF Qi deficiency=Yes THEN tiredness=Yes R6:IF Qi deficiency=No AND Blood stasis=tends to Yes THEN tiredness=Yes R7:IF Yin deficiency=Yes AND Qi deficiency=No AND Blood stasis=No THEN tiredness=Yes Classification rules for abnormal sweating=Yes: R1:IF Phlegm-dampness=tends to Yes AND Damp-heat=No AND Gentleness=No THEN abnormal sweating=Yes R2:IF Damp-heat=tends to Yes AND Special diathesis=Yes AND Gentleness=No THEN abnormal sweating=Yes R3:IF Damp-heat=No AND Gentleness=Basically Yes THEN abnormal sweating=Yes R4:IF Phlegm-dampness=Yes AND Damp-heat=No AND Gentleness=No THEN abnormal sweating=Yes R5:IF Qi deficiency=No AND Phlegm-dampness=No AND Damp-heat=No AND Blood stasis=No AND Gentleness=No THEN abnormal sweating=Yes R6:IF Damp-heat=tends to Yes AND Special diathesis=No AND Gentleness=No THEN abnormal sweating=Yes R7:IF Damp-heat=tends to Yes AND Gentleness=No THEN abnormal sweating=Yes Classification rules for feeling annoyed=Yes: R1:IF Damp-heat=No AND Blood stasis=Yes AND Special diathesis=Yes THEN feeling annoyed=Yes R2:IF Phlegm-dampness=tends to Yes AND Blood stasis=tends to Yes AND Special diathesis=Yes THEN feeling annoyed=Yes R3:IF Qi deficiency=tends to Yes AND Blood stasis=No AND Special diathesis=tends to Yes THEN feeling annoyed=Yes R4:IF Phlegm-dampness=No AND Blood stasis=tends to Yes THEN feeling annoyed=Yes R5:IF Blood stasis=Yes AND Special diathesis=tends to Yes THEN feeling annoyed=Yes R6:IF Phlegm-dampness=Yes AND Blood stasis=tends to Yes THEN feeling annoyed=Yes R7:IF Phlegm-dampness=Yes AND Damp-heat=Yes AND Blood stasis=Yes ANDSpecial diathesis=Yes THEN feeling annoyed=Yes R8:IF Blood stasis=tends to Yes THEN feeling annoyed=Yes R9:IF Yin deficiency=No AND Qi deficiency=tends to Yes AND Blood stasis=No AND Special diathesis=No AND Gentleness=Basically Yes THEN feeling annoyed=Yes R10:IF Phlegm-dampness=tends to Yes AND Damp-heat=Yes AND Blood stasis=Yes AND Special diathesis=Yes THEN feeling annoyed=Yes Rules for TCM diagnose=Postpartum Prolonged Lochia: R1:IF Yin deficiency=Yes AND Qi deficiency=tends to Yes AND Phlegm-dampness=No AND Special diathesis=No THEN TCM diagnose=Postpartum Prolonged Lochia Rules for TCM diagnose=Postpartum pain: R1:IF Yin deficiency=tends to Yes AND Qi deficiency=Yes AND Special diathesis=tends to Yes THEN TCM diagnose=Postpartum pain Rules for TCM diagnose=Postpartum Prolonged Lochia and Postpartum pain: R1:IF Yang deficiency=Yes AND Yin deficiency=No AND Qi deficiency=Yes AND Blood stasis=tends to Yes THEN TCM diagnose=Postpartum Prolonged Lochia and Postpartum pain R2:IF Yin deficiency=tends to Yes AND Qi deficiency=tends to Yes AND Phlegm-dampness=No AND Special diathesis =No AND Gentleness=No THEN TCM diagnose=Postpartum Prolonged Lochia and Postpartum pain R3:IF Yin deficiency=Yes AND Qi deficiency=Yes AND Special diathesis =No THEN TCM diagnose=Postpartum Prolonged Lochia and Postpartum painConclusion 1.In decending order,the distribution of the TCM constitution are: Yin deficiency> Yang deficiency,Blood stasis> Qi deficiency> Phlegm-dampness,Special diathesis> Damp-heat> Qi stagnation> Gentleness.Most of the samples had constitution types other than Gentleness.Single type constitution is more common than the complex constitution type people which more than 1 type and 3 types have the largest percentage 2.Postpartum Prolonged Lochia is the most common postnatal symptoms among the others.Unfortunately,it is always necglected by the females.3.Although some classes were not able to generate classification rules,it is still satisfied with the results.4.Tiredness appears during postpartum period mainly due to the loss ofQi and Blood,which causes the Qi upward movement has been blocked.Among those 7 chosen rules,R2 is not informative.R1,R4,R6 are relatively less instructive.R3,R5 and R7 would be better rules from the others.5.Abnormal sweating has selected 7 rules,R3 and R5 are not useful in clinical.R1 and R4 would be more instructive rules.6.Feeling annoyed has isolated 9 rules,R2,R3,R4,R8 and R9 are not very informative.The other 4 rules are relatively reasonable and meaningful.7.Dry mouth appears due to the deficiency of Yin and body fluid.Among the chosen 11 rules,R3,R8,R9 and R10 are not instructive.R8 is recommended to delete.The other 7 rules are reasonable and clinically informative.8.Postnatal body pain has selected 9 rules,R2 and R9 are not informative enough.The other rules are clinically meaningful.