Research On Modification Of Banxiaxiexin Tang Cases Published In Last Five Decades Basing On The Principle Of Attribute Partial Order Chart

ObjectiveBanXiaXieXin Tang(BXXXT)is one of the common prescription used by Traditional Chinese Clinicians(TCC).It is useful in treating various diseases and symptoms after the modification(addition and/or subtraction of drugs)of the BXXXT formula.In order to study the TCC's experiences on BXXXT,this research focuses on the effective medical records of oral BXXXT treatment over the last five decades published on Chinese Journals.Through analyzing and comparing the Attribute Partial Order Chart(APOC),TCC's experiences on different modification of BXXXT,including the main drugs and modified drugs,were examined and analyzed.The comparative study of APOC is an innovation point of the research.MethodsModern Chinese medical journal articles of the effective medical reports about the treatment of BXXXT,published from 1960 to 2017 were collected.After the process of inclusion criteria,exclusion criteria,standardized expression and main drugs grouping by different dose level,the database of effective BXXXT medical records was established.Based on the knowledge discovery method of APOC database,the various ‘objectattribute ' Form Backgrounds were formed.Then the various APOCs were constructed by the research team of Professor Hong Wenxue of the Institute of Biomedical Engineering of Yanshan University.Mainly through comparing the symptoms and signs between different group's APOCs of the main drug groups(high-dose group,original-dose group,low-dose group,drug deletion group)and additional drug groups,the results of similarities and differences between the groups were showed in APOCs and the results of chisquare test between groups were as corroboration.ResultsThe study included 689 cases of effective BXXXT treatment medical reports.Only 2 cases were the original BXXXT prescription without additional drugs,and 11 cases were the original BXXXT prescription with/without additional drugs.64.2% of BXXXT patients' diseases were related to the spleen-zang and stomach-fu systems of tradition Chinese medicine(TCM)theory.The main TCM syndromes were ‘ cold and hot miscellaneous'(50.9%)and ‘spleen-zang deficiency'(40.0%).The main symptoms and signs were related to spleen-zang and stomach-fu system in TCM concept.In the collected cases,the patient's most common symptoms was epigastic discomfort.Loose stool were observed in the cases of original BXXXT without additional drugs group were The patients in original BXXXT with/without additional drugs group often experience belching as a comcomitant symptom.The patients in modified BXXXT group often presented with‘yellow tongue coating,epigastric discomfort,poor appetite,greasy tongue coating ' and quite often with ‘loose stool,red tongue and fatigue.'There were 30 sub-groups of different dose level of main drugs.Comparing the main symptoms results between different dose level groups in each main drug,the main symptoms in 4 different dose level of Pinellia groups are loose stool and epigastric discomfort.The main symptoms in high-dose group and normal-dose group were yellow tongue coating,greasy coating and fatigue.Abdominal pain was often presented in Removing Pinellia group and it was not presented in the other 3 groups;The main symptoms of4 dry ginger groups involved epigastric discomfort and yellow tongue coating.The main symptoms in high-dose group involves relaxing with pressure(??)and white tongue coating.It did not involve greasy tongue coating.Poor appetite and loose stool were frequently presented in the originaldose and low-dose groups.Fatigue was not involved with removing group;The main symptoms of 4 Coptis Chinensis groups involved epigastric discomfort,yellow and greasy tongue coating.Fatigue was not the main symptoms in removing group;the main symptoms of 4 Scutellaria Baicalensis groups involved epigastric discomfort and yellow tongue coating.The patients had red tongue with greasy coating frequently in the original-dose and highdose group;the main symptoms of 4 Ginseng groups involved yellow coating,epigastric discomfort,nausea and greasy coating.The main symptoms included poor appetite,fatigue and loose stool in high-dose and originaldose groups;the main symptoms of 4 Liquorice groups involved yellow tongue coating,poor appetite,greasy coating and red tongue.The main symptom in high-dose groups were aphtha instead of epigastric discomfort.The main symptoms in 3 jujube groups involved epigastric discomfort,yellow coating,poor appetite,greasy coating and loose stool.The patients had red tongue in removing jujube group.The patients in original group were often presented with fatigue.The main symptoms in 3 ginger groups included epigastric discomfort,yellow coating,greasy coating,and red tongue.The non-low-dose ginger group did not involve nausea and poor appetite.From another point of view,except low-dose Pinellia group and removing Pinellia group,remaining 28 sub-groups'main symptoms involved yellow tongue coating.Except the high-dose Pinellia group,remaining 29 sub-gourps'mian symptoms was epigastic discomfort.There were 261 types of additional drugs in the cases collected in this stdy.The highest frequency of the first three additional drugs(excluding Codonopsis pilosula)were Poria cocos,Largehead Atractylodes and tangerine peel/citrus.The common 52 types of additional drugs were observed.After comparing the main symptoms between different additional drugs,the result showed 41 additional drugs'main symptoms were associated with gastric glomus(??)and only 2 addition durgs(tangerine peel/citrus,caulis bambusae)had statistical difference in frequency analysis between that additional drug groups and non-additional drug groups.15 additional drugs'main symptoms were involved with yellow tongue coating and 4 of them(Concha arcae,Ligusticum wallichii,Mangnolia officinalis,atractylodis)had statistical difference.28 additional drugs'main symptoms were involved with poor appetite and 3 of them(Codonopsis pilosula,Ventriculi galli mucosa,medicated leaven)had statistical difference.28 additional drugs'main symptoms were involved with poor appetite and 3 of them(Codonopsis pilosula,Ventriculi galli mucosa,medicated leaven)had statistical difference.28 additional drugs'main symptoms were involved with greasy tongue coating and 3 of them(Codonopsis pilosula,rhizoma corydalis,semen coicis)had statistical difference.9 additional drugs'main symptoms were involved with loose stool and all of them(Codonopsis pilosula,Poria cocos,Largehead Atractylodes,Radix Astragali,Rhizoma Dioscoreae,medicated leaven,rhizoma atractylodis,semen coicis,radix sileris)had statistical difference.15 additional drugs'main symptoms were involved with red tongue and 5 of them(Codonopsis Pilosula,Fructus Gardeniae,Inula Flower,Reddle,Radix Ophiopogonis)had statistic difference.6 additional drugs'main symptoms were involved with fatigue and 5 of them(Codonopsis Pilosula,Radix Astragali,Largehead Atractylodes,monkshood,Semen Zizyphi Spinosae)had statistic difference.15 additional drugs'main symptoms were involved with epigastic pian and all of them(Radix Bupleuri,Radices Paeoniae Alba,Fructus Aurantii Immaturus,Rhizoma Corydalis,Citrus Chirocarpus,Dandelion,Danshen Root,Radix Notoginseng,Evodia Rutaecarpa,Fructus Amomi,medicated leaven,malt,Rhizoma Bletillae,cuttlefish bone)had statistic difference.5 additional drugs'main symptoms were involved with epigastic pian and all of them(Evodia Rutaecarpa,Fritillaria thunbergii Miq,cuttlefish bone,Concha Arcae,Rhizoma Bletillae)had statistic difference.ConclusionBased on the Principle of Attribute Partial Order Chart(APOC),the research preliminarily sorted out the regular pattern of application of BXXXT by modern TCC,including the basic applications of BXXXT(types of disease,TCM syndromes,symptoms)and the common rules of modification of BXXXT(the main symptoms in different dose level of main drugs and additional drugs).The following results of different main symptoms were proven by the frequency analysis of Chi-square test:Abdominal pain was often in Removing Pinellia group(P<0.01).Relaxing with pressure and white tongue coating were involved in high-dose dry ginger group(P<0.001).Patients in highdose groups get aphtha frequently(P<0.001)and were not involved with epigastric discomfort(P<0.05).APOC is effective in finding out the commonness between attributes.Analyzing and comparing the results of different dose level of main drugs' main symptoms,the difference and commonness(background factor)were found out as well as the difference of main symptoms between various additional drugs.