| Objective:1.To explore the causes of yellow-greasy coating and white-greasy coating common in greasy coating and the experiences in diagnosis and treatment,provide useful references for the diagnosis and treatment of yellow-greasy coating and whitegreasy coating during the disease process.2.To explore the compatibility of drugs with yellow-greasy coating in the indications of Chinese patent medicine.3.To explore the law of drug compatibility with white-greasy coating in the indications for formula of Chinese medicine.4.To explore the differences and diversity of the tongue flora for yellow-greasy and white-greasy coating common in greasy coating patients with diarrhea.Methods:1.Through literature research methods,literatures related to yellow-greasy coating and white-greasy coating are screened in ancient Chinese medicine books and in databases such as CNKI,Wanfang,and other databases to find suitable documents.And to sum up the causes of yellow-greasy coating and white-greasy coating common in greasy coating and the experiences in diagnosis and treatment.2.In the text of the fifth edition of the Chinese Medical Code,search for "yellowgreasy",and screen for Chinese patent medicines in the search results.Extract the data such as the formula name and composition of the Chinese patent medicine,and then use Excel to organize the data.Insert the organized data into Access for cross-tab query.The query results are imported into Weka for associated data analysis,and the obtained data is imported into Cyto Scape for visualization.3.Search "white-greasy" in the Chinese prescription database,and select the white-greasy coating that appears in formula of Chinese medicine in the search results.Extract the data such as the formula name and composition,and then insert the data into Access after finishing the data with Excel.Perform a cross-tab query.The results of the query are imported into Weka for data association,and the obtained associated data is imported into Cyto Scape for visualization.4.From April 2018 to May 2019,in the Department of Gastroenterology,Jiangxi Provincial Hospital of Traditional Chinese Medicine,two experienced Chinese physicians used blind methods to observe the tongue picture of patients with diarrhea;60 patients with yellow-greasy coating with a high degree of diagnostic consistency were selected and classified into the yellow-greasy coating group(group H);60 patients with white-greasy coating samples with higher degree of diagnosis consistency were sampled and classified as white-greasy coating group(group B);Tongue coating samples were collected from 60 healthy students at the university and classified as normal tongue coating group(group Z).After DNA extraction using a DNA extraction kit,high-throughput sequencing was performed using Illumina Miseq 600,and the sequencing data was processed and analyzed.Results:1.In addition to ancient Chinese medicine books,19 papers about yellow-greasy coating were selected.It was found that in addition to damp and heat,yellow-greasy coating can also be caused by fluid retention and heat equally,phlegm heat,stagnation,yang deficiency,superficies pathogens involving interior,sunstroke and damp-warm syndrome.Yellow-greasy coating can appear in the dry cough,acute stage of stroke,spleen and stomach disease,liver disease,kidney disease,depression and other diseases;the treatment method involves clearing heat,warmly invigorating,catharsis,expelling pathogens from both interior and superficies,resolving food stagnation,invigorating spleen for eliminating dampness,and separating clear and excreting turbid.In addition to ancient Chinese medicine books,11 papers about white-greasy coating were selected,and it was found that white-greasy coating can be caused by phlegm dampness,dampness-heat syndrome with predominant dampness,fluid retention-heat syndrome with predominant fluid retention,superficies syndrome,lung cold,pathogenic qi in middle jiao,and damp-warm syndrome,etc.;white-greasy coating can appear in heart and brain diseases,kidney disease,spleen and stomach disease,eczema,acne and other diseases;the treatment method involves invigorating spleen for eliminating dampness,eliminating dampness and phlegm,dissipating phlegm for resuscitation,invigorating spleen and replenishing qi,removing turbidity and detoxification,and acupuncture.2.A total of 54 Chinese patent medicines were found in the Chinese Medical Code,and 362 data were compiled using Excel.Among the symptoms treated by Chinese patent medicines,the most commonly used drugs for yellow-greasy coating are Radix Scutellariae,Rhizoma Coptidis,Radix et Rhizoma Rhei and other heat-clearing drugs.The most commonly used are heat-clearing drugs,followed by drugs for diuresis and diffusing dampness.3.A total of 59 formulas of Chinese medicine were queried in the Chinese prescription database,and 502 data were compiled using Excel.Among the symptoms treated by the formula of Chinese medicine,the most commonly used for white-greasy coating is Rhizoma Pinelliae,Poria,Pericarpium Citri Reticulatae,Cortex Magnoliae Officinalis,etc.The most commonly used types are drugs for tonifying deficiency,followed by heat-clearing drugs.4.The yellow-greasy coating group got 40 high-quality sequences,the whitegreasy coating group got 40 high-quality sequences,and the normal tongue coating group also got 40 high-quality sequences,a total of 120 high-quality sequences.The average sequence read length of all samples was 423.49 bp.After comparison with the database,the flora was determined to belong to 19 phyla,37 classes,97 orders,166 families,326 genera,603 species,and 903 OTUs.The three groups of samples had similar dominant flora at the phylum level,namely: Bacteroidetes,Firmicutes,Proteobacteria,Fusobacteria,Actinobacteria,and Patescibacteria.Although the predominant flora at the phylum level of the three groups of samples is similar,the proportion of each flora is different.Group H accounts for the top four: Bacteroidetes(31.90%),Firmicutes(26.19%),Proteobacteria(22.71%),Actinobacteria(9.01%);Group B accounts for the top four: Firmicutes(27.84%),Proteobacteria(27.08%),Bacteroidetes(26.49%),Fusobacteria(9.40%);Group Z accounted for the top four: Bacteroidetes(33.57%),Firmicutes(26.18%),Proteobacteria(24.27%),Fusobacteria(8.17%).And at the level of phylum,there were differences between groups H and B in Fusobacteria,Tenericutes and Acidobacteria;groups H and Z had differences in Actinobacteria,Cyanobacteria,Acidobacteria and Chloroflexi;groups B and Z had differences in Bacteroidetes.At the level of class,there were differences in Fusobacteriia and Gracilibacteria between group H and group B;there were differences in Actinobacteria,Oxyphotobacteria and Alphaproteobacteria between groups H and Z;there were differences between groups B and Z in Bacteroidia.At the level of order,there were differences in Fusobacteriales between group H and group B;there were differences between groups H and Z in Pasteurellales and Chloroplast;there were differences between groups B and Z in Bacteroidales,Pasteurellales,Flavobacteriales and Bacillales.At the level of family,there were differences between group H and group B in Prevotellaceae,Fusobacteriaceae and Porphyromonadaceae;there were differences between groups H and Z in Pasteurellaceae and Porphyromonadaceae;there were differences between groups H and Z in Prevotellaceae and Pasteurellaceae.At the level of genus,there are differences between group H and group B in Prevotella?7,Fusobacterium,Porphyromonas,Alloprevotella;Groups H and Z have differences in Haemophilus,Porphyromonas,Prevotella?6;Groups B and Z have differences in Prevotella?7,Haemophilus,Alloprevotella.At the level of species,there are differences between groups H and B in uncultured?bacterium?g??Porphyromonas;Groups H and Z have differences in Haemophilus?parainfluenzae?T3T1,uncultured?bacterium?g??Porphyromonas and Prevotella?pallens;differences between groups B and Z are in Prevotella?melaninparain?e?3?ATCC?1.Conclusion:1.The causes of yellow-greasy coating and white-greasy coating common in greasy coating are complex,involving a wide range of diseases,various treatment methods.It should be carefully analyzed and needs reasonable treatment.2.The most frequent drug combinations that have yellow-greasy coating in the symptoms of Chinese patent medicines are divided into four categories,namely Radix Scutellariae,Rhizoma Coptidis,and Radix et Rhizoma Rhei in heat-clearing drugs;Radix Aucklandiae,Pericarpium Citri Reticulatae,Semen Arecae in drugs for activating qi flowing;Rhizoma Pinelliae in drugs for dispelling phlegm and Radix Angelicae Sinensis in drugs for replenishing blood.3.The most frequent drug combinations with white-greasy coating in the prescriptions treated by the formula of Chinese medicine are divided into six categories,namely Radix Ginseng,Rhizoma Atractylodis Macrocephalae,Radix Glycyrrhizae,and Radix Angelicae Sinensis in drugs for tonifying deficiency;Radix Aucklandiae and Pericarpium Citri Reticulatae in drugs for qi flowing;Rhizoma Pinelliae in drugs for phlegm-expelling;Rhizoma Ligustici Chuanxiong in drugs for promoting blood circulation for removing blood stasis;Poria in drugs for diuresis and diffusing dampness and Cortex Magnoliae Officinalis in drugs for eliminating dampness.4.Actinobacteria may be the key bacteria causing yellow-greasy coating.Bacteroidetes may be the key bacteria causing white-greasy coating.Fusobacteria may be the key bacteria to distinguish yellow-greasy coating and white-greasy coating. |
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