The Study On Professor Liu Qiquan's Experience In The Treatment Of Gastroesophageal Reflux Disease By Using Data Mining And Clinical Research From "Fire Heat Theory"

Part? Discussion on the the academic thoughts of Professor Liu Qiquan on the treatment of gastroesophageal reflux disease from "fire heat theory"Objective: From the perspective of "fire heat theory" of Liu Wansu's treatment of exogenous fever,this part explored the academic thought of Professor Liu Qiquan in treating gastroesophageal reflux disease.Methods: By combing Liu Wansu's theory of etiology,pathogenesis,and rule of law for "fire heat theory",this part explored Professor Liu's thoughts on the etiology,pathogenesis,rule of law,and rule of clinical medication of this disease.Results: The key to the pathogenesis of this disease is "qi" and "heat".Professor Liu is good at treating GERD from fiery heat.It is believed that the treatment of gastroesophageal reflux disease should focus on the opening of stagnation,pay attention to promoting qi movement and reducing stomach fire,while using bitter and cold medicines and taking care of nourishment yin fluid.In clinical treatment,five major treatment methods of dispersing,clearing,dissolving,ventilating,and nourishing were proposed.Conclusion: Professor Liu's treatment of this disease originates from the classics,and he is good at summarizing,daring to innovate,and clinically good at treating GERD from fiery theory.It provides theoretical support for the subsequent data mining analysis and clinical research of the clinical case of the mentor,promotes the inheritance and innovation of the basic theory of Traditional Chinese Medicine,and has important significance for the inheritance and development of Professor Liu's academic thoughts.Part ? A Case Study of 512 Cases of Gastroesophageal Reflux Disease Treated by Professor Liu Qiquan Based on Data MiningObjective: Through the "Traditional Chinese Medicine Inheritance Support System(TCMISS)" V2.5 software,data mining of clinically effective medical records of Professor Liu for GERD was conducted with a view to further analyzing Professor Liu on the academic thought of "fire heat theory",it is beneficial to the inheritance of famous old Chinese medicine experience,and provides objective basis and reference for GERD clinical medicine and subsequent clinical research.Methods: The clinical retrospective study method was used.It is based on 512 original medical records of Professor GERD treated in the outpatient clinic of Hebei Province Chinese Medicine Hospital from January 2013 to December 2017,and applied TCMISS(V2.5)software integrates data analysis methods such as frequency analysis,association rule analysis,Apriori algorithm,improved mutual information method,and entropy clustering algorithm for complex systems,and combined expert interviews to systematically analyze the effectiveness of Professor Liu's treatment of the disease the first consultation of prescription medical cases,mining the basic situation of the disease and Professor Liu's medication law and clinical experience in treating the disease.Results:1.Basic information of the patients: Among the 512 patients,308 were male and 204 were female;most of them were concentrated between 50-69 years of age;clinical symptoms were diverse,mainly heartburn and acid reflux;dark red tongue,thin yellow moss,string slippery veins;liver and stomach stagnation and heat syndrome are the most common types of TCM syndromes.2.Analysis of medication rules: 512 prescriptions involved 202 Chinese herbal medicines,among which the medicinal flavors were mainly warm,cold,bitter,and astringent,and they mostly belonged to the three meridians of the spleen,stomach,and liver.According to the efficacy classification,17 types of drugs are involved,of which qi and heat-reducing drugs account for the largest proportion.In the statistics of high-frequency drug usage,6g is commonly used in Radix Bupleuri,20 g is commonly used in Dandelion,20 g is commonly used in Ground Elm and 15 g is commonly used in Artemisiae Scopariae Herba.Analysis of association rules was performed on 233 cases of liver and stomach stagnation and fever type with the highest frequency of syndrome types,and 16 core drugs were extracted.3.New party analysis: Based on the improved mutual information method,24 drug pairs with correlation coefficients above 0.043 were obtained.Based on the entropy clustering algorithm,18 core combinations and 8innovative new prescriptions were obtained.4.Analysis based on expert interviews: The results obtained by the above data mining are basically consistent with Professor Liu's actual clinical application,which basically accords with ordinary drug experience.The obtained drug pairs and new prescriptions need to be further verified in the clinic.And the core prescriptions have been optimized,and the specific composition is: Dandelion,Artemisiae Scopariae Herba,Scutellariae Radix,Curcumae Radix,Ground Elm,Paeonia Lactiflora,Acorus Tatarinowii,Radix Bupleuri,Akebiae Quinata,Cyperi Rhizoma,Fried Fructus Aurantii Immaturus and Citri Sarcodactylis Fructus.Conclusion:1.Through data mining technology,Professor Liu's medication law and clinical experience in treating GERD can be more intuitively condensed and displayed.It is concluded that liver-stomach stagnation-heat syndrome is the common type of this disease.Professor Liu treats this disease with the basic rules of "opening depression,spreading air,and reducing stomach fire".Clinically,the five internal organs of the medicine are coordinated and the liver and spleen are the most important.And he is good at using bitter cold,warming and applying,and lowering bitterness,paying attention to the grasp of drug dosage,and making good use of the paired herbs.2.The paired herbs and new prescriptions obtained are conducive to the inheritance and innovation of Professor Liu's academic thoughts.At the same time,they have the characteristics of simple and inexpensive testing,which can reduce costs and provide new ideas and references for GERD treatment.3.Through the form of expert interviews,the core prescriptions of liver and stomach stagnation and fever obtained by data mining were carried out.After optimization,Professor Liu's experience in treating GERD liver and stomach stagnation and fever syndrome was developed,which provided an objective and scientific basis for the implementation of subsequent clinical research.Part ? Evaluation and Mechanism of Core Prescription in Treating Gastroesophageal Reflux Disease of Liver-Stomach Depression TypeObjective: To objectively evaluate the clinical efficacy and gastrointestinal hormones of core prescriptions obtained from data mining in the treatment of patients with liver and stomach stagnation fever type GERD,to verify the effectiveness,recurrence rate,improvement of patients' quality of life,and safety in the treatment of liver and stomach stagnation and fever syndrome with core prescriptions,and to explore its mechanism of action.Methods: A total of 110 patients diagnosed with gastroesophageal reflux disease of liver and stomach stagnation fever were randomly divided into 55 cases in the treatment group and 55 cases in the control group.The treatment group was given a core prescription,and the control group was treated with rabeprazole enteric-coated capsules.The course of treatment was 8 weeks,followed up for 3 months.The RDQ scores,TCM syndrome scores,gastroscopy inflammation scores,quality of life,recurrence rate,and adverse reactions were recorded before and after treatment in both groups.At the same time,50 healthy volunteers in the same period were selected as the normal group,and the changes of serum MTL,NO,SP,VIP,Ghrelin and Leptin before and after treatment were observed in the three groups.Results:1.Clinical efficacy analysis: The symptom score,frequency score and total score of the RDQ scale of the treatment group were significantly reduced improving reflux and heartburn(P<0.05).And it is better than the control group in improving the secondary symptoms such as irritability,belching or antifeeding,dry mouth and bitterness,noisy hunger,abdominal distension,and constipation(P<0.05).In terms of gastroscopy test results,treatment after treatment,the inflammation score under gastroscopy was lower than before treatment(P<0.05).Compared with the comprehensive efficacy of TCM syndromes in the two groups,the total effective rate of the medical effect in the treatment group was 92.16%,which was significantly higher than that in the control group(74.00%)(P<0.05).After treatment,the score of each dimension of the SF-36 scale was significantly higher than before treatment(P<0.05),and compared with the control group,the treatment group had dimensions such as energy,emotional function,mental health,social function and overall health.The treatment effect is more prominent(P<0.05);the relapse rate of the treatment group is 13.33%,which is lower than that of the control group(P<0.05),and the adverse reaction rate of the treatment group is lower(1.96%).2.Analysis of serological indicators: The levels of MTL and SP in the treatment group and control group before treatment were lower than that in the normal group(P<0.05),and the levels of MTL and SP after treatment in both groups were higher than before treatment(P<0.05).After treatment,the SP level of the treatment group was higher than that of the control group(P<0.05).The NO and VIP levels of the treatment group and the control group before treatment were higher than that of the normal group(P<0.05),and the NO and VIP levels of the two groups after treatment There was a downward trend,and the levels of NO and VIP in the treatment group after treatment were better than those in the control group(P<0.05).The concentration of Leptin in the treatment group and the control group before treatment was higher than that in the normal group(P<0.05).After treatment,the concentration of Leptin in the treatment group and control group was significantly lower than before treatment(P<0.05),and the level of Leptin in the treatment group after treatment was better than the control group(P<0.05).The Ghrelin concentration of the treatment group and the control group before treatment were lower than the normal group(P<0.05).The Ghrelin concentration of the treatment group and the control group increased significantly after treatment(P<0.05),and the treatment the level of Ghrelin increased after treatment in the group than in the control group(P<0.05).Conclusion:1.The core prescription is effective in treating liver-gastric stagnation-type GERD,and has obvious advantages in improving TCM symptoms such as irritability,irritability,belching or regurgitation,dry mouth and bitterness,and can significantly improve the quality of life of patients with long-term effects.It has good safety and provides a basis for the development of clinical preparations.It is worth continuing to deepen and promote in the clinic.2.The core prescription can increase the serum MTL,SP and Ghrelin levels of GERD patients,reduce the levels of serum NO,VIP and Leptin,and coordinate the secretion of the above-mentioned gastrointestinal hormones.And besides,it can target the pathogenesis of GERD liver and stomach stagnation and stomach upset,and co-regulate of esophageal and gastrointestinal motility.The mechanism of action may be achieved by regulating gastrointestinal motility in patients with GERD.General conclusion:1.It is concluded that Professor Liu is good at treating GERD from fiery theory.The party's medication is focused on opening up depression.In view of the key to the pathogenesis of GERD's "qi" and "heat," five principles of dredging,clearing,resolving,propagating,and raising are proposed.It provides theoretical support for the subsequent data mining analysis and clinical research of the clinical case of the mentor,promotes the inheritance and innovation of the basic theory of traditional Chinese medicine,and is of great significance to the inheritance and development of Professor Liu Qiquan's academic thinking.2.Through the combination of data mining and expert interviews,Professor Liu Qiquan's medication rules and clinical experience in treating GERD were more intuitively and concisely displayed.It further confirms that the key to the pathogenesis of this disease is "qi" and "heat",which objectively reflects Professor Liu's academic thoughts of opening the depression,exchanging qi,and reducing stomach fire.The core prescription of liver-stomach stagnation-heat type was optimized,which provided an objective and scientific basis for the implementation of subsequent clinical research.3.The core prescription is effective in treating liver and stomach stagnation type GERD.It has advantages in improving TCM syndromes and quality of life of patients,and has long-term efficacy and safety.It provides a basis for the development of clinical preparations and is worth continuing in the clinic to deepen and promote.At the same time,it can increase serum MTL,SP,and Ghrelin levels in GERD patients,reduce serum NO,VIP,and Leptin levels,and jointly regulate esophageal and gastrointestinal motility.Its mechanism of action may be achieved by regulating gastrointestinal motility in GERD patients.