| ObjectiveThis study by conducting questionnaires on patients with Recurrent Abortion Spontaneous(RSA)in the gynecological clinic and inpatient department of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and collecting clinical cases of RSA treated by Professor Luo Songping,studied the factors affecting the psychological state and personality of RSA patients,for improved the psychological attention of clinicians to RSA patients,provided theoretical basis for clinical psychological intervention to treat RSA,and studied the medication characteristics of RSA.Methods1.Clinical questionnairesWith the approval from the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine,the batch number is Y?2019?211 and the patient's informed consent.Randomly select patients from March 2019 to December 2019 who were admitted to the Gynaecological Clinic and Inpatient Department were clearly diagnosed as RSA(2 and above spontaneous abortions).The RSA epidemiological questionnaire and chinese medicine scale shall be completed by the physician after consultation with the subject.The Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS),and Eysenck Personality Questionnaire(EPQ)were completed by the subjects themselves.Using Microsoft Office Excel software to establish a database and imported into IBM SPSS 23.0 software for description and frequency statistical analysis of data.Last,explore the single-factor of depression and anxiety by binary logic regression,and then multi-factor of the remarkable results,have been P<0.05 considered statistically significant.2.Data mining of Prof.Luo Songping treatment of RSAData mining was carried out on patients with RSA who had been treated by Prof.Luo Songping for more than 3 months.The clinically collected prescriptions are key into Microsoft Office Excel to establish a preliminary database,using TCM Miner system to standardize the chinese medicine name.Use the COUNTIF function of Microsoft Office Excel to count the frequency of medications,and the frequency of drug fours,fives,meridial,efficacy,and syndromes type in prescriptions by manually replacement.The confidence and support level between high-frequency drugs(drug frequency ?30)were then calculated using the TCM Miner correlation mining function,and the complex network analysis of high-frequency drugs was performed using the SPS Modeler 14.1network module.Finally,using IMB SPSS 25.0 software clustering module to analyze highfrequency drug clustering,the results are shown in a tree genealogy map.Results1.Clinical questionnaires(1)General condition of RSA patients: A total of 335 questionnaires were sent out in this study,with a total of 313 recovered and 290 valid questionnaires.Among the 290 patients in this survey,the youngest was 24 years old,the oldest was 40 years old,and their average age was 33.27±4.18 years.Among the 290 surveyed patients,the minimum number of pregnancies was 2 and the maximum was 9,and their average pregnancies was3.56±1.27.Among them,43.8% were among 4 pregnancies and above;35.9% of 3pregnancies;20.3% of 2 pregnancies.Among the 290 surveyed patients,the minimum number of spontaneous abortions was 2 and the maximum was 8,and their average number of spontaneous abortions was 2.68±0.87.Among them,there were 52.4% of 2 times abortions;29.0% of 3 times abortions;18.6% of 4 times and above abortions.(2)The distribution of TCM syndromes of RSA: The syndrome of deficiency of both spleen and kidney is the majority,accounting 36.2%;followed by syndrome of yin deficiency and blood heat,accounting 27.6%;the third is syndrome of kidney deficiency,accounting 17.2%;the proportions of Qi-blood weakness and blood stasis syndrome are accounting 9.7% and 9.3% respectively.(3)The distribution of depression,anxiety and personality in RSA patients: The lowest depression score of the 290 surveyed patients was 26 points,and the highest was 79 points.Their average depression score was points.There were 29.7% of patients who were positive for depression.Among them,14.8% of mild depression;9.0%of moderate depression;5.9% of severe depression.The lowest anxiety score was 30 points,and the highest was 76 points.Their average anxiety score was points.There were 476.% of patients who were positive for anxiety.Among them,20.0% of mild anxiety;17.2% of moderate anxiety;10.3% of severe anxiety.Among the surveyed patients,44.8% were intermediate type;19.3% respectively were typical extroversion and extroversion tendency;12.1% were introversion tendency;4.5% were typical introversion.In the emotional stability,46.6% of intermediate type;14.8% of typical stability;13.4% of typical instability;12.8% of unstable tendency;12.4% of stable tendency.In the psychiatric group,there were 64.8% of intermediate type;31.0% of conforming to the rules;4.1% of typical psychosis.(4)Logistic regression results of depression and anxiety in RSA patients: Binary logistic single factor regression analysis showed that rural household registration,lower education level,work pressure,multiple miscarriages,introverted personality,emotional instability are common potential risk factors for depression and anxiety;while bad sleeping quality is a single potential risk factor for anxiety.Logistic multivariate regression analysis showed that multiple miscarriages are a common independent risk factor for depression and anxiety;while emotional instability is an independent risk factor for anxiety.2.Data mining of Prof.Luo Songping treatment of RSAA total of 106 cases of RSA were collected in this study,with a total of 642 prescriptions.The top 5 syndromes with the highest frequency were spleen and kidney insufficiency syndrome(34.27%),kidney yin deficiency syndrome(19.47%),kidney deficiency and blood stasis syndrome(10.90%).),deficiency-heat syndrome(7.79%),kidney deficiency syndrome(6.85%).Among the 642 prescriptions,there were 117 type of herds.The top 5 Chinese medicines with the highest frequency were Tusizi(7.860%),Shanyao(7.496%),Sangjisheng(7.444%),Xuduan(7.444%),Fupenzi(5.713%)).The top5 drugs with the highest frequency of efficacy were tonic drugs(50.06%),astringent drugs(9.41%),blood circulation and blood stasis drugs(7.75%),rheumatism drugs(7.69%),qi regulating drugs(6.65%).In terms of the four qi and five flavors of the meridian,the top three meridians were the liver meridian(27.66%),the kidney meridian(26.67%),and the spleen meridian(19.68%);the four qi in the top three were flat.(42.61%),warm(35.49%),cold(16.62%);the top three five flavors were sweet(41.97%),bitter(28.85%),and pungent(17.22%).Generally speaking,it is mainly sweet and smooth.According to the analysis of association rules,there are a total of 95 drug pair associations.The first 5 drug pairs are Shanyao-Tusizi,Tusizi-Shanyao,Sangjisheng-Xuduan,Xuduan-Sangjisheng,ShanyaoXuduan.Complex network analysis shows that the core drugs are Tusizi,Xuduan,Sangjisheng,and Shanyao,that is,Jianwei Shoutai Wan as the main prescription.Cluster analysis showed that there were five groups of drug combinations with more than 3 flavors.Group C1 had Sangjisheng,Xuduan,Shanyao,Tusizi,Fupenzi,Shanzhuyu,Shihu,Hehuanhua,Huangjing(nourish kidney Yang and Yin,strengthen essence and nourish liver and kidney);Group C2 had Gouji,Baishao,Nvzhenzi,Mohanlian,Digupi,Yujin(nourishing Yin and clearing deficiency heat);Group C4 had Baizhu,Dangshen,Huangqi,Chenpi,Qianshi,Changzhu,Baibiandou(replenishing qi,regulating qi and dampness);C7 group had Lizhihe,Juhe,Biejia,Niuxi,Chishao,Danshen,JIxueteng,Xiangfu(promoting qi,dispelling stagnation and promoting blood circulation);C8 group had Fuling,Chaihu,Bajitian,Danggui,Shichangpu,Yuanzhi,Suxinhua(soothing the liver and relieving depression,calming the heart and nerves,tonifying qi and blood).Conclusion1.The average depression score of the RSA patients was points,and29.7% of patients had depressive symptoms;while the average anxiety score was points,and 47.6% of patients had anxiety symptoms.Among them,patients with multiple miscarriages,rural household registration,lower education level,work pressure,introverted personality,and emotional instability are at higher risk of depression and anxiety.Clinically,we should pay attention to the psychological state of patients with these social demographic characteristics.2.Professor Luo Songping,the representative inheritor of the Lingnan Luo Family Gynecology School.The diagnosis and treatment of recurrent miscarriage follows the method of pre-cultivating its damage,paying equal attention to nature and nurture,taking the method of invigorating the kidney and strengthening the spleen,and strengthening the yuan to cultivate the origin,mainly applied Shoutaiwan and Sijunzi Decoction... |
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