Reexamination On Tcm Master Fuxing Liu’s Clinical Experience For The Treatment Of Herpes Zoster Based On Statistic Methodology

1. Objectives:Based on TCM inheritance assist platform(V2.0) software the medical cases for the treatment of herpes zoster in the clinic of Dr. Fuxing Liu, this paper reexamines the medication experience of Dr. Liu for treating herpes zoster. Through the real-time, online and domestic demonstration of the rules in the aspect of symptoms, syndromes and medications, this paper aims at reexamining the clinical experience of Dr. Liu for treating herpes zoster, investigating the inheritance situation of the academic ideology and exploring the disciplines of perspiration and medication in clinic.2. Methods:The original data of the medical cases that met the requirements of recruitment were recorded in a standard format to TCM inheritance assist platform(V2.0), which was developed by Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences. By applying the statistics table system and statistics analysis system provided by the platform, this paper performed association analysis and the complex system entropy clustering analysis etc. Then a discussion on these results was made by applying TCM theories.3. ResultsUnder the dual standards of recruitment and exemption, 139 patients(69 male; 70 female) were recruited and 154 prescriptions were analyzed. Among the 139 patients, 110 patients(79% of the total) fallen into the age range of 51 to 80 years; 94 patients(67.6% of the total) presented the syndrome of dampness-heat of the liver and gallbladder. Among the 154 prescriptions, Decoction of Gentian to Purge the Liver(58.4%) was the most frequent prescription and Minor Decoction of Bupleurum(18.8%) was the second most. By applying TCMISS statistical analysis, it was founded that the common symptoms were dermatodynia, erythema,blain,poor sleep,dry mouth, bitter mouth, dry stool, dark urine, poor appetite, herpes. Among the182 kinds of collected medicines, Scutellaria baicalensis(79.2% of the total medicines) had the highest frequency which was used for 122 times. The commonly used medicines include scorpion, gentian, centipede, Semen Plantaginis(plantain seed), Radix Bupleuri(Chinese thorowax root), caulis clematidis armandii, Angelica sinensis, fried alismataceae, rhizome of rehmannia etc. As for the nature of the collected medicines, the cold, cool, neutral and warm medicines were the most and had the same frequency; whereas there were only 6 kinds of warm medicine which consisted of 4.5% of the total. And among the five tastes of drugs, drugs with bitter taste are in the majority, accounting for 36.9%, followed by acrid, sweet taste. In terms of channel tropism, the liver channel and lungs channel are in the majority, and the rest channel tropisms of medicine are not significantly different.In the association rules of symptoms, 37 pieces of rules and 8 varieties of symptoms were obtained when setting the support degree at 60 and the confidence coefficient at 0.9. Among the 31 pieces of rules, 20 of them had a confidence coefficient at 1, including dermatodynia, pale red tongue, thread and slippery pulse, poor sleep, bitter mouth, red tongue, white and greasy tongue coating, yellow and greasy tongue coating and dry stool. Based on association rules of TCM prescription combinations, 46 pieces of rules could be obtained when setting the support degree at 60 within the 154 prescriptions. Whereas 43 pieces of rules could be obtained when setting the confidence coefficient at 0.9, which included 10 kinds of medicines, namely radix scutellariae, scorpion, centipede, caulis clematidis armandii, Radix Bupleuri(Chinese thorowax root), gentian, rhizome of rehmannia, angelica sinensis, Semen Plantaginis(plantain seed), and fried alismataceae. The major functions of these 10 medicines were clearing heat and promoting diuresis and activating meridians to stop pain. Based on the complex system entropy clustering algorithm, 14 core medicine combinations were obtained for the treatment of herpes zoster. According to unsupervised hierarchical clustering algorithm, 7 new prescriptions were obtained. By applying the “case study” in the TCM inheritance assist platform, the “key symptoms” and the “critical medicines” for the syndrome of the dampness-heat in the liver and the gallbladder, the syndrome of spleen deficiency and excessive dampness, the syndrome of blood stasis with qistagnation and the deficiency syndrome of liver-yin, respectively. Due to the fact that each syndromes had different number of medical cases, the node threshold was set at 60, 35, 25, and 30, respectively. The evaluation on similarities were performed between the clinical prescriptions with the same amount of medicines from the clinic of Dr. Fuxing Liu and the system calculated prescriptions with a decreasing sequence of the node threshold. And the result of the evaluation on similarities were 0.6842,0.2 727,0.2941and0.4737,respectively.4. Conclusions:1.Herpes zoster mainly affects the elder people and the morbidity of herpes zoster in male and female is around the same. Most patients with herpes zoster in the acute stage demonstrate the syndromes of dampness-heat of liver and gallbladder.2.This paper provides new scientific method for the treatment of herpes zoster by using data mining methods such as frequency count method, complex system entropy cluster, the improved mutual information and unsupervised hierarchical cluster.3.The input and statistical analysis of prescription data by TCMISS will not only benefit to the research of the medication rules for treating herpes zoster and the discovery of new prescription, but also contribute to the inheritance of clinical experience of TCM experts.Combing with experience and judgment of clinical physicians, clinical experiments are needed to validate the rationality and efficiency of the core combinations and the new prescriptions generated by this software, which stay in the theoretical level.