Research On Arthralgia Syndrome Composition Rules Of Representative Doctors Of Epidemic Febrile Diseasesschool

Background:Arthralgia syndrome is a disease in traditional Chinese medicine (TCM) with the syndrome of symptoms such as local ache, numbness, soreness and stiffness in bones, joints or muscles and signs of swelling and deformity of joints. Due to wind, coldness, dampness and hotness, the pathogenic qi blocks the meridians and qi-blood circulation that might attribute to the disease. Diseases in west medicine such as rheumatoid arthritis, ankylosing spondylitis and osteoarthritis all belong to arthralgia syndrome. Because of difficult conditions and definite efficacy of TCM, the exploring of TCM treatment on arthralgia syndrome is necessary. Besides, epidemic febrile diseases school established in Qing dynasty with its unique therapeutic thoughts, stands for the high level of TCM. Therefore, to study the composition rules of arthralgia syndrome is indispensible, which could provide reference for the clinical treatment.Aims:Via case analyzing from epidemic febrile diseases school, to explore the medication characters of the school, then to summarize their differences and similarities of four doctors via comparison. Besides, to explore the composition characters when treating the disease in different parts and with different symptoms to study the academic thought and expand our mind in clinical practices.Method:Collect the cases treating arthralgia syndrome of four representative doctors according to the inclusion and exclusion criterion. Then process the data. Firstly, clean the data. Secondly, put in all the data into Traditional Chinese Medicine Inheritance Support System (TCMISS). Thirdly, analyze the data based on association rules and improved mutual information method, etc. Fourthly, decode the data from two aspects, disease and symptom, to explore the composition rules of four representative doctors when treating arthralgia syndrome.Outcomes:1. When treating arthralgia syndrome, doctor Ye Gui used lots of sweet and warm natured drugs to benefit qi and nourish blood. Herbal medicines like Poria,Angelicae Sinensis Radix,Cmnamomi Mmulus,Atractmlodis Macrocephalae Rhizoma,Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle,Armeniacae Semen Amarum,Stephaniae Tetrandrae Radix,Lycii Fructus,Ginger, and Coicis Semen have the highest frequency.18 core drug combinations were obtained via association rules analysis. Besides, core drugs are mainly those that can warmly benefit qi and nourish blood, including Cmnamomi Mmulus, Poria, Angelicae Sinensis Radix, Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle, Stephaniae Tetrandrae Radix and Atractmlodis Macrocephalae Rhizome, etc. were mined. In a word, in arthralgia syndrome treatment, doctor Ye focused on holism and the core pathogenesis, and treated the disease based on syndrome differentiations.2. Doctor Wu Tang mainly applied drugs with pungent and warm nature and drugs for diuresis and diffusing dampness, such as Cmnamomi Mmulus, Stephaniae Tetrandrae Radix, Armeniacae Semen Amarum, Poria Peel, Citri Reticulatae Pericarpium, Coicis Semen, Pinelliae Rhizoma, Gypsum Fibrosum, Talcum and Aurantii Fructus Immaturus.15 core drug combinations were obtained via association rules analysis. Besides, core drugs are mainly those that can warm yang to promote diuresis. Cord drugs include Cmnamomi Mmulus, Stephaniae Tetrandrae Radix, Poria Peel, Armeniacae Semen Amarum and Coicis Semen etc. Besides, doctor Wu also focuses on holism and the thoughts treating diseases based on syndrome differentiations.3.Doctor Wang Shixiong applied lots of sweet and cool natured formula and lots heating-clearing drugs, such as Toosendan Fructus, Luffae Fructus Retinervus, Bambusae Caulis In Taenias, Phellodendri Amurensis Cortex, Gardeniae Fructus, Anemarrhenae Rhizoma, Dendrobii Caulis, Scutellariae Radix and Angelicae Sinensis Radix.12 core drug combinations were obtained via association rules analysis. Besides, core drugs are mainly those that can nourish blood, clear heat and promote diuresis as well as dredge collateral for pain killing. Core drugs includes Luffae Fructus Retinervus,Toosendan Fructus,Angelicae Sinensis Radix,Bambusae Caulis In Taenias, and Dendrobii Caulis etc. Luffae Fructus Retinervus and Toosendan Fructus are Doctor Wang’s favorite two drugs in arthralgia syndrome treatment.4.Doctor Xue Xue used lots of sweet and warm natured formula and lots of tonifying drugs such as Angelicae Sinensis Radix, Poria,Cmnamomi Mmulus, Atractmlodis Macrocephalae Rhizoma, Astmgali Radix,Lycii Fructus, Ginseng Radix Et Rhizoma, Stephaniae Tetrandrae Radix, Saposhnikoviae Radix, and Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle.10 core drug combinations were obtained via association rules analysis.Besides, core drugs are mainly those that can tonify qi and nourish blood as well as promote the circulation of qi and strengthen exterior. Core drugs includesAngelicae Sinensis Radix,Astmgali Radix, and Cmnamomi Mmulus.Conclusion:1.Similarities in four doctors of epidemic febrile diseases school when treating arthralgia syndrome:① Holism and the thought of treating disease based on the syndrome differentiation are the core thoughts for the disease treatment.② Building up vital qi, especially warmly benefiting qi and blood and kidney yang,is focused on.③ Pathogenic factor elimination, especially clearing heat and promotingdieresis, is important.④ Collateral dredging and warm, pungent drugs that could activate the circulation of qi and blood are indispensible.⑤ For those enduring patients, insect drugs should be applied to promote blood circulation to remove stasis.2. Characters of Each Doctor and comparison between four doctors of epidemic febrile diseases schoolwhen treating arthralgia syndrome:In arthralgia syndrome treatment, Doctor Ye used lots of classical prescription from Zhang Zhongjing’s Shanghan Lun and developed a lot. Doctor Ye and Xue showed lots of similarity in therapeutic thoughts, both of them focused on vital qitonifying, especially warmly benefiting qi and blood. However, via comparison, doctor Xue emphasized more on warm and pungent drugs adoption, and doctor Ye paid more attention to pathogenic wind dispelling and dampness removing as well as dieresis promotion. As for doctor Wu, he hold the opinion that dampness-heat might dredge collaterals, therefore, he used lots of drugs with dampness-heat removing function, and lots of cold and warm natured medicine in one prescription. Doctor Wang emphasized that yin deficiency could also attribute to arthralgia syndrome, therefore sweet and cool natured drugs and drugs that could eliminate dampness-heat were often adopted.3. Composition rules on Treating arthralgia syndrome with different symptoms and locations:For different symptoms and locations, all doctors used close prescriptions to which when they treated the whole disease. Therefore, the holism in therapeutic thoughts is obvious.