Cross-sectional Survey And Data Mining Of Traditional Chinese Medicine For The Treatment Of Type 2 Diabetes And Retinopathy

Objective:To investigate the patient willing of acceptance and acquire the current situation of application about traditional Chinese medicine(TCM),analyses the related factors,to investigate the patient's understanding and requirement on health knowledge about diabetic retinopathy(DR),to analyse the blood glucose standard recovery rate and the related factors.Data mining based on modern literature about TCM treatment of diabetic retinopathy,to probe the Chinese herbs' category,medicinal properties,core drugs,drug association rules and group rules,etc.To provide suggestions for further application of TCM,promote the clinical practice,provide clues and etiology hypotheses for further studies.To provide data support about the rules of Chinese herbal prescriptions of traditional Chinese medicine.Method:Using the cross-sectional survey method and adopting the continuous sampling to include type 2 diabetes mellitus(T2DM)patients in the TCM diabetes department and endocrinology department of a third grade hospital in Beijing.Choosing the appropriate sample content estimation formula to calculate the sample size,design a questionnaire by reading literature and consulting experts,do a pre-survey and complete the questionnaire,to carry out the survey and collect 1286 patients who are T2DM.Using the Epidata3.1 to establish database,input data and check,then export the data to SPSS20.0 software,analyse the data according to the data type and research purpose.About the data mining research,we make the search term according to the trait of each database,and then search the knowledge service platform of China(CNKI),Chinese academic conference papers database and Chinese dissertation database(Wanfang),Chinese VIP information(VIP)and Chinese biomedical literature database(SinoMed),to collect the clinical rescarchs about the treatment of diabetic retinopathy used the traditional Chinese medicine.Screening the qualified literature,designing a data extraction table,extracting the data and sorting the data,then import the data into statistical analysis software for analysis.Using the SPSS20.0 to analyse the classification of medicinal herbs and medicinal properties and using the FP-growth and Create Association Rules of RapidMiner Studio data mining software to analyse the associated core drugs and drug combinations,and the correlation analysis network diagram of the high frequency core drug is obtained.Result:(1)A total of 1286 questionnaires were collected from a third hospital in Beijing from March 2015 to March 2017.The prevalence rate of diabetic retinopathy(DR)is 17.1%.The acceptance willing of TCM in patients of T2DM and DR is 46.7%and 52.7%respectively,and the current situation of application rate is 21.8%and 24.1%respectively.The reason that patients are willing to accept the TCM treatment include:the treatment of TCM is effective(36.2%),willing to make an attempt(29.3%);the reason that patients don't want to accept the TCM treatment include:think the curative effect and mechanism of TCM are unknown(45.3%)and it's bothering to decoct the Chinese herbs.The blood glucose standard recovery rate of patients in fasting blood-glucose,2-hour post-meal blood glucose and glycosylated hemoglobin is 36.9%,32.1%and 23.1%.The related factors of diabetic retinopathy are sex,course of the disease,accompanied with peripheral neuropathy and renal dysfunction,the patients who are male,who have a longer course of the disease,who accompanied with peripheral neuropathy and renal dysfunction have the higher rate of DR.The patients who accompanied with DR will pay more attention to their own health.36.4%patients conduct regular eye examination,and the average inspection period is 11.57 months each time.The rate of T2DM patients accept the treatment of fundus disease and DR is 9.3%and 4.1%,and the rate of T2DM patients prevent the retinopathy is 10.5%.The rate of DR patients treat and prevent the DR is 24.5%and 22.0%.The accept willing of patients about the health knowledge of retinopathy is 85.8%,47.3%patients think they prefer the education method by use brochures,48.9%patients think they want to know the treatment of DR and 22.8%patients want to know the prevention knowledge of DR.(2)A total of 152 articles were included in this study,which involved 117 randomized controlled study(RCTs),20 non-randomized controlled studies,1 self-control research,14 case series,152 TCM prescriptions and 1657 Chinese medicine herbs.The frequency of using drugs accounted for more than 50%include:nonproliferative diabetic retinopathy(NPDR)involves astragalus,salvia miltiorrhiza and radix rehmanniae(in 54 TCM prescriptions,572 Chinese medicine herbs);during the 3-4 stage of diabetic retinopathy involves baishu,danshen,licorice,medlar,astragalus(in 9 TCM prescriptions,84 Chinese medicine herbs);proliferative diabetic retinopathy(PDR)involves puhuang,sanqi(in 4 TCM prescriptions,41 Chinese medicine herbs);the first five herbs in overall medication is astragalus,salvia miltiorrhiza,radix rehmanniae,medlar and pueraria(in 152 TCM prescriptions,1657 Chinese medicine herbs).The category of Chinese herbs:the first is virtual supply medicine,eliminate heat medicine and blood circulation and blood stasis medicine,the nature of the most drugs are cold.The result of correlation analysis:astragalus is the core of all herbs,and danshen,radix rehmanniae,medlar and pueraria have strong correlation with astragalus,there also have a formula correlation between angelica,red peony and chuanxiong.Conclusion:The patients of T2DM and DR have the higer willing to accept the TCM treatment,which is higer than the current actual application rate;the blood glucose standard recovery rates are unsatisfactory among the T2DM patients.The treatment and prevention of DR are not ideal,and most patients want to get the healthy education to acquire the DR knowledge.The treatment of DR by using Chinese herbal medicines is place emphasis on ivigorate qi,blood and liquid in NPDR,pay attention to tonifyspleen during the 3-4 stage,and use the invigorate blood herbs in PDR,astragalus is the core of Chinese herbs,with danshen,radix rehmanniae,medlar and pueraria are always used together.We should strengthen the publicity of TCM knowledge in the future,set up more retinopathy healthy education column and provide patients for more health manual about DR knowledge.What's more,we should promoting the patients to treatment and prevent the disease according to the strategy of "five carriages" in order to delay the complications and improve the quality of life,optimizing the treatment plan and using precise medicationto improve the blood glucose standard recovery rate.