The Clinical Experience Reserch On The Professor Zhou Zhongying Pathogenesis Differentiation Of Liver Cirrhosis Based On 336 Cases Of Medical Records

Research objective:Based on multi-angle and multi-level research on famous Chinese medicine cases,through the data mining analysis of medical records and the interpr etation of typical medical records,Professor Zhou Zhongying's clinical experience in the treatment of liver cirrhosis was discussed.Based on the method of pathogenesis,summarizing and forming Professor Zhou Zhongying's clinical plan for the treatment of liver cirrhosis,and refining his academicideas,it can better guide the clinical application of traditional Chinese medicine in the treatment of liver cirrhosis and improve clinical efficacy.Research methods:Through the medical records of the liver cirrhosis in the medica 1 record database of the Chinese medicine master Zhou Zhongying's studio,after screening and cleaning,the data were in compliance with the inclusion criteria and the exclusion criteria,including 336 cases.It mainly uses frequency analysis,association rules and factor analysis methods,multi-level analysis of syndromes,pathogenesis,and prescriptions of medical records,and summarizes Zhou Zhongying's treatment of primary nature through human-computer combination,typical medical record interpretation,and qualitative medical interviews.and finally establishes the pathogenesis differentiat ion of liver cirrhosisResearch result:(1)General situation:In 336 cases of liver cirrhosis,there were 225 males and 101 females,the oldest being 83 years old and the youngest being 17 years old.The average age is(49.2 ± 13.2)years old.There were 145 cases of compensated liver cirrhosis and 191 cases of decompensated cirrhosis.There were 191 cases of hepatitis cirrhosis,16 cases of cholestasis cirrhosis,7 cases of schistosomiasis cirrhosis,3 cases of alcoholic cirrhosis,3 cases of autoimmune cirrhosis,1 case of hepatic venous return cirrhosis,and hereditary metabolic liver.1 case of hardening,1 case of drug-induced cirrhosis,1 case of autoimmune with cholestasis cirrhosis,and 112 cases of no cause.(2)Distribution of syndromes:There were 216 symptoms in 336 cases.The symptoms with frequency above 10%were urinary yellow,abdominal distension,dry mouth,hypochondriac pain,fatigue,complexion dull,normal diet,loose stool,normal bowel movement,anorexia,lower extremity edema,facial yellow,gums,abdominal fullness,oliguria,mouth bitter,eye yellow.(3)Distribution of pathogenesis:There are 158 kinds of pathogenesis of 336 cases of liver cirrhosis.The frequencies from high to low are deficiency of liver and spleen,dampness-heat-blood stasis-toxin compound,dampness-heat-blood stasis compound,damp heat,blood stasis and phlegm,qi stagnation and water stop,qi and yin deficiency,liver Kidney yin deficiency is the most common,among which the dampness-heat-blood stasis-toxin compound,deficiency of liver and spleen,account for 57.35%of the total number of pathogenesis,so it can be regarded as the main pathogenesis or basic pathogenesis of liver cirrhosis.Pathological factors are divided into two aspects:so lid pathological factors are mainly heat,phlegm,dampness,and toxin,and virtual path ological factors are mainly yin deficiency and qi deficiency.The disease is a mixture of false and real,the disease is mainly in the liver,spleen,and kidney involving thes tomach,lungs,rarely to the heart.(4)Distribution of traditional Chinese medicine:279 kinds of drugs in 336 cases,a total of 5888 kinds of times,the frequency of more than 50 times(including 50 tim es)of the drugs are:Atractylodes,absinthium,Poria ruber aglaophotis,concha testudo,Tanacetum,Bos taurus,Bupleurum falcatum,Polyporus,Alisma,herba,turmeric geranium,Magnolia kobus,hyacintho,heterophylla,sub pomo,Eclipta,Dan,medlar,Citrus aurantium,coxarum,nummularifolia,amomi,traditum Seres medicina,Septentrionalis harenae reference,RHIZOMA,Polygonum orientale,Ligustrum lucidum,Zelandia,Herb a Abri,coquuntur RHEUM,,APHACA,Codonopsis,Ophiopogon japonicus,Cyperus rotundus,Montenegro gardenia,Sophora.(5)Analysis of drug factors:67 drugs were analyzed,and 17 common factors were extracted.For example,factor 1 consisted of Descuriniae semen lepidii semen,Men ispermaceae,Zanthoxylum amomumet odoramentorum et cucurbita Chen,flavo,Polygonum orientaled and vinegar Bupleurum falcatum.6.Association rule results:The association rules were used to analyze the relationship between common pathological factors,pathogenesis,symptoms and drugs.Such as:wet related drugs are:Rumex,Sophora,Abri Herbavel apsinthium sarmentosum,ad pileolum,Corcagium.Drugs related to liver and spleen deficiency:Bupleurum falcatum vinegar,Astragalus,Poria,Codonopsis,amomi,Atractylodes,ad hoc Coxit.Research conclusions:(1)Professor Zhou Zhongying treats liver cirrhosis with a combination of disease and syndrome,focusing on the comprehensive analysis of the compound pathogenesis,that is,paying attention to the pathogenesis syndrome.By grasping the main symptoms,tongue and pulse,physical and chemical examination,to identify the main basis of pathogenesis syndrome(to pathological factors,detailed identification of disease,disease).On this basis,it emphasizes the combination of disease differentiation and syndrome differentiation,clarifies the primary and secondary specimens of liver cirrhosis pathogens,prioritizes them,and then determines the focus of the prescriptions,and according to the syndrome,randomized medication.(2)Professor Zhou proposed that the basic pathogenesis of liver cirrhosis is wet heat,phlegm and blood stasis,and liver and spleen injuries.The pathological factor is based on blood stasis and heat,and it is combined with wet,hot,sputum,sputum,stagnation and other cementation.The disease is mainly in the liver spleen and kidney,involving the gallbladder,stomach,kidney lung and heart.Most of the pathological properties belong to this virtual standard,and the virtual and real are mixed.(3)Professor Zhou's compound pathogenesis for liver cirrhosis,the use of complex method prescriptions in the clinical card,and the early use of the evil spirits to Gu Zheng,using the Qinghua damp heat.Discretion should be added to soothes the liver and spleen,nourish the liver and kidney or supplement the qi and nourish the yin;the middle and late stage of liver cirrhosis is mainly due to qi deficiency,emphasizing the righteousness to help the evil spirits,including Soothing the liver and strengthening the spleen and stomach,nourishing liver and kidney,nourishing yin and clearing heat.The same method,accompanied by Qinghua damp heat,phlegm and blood stas is,blood stasis and soft.In the whole treatment process,it is necessary to pay attention to conditioning the spleen and stomach first,to avoid the decline of the spleen and stomach.This study obtained the ideas and experience of Professor Zhou Zhongying in the treatment of liver cirrhosis through data mining methods,human-machine combination methods and qualitative interviews with famous doctors.From the medical records,Professor Zhou Zhongying's clinical plan for the treatment of liver cirrhosis was summarized,which provided an example for the treatment of liver cirrhosis with Chinese medicine.