Analysis Of Clinical Regularity Of Mammary Gland Hyperplasia And Professor Lin Yi's Experience For Whom By Data Mining

ObjectiveRetrospectively collecting cases of mammary gland hyperplasia(MGH)diagnosed and treated by Professor Lin Yi to establish a database of medical records and on this basis,establishing the identification models of MGH syndromes,analysing the regularity of symptoms and Lin ' s medication regular patterns to provide reference for clinical diagnosis and treatment.MethodsThe original data of MGH cases diagnosed and treated by Professor Lin Yi in Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2008 to May 2019 were collected.After screening and standardization of medical records,a database was established through traditional Chinese medicine inheritance support system(TCMISS)V 2.5 information collection system.Through literature retrieval,screening and determination of relevant objective indicators of MGH syndrome types,Chi-squared automatic interaction detector(CHAID)decision tree algorithm of SPSS 19.0 was used to establish a decision tree identification models of three MGH syndrome types.Finally,driven by the professional needs of designated diseases and designated syndromes,the symptoms of MGH and the medication regular patterns of Professor Lin were analyzed.Results1.Professor Lin' s medical record database for treating MGH has been establishedA total of 7,632 cases of MGH treated by Professor Lin were collected,involving 5,865 patients.593 cases that met the requirements were screened out according to relevant standards.A database was established,involving 593 patients,describing 216 symptoms or signs and 155 prescription drugs.Including 242 cases of liver depression and qi stagnation,152 cases of phlegm and blood stasis,199 cases of imbalance of chong and ren meridians.2.The identification models of MGH have been established by CHAID decision tree algorithmNine indexes,LH,E2,PRG,FSH,PRL,TSTO,E2/PRG,E2/TSTO,PRG/TSTO,which were screened and determined,were analyzed by decision tree to establish three MGH syndrome identification models,namely liver depression and qi stagnation,phlegm and blood stasis,and imbalance of chong and ren meridians.The specificity,sensitivity and accuracy of the model of liver depression and qi stagnation are 90.34%,97.14%and 92.28%respectively,including E2 and FSH.The depth of the model is 2,with a total of 10 nodes and 7 end nodes,forming 3 identification routes of liver depression and qi stagnation and 4 identification routes of non-liver depression and qi stagnation.The specificity,sensitivity and accuracy of phlegm and blood stasis syndrome model are 91.88%,76.39%and 87.07%respectively,including E2,FSH and PRL.The depth of the model is 3,with a total of 15 nodes and 10 end nodes,forming 2 identification routes for phlegm and blood stasis syndrome and 8 identification routes for non-phlegm and blood stasis syndrome.The specificity,sensitivity and accuracy of the model for imbalance of chong and ren meridians syndrome are 87.18%,88.89%and 87.80%respectively,including FSH,E2/TSTO,E2 and PRG.The depth of the model is 3,with 17 nodes and 11 end nodes,forming 5 identification routes for imbalance of chong and ren meridians syndrome and 6 identification routes for non-imbalance of chong and ren meridians syndrome.3.To study Professor Lin' s experience in treating MGH based on data miningA total of 593 cases were included,including 242 cases of liver depression and qi stagnation,152 cases of phlegm and blood stasis and 199 cases of imbalance of chong and ren meridians.Breast lump,breast pain and nipple discharge are the main symptoms of MGH.Breast pain symptoms can be divided into distending pain,stuffy pain,stabbing pain,dull.pain and string pain according to their nature.Considering inducing or relieving related factors,they can also be divided into periodic pain,pain and dyspnea,and concurrent symptoms are usually manifested as syndromes of different syndromes.The tongue is light red or red,with little coating or light and fat tongue,with tooth marks on the side and wiry pulse,which may also be characterized by thin,rapid,uneven,and sunken.When dispensing the prescription,the general principle is to soothe the liver and regulate qi.The medicine is good at soothing the liver and regulating qi,promoting blood circulation and removing blood stasis,promoting diuresis and eliminating phlegm,invigorating qi and blood,nourishing yin and tonifying kidney.Among them,the proportion of drugs for strengthen spleen and invigorate qi and promoting digestion is relatively large.The four-qi are mainly warm and placid,the five-flavor are mainly pungent,sweet and bitter,and the liver,spleen,heart and stomach meridians are used most frequently.The prescription Chaihu Shugan Powder is often modified.Breast pain of MGH due to liver depression and qi stagnation is mostly distending pain or string pain,which is periodic and is related to emotion.It is often accompanied by impatience,irritability,emotional depression,sighing,hypochondriac pain due to hypochondriac distention,vexation and insomnia,reddish tongue and wiry pulse.There may also be concurrent symptoms such as bitter mouth and dry throat.The treatment is based on the basic principles of soothing the liver,regulating qi,eliminating phlegm,removing blood stasis,resolving hard mass and relieving pain,and it can also strengthen spleen and invigorate qi.The four-qi classification of prescription drugs is mainly warm and cold,and the five-flavor classification is mainly pungent,bitter and sweet,with liver,spleen,heart and stomach meridians taking the most drugs.The commonly used counter drugs are mostly in the form of"soothing liver and regulating qi-promoting blood circulation and removing blood stasis",and the formula rule is the modified formula of Chaihu Shugan Powder.Breast pain of phlegm and blood stasis syndrome MGH is mostly stabbing pain,stuffy pain,fixed pain,pain at night;It is often accompanied by abnormalities such as chest tightness and less menstrual flow,with pale purple or dark purple tongue,tooth marks on the tongue,white fur,blue and purple sublingual veins,and wiry,uneven and thin pulse conditions.It can be seen that the symptoms of retention of phlegm-dampness in the middle energizer,such as anorexia and aversion to food,foreign body sensation in pharynx,etc.The treatment is based on the basic principles of promoting blood circulation and removing blood stasis,resolving phlegm and resolving masses,and it can also regulate qi and invigorate the spleen.The four-qi of prescription drugs are mainly warm,placid and cold,the five-flavor are mainly bitter,pungent and sweet,and the liver and spleen meridians are the most commonly used drugs.Commonly used drug pairs are mostly drug combinations of "soothing liver and regulating qi-promoting blood circulation and removing blood stasis-resolving phlegm and resolving hard mass",and the formula rule is Xiaoyaoloubei powder plus blood-enriching and blood-activating drug groups.Breast pain of imbalance of chong and ren meridians is mostly dull pain and stuffy pain,often accompanied by bone and joint symptoms such as lumbago and lumbar spine pain,as well as yin deficiency symptoms such as zygomatic red and night sweat,and yang deficiency symptoms such as cold limbs,aversion to cold,preference to warm and aversion to cold,cold limbs,etc.Tongue is pale or light and fat,with tooth marks on the side,sunken pulse,or cracked tongue,less coating,thin and rapid pulse.The treatment is based on the basic principles of warming the kidney and helping yang,nourishing yin and promoting fluid production,and uses both digestion promotion and stagnation elimination.The four-qi classification of prescription drugs is dominated by placidity,followed by saltiness and pungency,and the placidity is much more than other types.In the five-flavor,sweet drugs are the most,salty and pungent drugs are the second,and sweet drugs are much more than other types.Kidney and liver meridians are the most common meridians,and the drugs in the two meridians are much more than those in other meridians.Commonly used drug pairs are mostly composed of six drugs of Liuwei Dihuang Pills,namely,Radix Rehmanniae Preparata,Corni Fructus,Rhizoma Dioscoreae,Poria,Alismatis Rhizoma,and Cortex Moutan.The rule of prescription also suggests that it is a drug group of modified Liuwei Dihuang Pills,but it has two grouping tendencies of warming kidney and helping yang and nourishing yin and tonifying kidney,which are mainly connected by Radix Rehmanniae Preparata and Atractylodis Rhizoma.ConclusionProfessor Lin Yi' s experience in the treatment of MGH through data mining technology analysis in this study is as follows:Chinese medicine and western medicine,using traditional Chinese medicine and western medicine at the same time,combining disease and syndrome when diagnosing,strengthening body resistance and eliminating pathogenic factors,tackling both symptoms and root causes when treating.MGH is related to five zang-organs,the liver is the most important,spleen and kidney are equally important,balance of them is the key.Tracing to the source and seeking new,knowing how to make good use of drugs,the prescription is exquisite,and the drugs are peaceful.The data mining method can be applied to the research on the pattern recognition model of MGH,showing its unique advantages in the manifestation of the symptom rule and medication rule of Professor Lin Yi' s treatment of MGH,which can provide reference for clinical diagnosis of MGH and syndrome differentiation to a certain extent.