The Experience And Academic Thoughts Research Of Gallbladder Cancer And Cholangiocarcinoma Treating By Professor ZHOU Zhongying Based On Data Mining

Objective:To summarize Professor ZHOU Zhongying's clinical experience,thinking methods and academic thoughts in the treatment of gallbladder cancer and cholangiocarcinoma,to establish a system of TCM in treating gallbladder cancer and cholangiocarcinoma,so as to guide the clinical treatment,to improve the curative effect,and to inherit the experience and academic thoughts of Professor ZHOU.Methods:To collect medical records of Professor ZHOU in treating gallbladder cancer and cholangiocarcinoma from 1994 to 2014,and formulate strict inclusion and exclusion criteria,use data mining technology to analysis the medical records inclueded,study the relevant reference,consult tutor and related experts etc.Results:1.General situation:Among all of the 79 patients of gallbladder cancer and cholangiocarcinoma,there are 37 men and 42 women.The ratio of men to women is 1:13.The youngest is 37 years old,the oldest is 84 years old and the average age is 62.78 years old.Patients with medical history of cholelithiasis are 20(25.31%),cholecystitis 10(12.66%),and gallbladder polyps 1(1.26%).2.Symptom distribution:Among all of the 230 cases of gallbladder cancer and cholangio-carcinoma,88 kinds of symptoms are presented,with a total of 826 frequency,an avera-ge of 9.39 symptoms per case.Symptoms appeared more th-an 30 times are:abdominal pain(30.86%),poor appetite(30.00%),right hypochondriac pain(29.13%),abdominal diste-nsion(28.69%),dry mouth(25.21%),urine yellow(23.47%),back pain(16.95%),skin yello-w(16.95%),eye yellow(15.65%),stool dry(15.65%),bitter mouth(13.91%).There are 181 cases with accurate li-ngual and pulse records,39 kinds of tongues and 10 kinds of puls-es are expre-ssed.The common tongues and pulses are yellow and greasy tongue(3 5.91%),dark tongue(25.97%)and smooth pulse(71.27%).3.Pathogenesis distribution:Among all of the 230 cases of gallbladder cancer and chola-ngiocarcinoma,there are 42 kinds of pathogenesis expressions,with a cumulative frequency of 624,and 2.71 pathogenesis per case,Pathogenesis appeared more than 60 times are:Qiyin injury(36.09%),Damp-heat stasis(30.00%),Hepatobiliary dampness-heat stasis(27.39%),Liver and spleen injury(2652%),among them,(hepatobiliary dampness-heat stasis appeared 132 times,freq-uency57.39%.Located in Liver(96.09%),Gallbladder(67.39%),Spleen(40.43%),S-tomach(27.83%),The pathological factors are Stasis(95.65%),Dampness(93.47%),Fever(92.17%),Cancer toxicity(74.78%),Yin deficiency(37.39%)and Qi d-eficiency(36.09%).4.Drug distribution:Among all of the 230 cases of gallbladder cancer and cholangiocarcinoma,191 kinds of drugs are used,with a cumulative frequency of 5551,an average of 24.13 drugs per case.The drugs with a frequency beyond 110 times are as follows:Hedyotis Diffusa(81.73%),Curcumae(79.56%),Scutellaria Barbata(75.65%),Jineijin(62.17%),Radix Pseudostellariae(59.56%),Pinellia(57.82%),Agrimonia pilosa(55.65%),YinChen(53.47%),Bupleurum(52.60%),Bayuezha(51.73%),Rhizoma Pleionis(50.43%),Salvia chinensis(49.56%)and Ophiopogon japonicus(48.69%).Of the drug categories,clearing heat and detoxifying,tonifying deficiency,promoting dampness and water,activating blood circulation and removing blood stasis,invigorating spleen and eliminating food,soothing liver and regulating qi are used more frequently.Conclusion:(1)The basic pathogenesis of gallbladder cancer and cholangiocarcinoma:dampness,heat,blood stasis and toxic damages liver and gallbladder,and Qiyin injuries.(2)Disease character and location:Cancer is the main pathological factor,throughout the whole development of the disease,dampness,heat,blood stasis is also an important pathogenic factor.The disease is mainly located in the liver,gallbladder,involving spleen,stomach,kidney,lung and other viscera.(3)Treating principles and the main methods:The treatment emphasizes Quxiefuzheng.Quxie with anti-cancer herbs throughout the treatment,compatible with soothing the liver and gallbladder,clear away dampness and heat,promoting blood circulation and removing blood stasis,soft firm tumors,and other treatment methods.Fuzheng mainly with Yiqiyangyin,compatible with tonify spleen and stomach,tonify liver and kidney,tonify qi and nourish blood.Nourishing spleen and stomach is of great importance.(4)Professor ZHOU Zhongying's basic prescription for the treatment of gallbladder cancer and cholangiocarcinoma:Bupleurum,Yinchen,Radix Pseudostellariae,Radix Glehniae,Agrimonia pilosa,Trionycis Carapax,Hedyotis Diffusa Bayuezha,Curcumae,Eupolyphaga,Salvia chinensis,Scutellaria Barbata,Coix Seed,nightshade,Rhizoma Pleionis,Radix Atractylodes macrocephala,Rhizoma Atractylodes macrocephala,Jineijin,etc.