Clinical Evaluation Of Ruanjian Sanjie Method In Treating Nodular Diseases Of The Liver Channel

1 Objective:1.1 Quantitative analysis of the current status of TCM Ruanjian Sanjie method or combined with conventional western medicine for the treatment of pathological diseases of the liver meridian(taking thyroid nodules,breast hyperplasia,and uterine fibroids for examples),to provide reliable evidence-based medical evidence for the objective evaluation of the efficacy of Ruanjian Sanjie method in the treatment of nodular diseases of the common liver meridian,and improve the clinical efficacy of Ruanjian Sanjie method in the treatment of liver nodular diseases.1.2 Analyse the TCM prescriptions for treating liver nodular diseases(thyroid nodules,breast hyperplasia,uterine fibroids),use data mining methods to explore the core drug combination for each disease,discover the high frequency medication,core prescriptions,and summarize Ruanjian Sanjie method of medication for each disease.1.3 To explore the rules of TCM differences and treatment of two or three diseases occurring in the same patients at the same time.2 Methods:2.1 Meta AnalysisComputer searches the CNKI,VIP,CBM,Wanfang,PubMed,Embase medical databases,and collects data from the establishment database to the publicly published Ruanjian Sanjie method or with the combination of conventional western medical treatment of thyroid nodules,breast hyperplasia,and uterine fibroids Randomized controlled trials(RCTs).The improved Jadad scale was used to score the literature quality.Revman5.3 as an analysis aid.According to the heterogeneity results,the corresponding forest map model was selected to display the analysis results.The funnel map was displayed to include the publication bias of the literature.2.2 Data miningCollect TCM prescriptions for the treatment of thyroid nodules,breast hyperplasia,and uterine fibroids,which were published from January 2010 to December 2019,and establish a TCM prescription sparse matrix table to extract data from documents that meet the inclusion criteria.Data mining model is established,Apriori model is calculated using Clementine 12.0 software,and association rule analysis is performed.Use IBM Statistic23 software to perform R-type clustering analysis,and explore the drug usage rules,commonly used drug combinations,and core prescriptions for the treatment of each disease by the Ruanjian Sanjie method,and discover new effective prescriptions.3 Results:3.1 Meta-analysis results of Ruanjian Sanjie Chinese compound medicine for thyroid nodules,breast hyperplasia,and uterine fibroidsThyroid nodules:34 RCTs were included in the study.The results of Meta-analysis showed that Ruanjian Sanjie or combined with western medicine was superior to western medicine in improving the overall clinical effectiveness and reducing the size of thyroid nodules,all have significant differences(P<0.05).Hyperplasia of mammary glands:40 RCTs were included in the study.The results of Meta-analysis showed that Ruanjian Sanjie or combination of western medicine can improve the total clinical effectiveness,reduce the size of nodular breast hyperplasia,nodular hardness,and related hormones(E2,P)level,breast pain score and other aspects are better than Western medicine treatment,all have significant differences(P<0.05).Uterine fibroids:29 RCTs were included in the study.The results of Meta-analysis showed that Ruanjian Sanjie Recipe or combination of western medicines had improved clinical effectiveness,reduced uterine fibroid volume,and related hormones(FSH,LH,E2,P),Breast pain score and other aspects are better than Western medicine treatment,all have significant differences(P<0.05).3.2 Data mining resultsThyroid nodules:A total of 96 prescriptions were screened,and a total of 5 herbs were used more than 50 times.The order of frequencyfrom high to low was:Xiakucao,Zhebei,Chaihu,E'zhu,Muli.The first three places in the drug combination are:Xiakucao,Yujin;E'zhu,Zhebei,Xiakucao;Xiakucao,Chenpi.The core formulas from cluster analysis,were:Cl:Yujin,Xiakucao,Chenpi,Gancao,Fuling,Lianqiao;C2:Sanleng,E,zhu,Qingpi;C3:Haizao,Kunbu,Banxia,Danggui;C4:Zhebei,Muli,Xuanshen.Hyperplasia of mammary glands:A total of 112 prescriptions were screened and 5 herbs were used more than 50 times.The frequency from high to low was:Chaihu,Xiangfu,Danggui,Baishao,Zhebei.The first three drug combination are:Chaihu,Xiangfu;Chaihu,Danggui;Chaihu,Baishao.The core formulas from cluster analysis:C1:Sanleng,E'zhu,Wangbuliuxing,Haizao,Kunbu,Muli;C2:Zhebei,Gualou,Chuanshanjia,Xiakucao,Yanhusuo,Da nshen;C3:Baizhu,Fuling,Baishao,Danggui;C4:Zhike,Gancao,Chuanxiong,Chaihu,Chenpi,Xia ngfu.Uterine fibroids:A total of 70 prescriptions were screened,and a total of 2 herbs were used more than 35 times.The order of frequency from high to low was:Sanleng,E,zhu.The first three places of the drug combination are:Sanleng,E'zhu;Sanleng,E'zhu,Xiakucao;Sanleng,E'zhu,Taoren.The core formulas from cluster analysis:C1:Sanleng,E'zhu,Xiangfu,Danshen;C2:Xiakucao,Niuxi,Muli,Haizao,Kunbu,Lizhihe;C3:Jineijin,Shanzha,Huangqi,Dang shen,Baizhu;C5:Taoren,Chuanshanjia,Chishao,Chuanxiong,Danggui,Guizhi,Fuling,Danpi.4 Conclusions:4.1 Meta analysis conclusionRuanjian Sanjie method alone or combined with Western medicine for the treatment of nodular diseases(thyroid nodules,breast hyperplasia,uterine fibroids)along the meridian path,is effective in reducing lesion size,stiffness,total effectiveness,and related indicators.It has advantages over western medicine therapy alone,and has fewer adverse reactions.4.2 Data mining conclusionsThe clinical medications for treating thyroid nodules are reducing phlegm and resolving masses medicine with regulating qi medicine and blood medicine,Xiakucao and Zhebei are the highest.The core prescriptions are Haizao Yuhu Decoction and Xiaoyao powder.It can be seen that the pathological changes in thyroid nodules of the human body are mainly sputum coagulation,accompanied by blood stasis and qi stagnation.The clinical medications for the treatment of hyperplasia of mammary glands are mainly to disperse liver and qi,cooperate with blood nourishing and blood circulation medicines,Huatan Sanjie medicines.The core prescriptions are Xiaoyao powder and Chaihu Shugan powder.It can be seen that the pathological changes of breast hyperplasia in the middle of the human body are characterized by liver stagnation and qi stagnation,accompanied by blood deficiency,blood stasis,and sputum coagulation.The clinical medications for treating uterine fibroids is mainly blood circulation,and the highest usage rates are Sanleng,E'zhu.The core prescriptions are Gui Zhi Fu Ling Pill and Bie Jia Jian Wan.It can be seen that the pathological changes in the lower part of the human uterine fibroids are mainly blood stasis,and Huayu Xiaozheng and Ruanjian Sanjie are the main treatment methods.If two or three of the thyroid nodules,hyperplasia of the breast,and uterine fibroids occur in the same patient at the same time,According to the performance of the patient,it can be judged which pathological changes in the patient are mainly sputum coagulation,qi stagnation and blood stasis.Based on the main change,the basic basis for prescription medication are used.The upper,middle,and lower parts of the human body where the lesion is located are used as an auxiliary reference.The research results show that the commonly used TCM for treating three diseases has multiple targets and can be clinically based on the patient's condition.The situation is flexible in choosing Chinese medicine.