Based On Data Mining, Professor Li Yuehua's Medication Rules For The Treatment Of Depression

Objective:Using a retrospective study,data mining methods of association analysis and clustering analysis were used,excavated the basic prescription of professor Li Yuehua's dialectical treatment for patients with depressive state,and the common medicine pair/team,to explore professor Li Yuehua's experience in treating depressive state and guide clinical medication.Methods:The data were collected from the geriatric clinic of professor Li Yuehua in XiYuan hospital of Chinese academy of traditional Chinese medicine from January 2016 to February 2019,whose basic statistics and drugs were collected,1361times in total.After standardizing the data,the basic information of patients and the Chinese medicine database were established.IBM SPSS Statistic 23.0 and SPSS Modeler 18.0 were used to conduct descriptive statistics,cluster analysis and association rule analysis on the database.Results:1.According to the statistical analysis of the month and season of onset,In January,there were 167 prescriptions,accounting for 12.27percent.In February,there were 97 prescriptions,accounting for 7.13%.In March,there were 153 prescriptions,accounting for 11.24 percent.In April,there were 107 prescriptions,accounting for 7.86%.In May,there were 121 prescriptions,accounting for 8.89%.In June,there were 119 prescriptions,accounting for 8.74%.In July,there were 110 prescriptions,accounting for 8.08 percent.In August,there were 120 prescriptions,accounting for 8.82%.In September,there were 98 prescriptions,accounting for 7.20%.In October,there were 74 prescriptions,accounting for 5.44 percent.In November,there were 116 prescriptions,accounting for 8.52 percent.In December,there were 79 prescriptions,accounting for 5.80%,significantly the prescriptions were higher in January and March than in other months.There were 381 prescriptions(27.99%)in spring,349 prescriptions(25.64%)in summer,288 prescriptions(21.16%)in autumn,and 343 prescriptions(25.20%)in winter,Obviously the number of prescriptions was more in spring,middle in summer and winter,and less in autumn.2.From the statistical analysis of depression state of TCM syndrome type,it belonged to liver stagnation and qi stagnation syndrome,with 21 prescriptions,accounting for 1.54%.There were 95 prescriptions,liver depression and spleen deficiency syndrome,accounting for 6.98%.There were 347 prescriptions,liver stagnation and phlegm obstruction syndrome,accounting for 25.50%,and 137 prescriptions,deficiency of heart and spleen syndrome,accounting for 10.07%.There were 761 prescriptions,disharmony of heart and kidney syndrome,accounting for 55.91%,therefore the main syndromes included in this study were liver depression and spleen deficiency syndrome,liver stagnation and phlegm obstruction syndrome,deficiency of heart and spleen syndrome and disharmony of heart and kidney syndrome,because all the medical records were collected from geriatric outpatient departments,mainly from the middle-aged and the elderly,they could not reflect the actual distribution characteristics of TCM syndromes of depressive state.3.According to the analysis of association rules,the three and four commonly used drug pairs in the syndrome of liver depression and qi stagnation syndrome were:Curcuma-Albizzia julibrissin durazz-Acorus tatarinowii,Bupleurum-Cyperus rotundus-Fructus aurantia-Ligusticum chuanxiong,etc.In the syndrome of liver depression and spleen deficiency syndrome,Bupleurum-Atractylodes macrocephala koidz-Angelica sinensis,Acorus tatarinowii-Polygala tenuifolia-Albizzia julibrissin durazz,etc.which were the three commonly used drug pairs.There were three commonly used herbs in the syndrome of liver stagnation and phlegm obstruction:Pinellia ternate-Mangnolia officinalis-Poria cocos,Acorus tatarinowii-Polygala tenuifolia-Albizzia julibrissin durazz etc.Three commonly used herbs in the syndrome of deficiency of heart and spleen included atractylodes macrocephala koidz-Radix Astragalus memeranaceus-Codonopsis pilosula,Acorus tatarinowii-Polygala tenuifolia-Albizzia julibrissin durazz etc.There were 3 kinds of drugs commonly used in disharmony of heart and kidney syndrome,such as Acorus tatarinowii-Polygala tenuifolia-Albizzia julibrissin durazz,etc.4 herbs for Morinda officinalis-Angelica sinensis-Phellodendron chinense Schneid-Anemarrhenae,etc.In addition,professor Li Yuehua treated depressive state in clinical practice,who was night sweats with kidney Yin deficiency,Gypsum-Cornus officinalis-Turtle shell was the commonly used drug pair in disharmony of heart and kidney syndrome.Diarrhea due to spleen deficiency,Myristica fragrans-Chinese yam was the commonly used drug pair.The patients were always to urinate in night,Lindera aggregate-Enodera sinensisi Saussure was the commonly used drug pair.4.Through cluster analysis and combined with clinical practice,the basic prescriptions called XinYue no.1 for depressive state with liver depression and qi stagnation syndrome were determined:Bupleurum,Cyperus rotundus,Ligusticum chuanxiong,Curcuma,Fructus aurantii,Semen ziziphi spinosae,Gastrodin,Tribulus terrestris,Albizzia julibrissin durazz,Acorus tatarinowii.The basic prescription called XinYue no.2 of the depression state of liver depression and spleen deficiency syndrome were:Bupleurum,Angelica sinensis,Paeonia lactiflora pallas,Poria cocos,Atractylodes macrocephala koidz.Mother pearl shellfish,Tribulus terrestris,Acorus tatarinowii,Acorus tatarinowii,Albizzia julibrissin durazz,Polygala tenuifolia.The basic prescription called XinYue no.3 of the depression state of liver stagnation and phlegm obstruction syndrome were:Pinellia ternata,Mangnolia officinalis,Poria cocos,Perilla leaf,Citrus,Acorus tatarinowii,Polygala tenuifolia,Albizzia julibrissin durazz,Bupleurum,Semen ziziphi spinosae,Acanthopanax senticosus,Rhodiola rosea.The basic prescription XinYue no.4 of the depression state of deficiency of heart and spleen syndrome were:Codonopsis pilosula,Radix Astragalus memeranaceus,atractylodes macrocephala koidz,Angelica sinensis,Schisandra chinesis,Poria cocos,Semen ziziphi spinosae,Polygala tenuifolia,Albizzia julibrissin durazz,Acorus tatarinowii,Mother pearl shellfish,Tribulus terrestris,Bupleurum.The basic prescription XinYue no.5 of the depression state of disharmony of heart and kidney syndrome were:Curculigo orchioides,Epimedium,Morinda officinalis,Acanthopanax senticosus,Angelica sinensis,Semen ziziphi spinosae,Ligusticum chuanxiong,Phellodendron chinense Schneid,Anemarrhenae,Polygala tenuifolia,Albizzia julibrissin durazz,Acorus tatarinowii,Schisandra chinesis,Bupleurum,Tribulus terrestris.Conclusion:1.In this study,patients with depression were collected with the method of retrospective study,and the basic information and prescriptions of 1361 times of diagnosis were collected for descriptive statistics it was found that Depression may be more likely to flare up or recur in January and march.2.In clinical practice,professor Li Yuehua treated depression of liver stagnation and qi stagnation syndrome,Curcuma-Albizzia julibrissin durazz-Acorus tatarinowii were the commonly used drug pairs to resolve stagnation for tranquilization;Bupleurum-Cyperus rotundus-Fructus aurantia-Ligusticum chuanxiong were the commonly used drug pairs to soothing liver.Acorus tatarinowii-Polygala tenuifolia-Albizzia julibrissin durazz were the commonly used drug pairs to resolve stagnation for tranquilization in other four TCM syndromes.Bupleurum-Atractylodes macrocephala koidz-Angelica sinensis were the commonly used drug pairs to soothing liver and strengthening spleen in the liver depression and spleen deficiency syndrome.Pinellia ternate-Mangnolia officinalis-Poria cocos were the commonly used drug pairs to regulating qi-flowing for eliminating phlegm in the liver stagnation and phlegm obstruction syndrome.Atractylodes macrocephala koidz-Radix Astragalus memeranaceus-Codonopsis pilosula were the commonly used drug pairs to nourishing qi to invigorate spleen in the deficiency of heart and spleen syndrome.Morinda officinalis-Angelica sinensis-Phellodendron chinense Schneid-Anemarrhenae were the commonly used drug pairs to nourish Yin and strengthen kidney and harmonize heart fire virtual hyperactivity.3.Professor Li Yuehua divided depression into three clinical stages and five syndromes.The three clinical stages were excess syndrome,deficiency syndrome and combination of both.The five TCM syndromes were liver stagnation and qi stagnation syndrome,liver depression and spleen deficiency syndrome,liver stagnation and phlegm obstruction syndrome,deficiency of heart and spleen syndrome and disharmony of heart and kidney syndrome.Professor Li Yuehua believes that the general syndrome evolution of depression from excess syndrome to and combination of both to deficiency syndrome.Among them,the empirical stage is liver stagnation and qi stagnation syndrome patients,generally young age,short course of disease,light illness,The stage of combination of both are liver depression and spleen deficiency syndrome and liver stagnation and phlegm obstruction syndrome,at this stage,middle-aged patients are the majority,and the course and condition were often in the middle.The stage of deficiency syndrome includes deficiency of heart and spleen syndrome and disharmony of heart and kidney syndrome,this phase of the elderly patients,a long course of illness,serious illness.Therefore,depressed patients with liver depression and qi stagnation syndrome are rarely seen in geriatric clinics.4.Through cluster analysis and combined with clinical practice,the basic prescriptions called XinYue no.1 for depressive state with liver depression and qi stagnation syndrome were determined:Bupleurum,Cyperus rotundus,Ligusticum chuanxiong,Curcuma,Fructus aurantii,Semen ziziphi spinosae,Gastrodin,Tribulus terrestris,Albizzia julibrissin durazz.Acorus tatarinowii.The basic prescription called XinYue no.2 of the depression state of liver depression and spleen deficiency syndrome were:Bupleurum,Angelica sinensis,Paeonia lactiflora pallas,Poria cocos,Atractylodes macrocephala koidz,Mother pearl shellfish,Tribulus terrestris,Acorus tatarinowii,Acorus tatarinowii,Albizzia julibrissin durazz,Polygala tenuifolia.The basic prescription called XinYue no.3 of the depression state of liver stagnation and phlegm obstruction syndrome were:Pinellia ternata,Mangnolia officinalis,Poria cocos,Perilla leaf,Citrus,Acorus tatarinowii,Polygala tenuifolia,Albizzia julibrissin durazz,Bupleurum,Semen ziziphi spinosae,Acanthopanax senticosus,Rhodiola rosea.The basic prescription XinYue no.4 of the depression state of deficiency of heart and spleen syndrome were:Codonopsis pilosula,Radix Astragalus memeranaceus,atractylodes macrocephala koidz,Angelica sinensis,Schisandra chinesis,Poria cocos,Semen ziziphi spinosae,Polygala tenuifolia,Albizzia julibrissin durazz,Acorus tatarinowii,Mother pearl shellfish,Tribulus terrestris,Bupleurum.The basic prescription XinYue no.5 of the depression state of disharmony of heart and kidney syndrome were:Curculigo orchioides,Epimedium,Morinda officinalis,Acanthopanax senticosus,Angelica sinensis,Semen ziziphi spinosae,Ligusticum chuanxiong,Phellodendron chinense Schneid,Anemarrhenae,Polygala tenuifolia,Albizzia julibrissin durazz,Acorus tatarinowii,Schisandra chinesis,Bupleurum,Tribulus terrestris.