Experiences In Diagnosis And Treatment Of Bulging By Masters Of Traditional Chinese Medicine Based On Literature Research

Objective:To summarize the characteristics of the diagnosis and treatment of cirrhosis ascites from masters of traditional Chinese medicine,and explores the unique insights of masters of traditional Chinese medicine of treatment of cirrhosis ascites,in order to provide clinical guidance.Methods: Collecting medical cases of masters of traditional Chinese medicine,record information of symptons,signs,tongue signs,pulse signs,syndrome types,drugs and other information,and standardize the various types of information to establish data tables.Using the Excel function in WPS Office 2017 to analyze the frequency of drugs,symptoms,and tongue pulses.Using Weka 3.8 to analyze the association rules of drugs,and select the best rules that meet the conditions,so as to obtain the commonly used drugs in the treatment of cirrhosis ascites,drug pair,drug group and common symptoms,tongue signs and pulse signs.Results: Through searching,22 articles were collected,including 57 medical cases;43 books were collected,including 142 medical cases,199 medical cases were collected in total(1)Analysis of the frequency of drugs: There were 232 kinds of Chinese medicine in 199 medical cases,with a total frequency of 2441 times.(1)Indian bread(118 times)was used most frequently,followed by Largehead atractylodesrhizome(107 times),Oriental waterplantain rhizome(74 times),Virgate wormwood herb(68 times),Liquorice root(70 times),Manyinflorescenced sweetvetch root(53 times),and so on.(2)There are 62 kinds of drugs that have been used 10 times or more.Among the 62 kinds of Chinese medicine,the top five categories that appear most frequently are: tonic medicine(13 kinds),diuretic and dampness medicine(10 kinds),and blood circulation and stasis medicine(9 kinds),Qi-regulating medicine(9 kinds),and heat-clearing medicine(5 kinds).(2)Symptom frequency analysis:(1)In 177 cases with complete symptom information,there were 102 types of symptoms with a total of 1302 frequencies.The highest frequency was abdominal distension(115 times)and abdominal bloating(115times),followed by loss of appetite(58 times),poor urination(50 times).(2)Of the 142 medical cases with "abdominal distension and abdominal bloating" as the main symptom,80 cases included the syndrome of spleen deficiency,59 cases included the syndrome of Qi stagnation,and 60 cases included the syndrome of damp heat.46 cases included the syndrome of blood stasis,47 cases included the syndrome of Yin deficiency of liver and kidney,and 18 cases included the syndrome of Yang deficiency of spleen and kidney.(3)Analysis of tongue and pulse signs frequency:(1)In 70 medical records with complete information of tongue and pulse signs,the most frequent occurrence of tongue sign was red tongue(32 times),followed by redpurple tongue(16 times)and pale-red tongue(7 Times),purple tongue(5 times),palepurple tongue(4 times),etc.The most frequent occurrence of tongue moss is yellow tongue moss(13 times),followed by yellow tongue moss with greasy(10 times)and white tongue moss(8 times),then thin yellow tongue moss(7 times),thin white tongue moss(7 times),etc.The most frequent pulses signs were wiry-thready-rapid pulse(8 times),followed by wiry-rapid pulse(6 times),wiry-thready pulse(6 times),and deepwiry pulse(5 times),(2)For 129 cases of incomplete or missing tongue and vein information,combined with the drugs,the prescription and the original text to interpret the tongue and vein information,68 cases showed spleen deficiency,25 cases showed Qi stagnation,and 15 cases showed damp heat,29 cases showed blood stasis,16 cases showed Yin deficiency;(4)Analysis of association rules:(1)Apriori algorithm was used to calculate 272 association rules of drugs in 150 medical cases.After screening rules,the core drug pairs were Gardenia and Virgate wormwood herb,followed by Radix heterophylla and Poria;the core triple drug group(three drugs used together)is Atractylodes macrocephala-Poria-Amomum,followed by Polyporus-Poria-Amomum.(2)Except for the Gardenia-Virgate wormwood herb medicine pair,all the remaining medicine pairs have the effect of invigorating the spleen and invigorating Qi or invigorating the spleen and dampness;the top 10 triple medicine groups all have the effect of invigorating the spleen and invigorating Qi,of which 5 groups are invigorating Qi of spleen,3 groups are regulating Qi and invigorating the spleen,2 groups are promoting Qi and invigorating the spleen.Conclusion:(1)The most common main symptoms of cirrhosis ascites are abdominal distension and abdominal floating,and the most common secondary symptoms belong to spleen deficiency syndrome;(2)The basic pathogenesis of cirrhosis ascites is the combination of deficiency and solidity,more deficiency and less solidity;mainly spleen deficiency,combined with Qi stagnation,damp heat,blood stasis and other syndromes.(3)The master of traditional Chinese medicine uses spleen and Qi-enhancing drugs for the treatment of cirrhosis ascites.The most commonly used drug is Poria,and the choice of spleen-invigorating and Qi-invigorating prescriptions such as Four Gentlemen Decoction is used commomly.