Chief Physician Li Zhihong's Clinical Research On The Treatment Of Chronic Atrophic Gastritis

Chronic atrophic gastritis(CAG)is a common and difficult disease in gastroenterology department,among which intestinal metaplasia and dysplasia are precancerous lesions of gastric cancer(PLGC).At present,western medicine has some shortcomings in treating this disease,while traditional Chinese medicine(TCM)has certain advantages.Chief physician Li Zhihong has accumulated rich experience in the diagnosis and treatment of CAG.He believes that common causes of CAG include feelings of exogenous pathogens,eating disorders,emotional disorders,and a weak body.He thinks when making a diagnosis,should pay attention to check tongue image,to promote the improvement of the resistance of the human body as the primary task,consider the influence of liver to this disease when making a diagnosis and treatment,choose medication according to different conditions,treat present disease while want to prevent the change of the disease,the prescription is concise for his characteristic.ObjectiveThrough data mining,this paper analyzes and deals with chief physician Li Zhihong's use of TCM in the treatment of CAG,and summarizes the characteristics and laws of the treatment of CAG.To accumulate evidence of evidence-based medicine for the inheritance of his academic thoughts and drug use experience.MethodsCollect case information of CAG diagnosed and treated by chief physician Li Zhihong in the clinic.It mainly includes general information of patients,disease diagnosis,TCM syndromes,Chinese herbal medicine,etc.The ancient and modern medical case cloud platform(V2.2.1)is used as a statistical analysis tool to convert the original data and prescription text into analyzable electronic data,and analyze these data from TCM syndromes,TCM and other aspects,including the statistics of medication frequency,association,clustering and complex network analysis of TCM,To summarize the commonly used drugs,drug pairs,self-designed prescriptions and the addition and subtraction of commonly used prescriptions for the treatment of CAG;Combined with the experience learned from chief physician Li,this paper summarizes the experience of medication and diagnosis and treatment of CAG.ResultThis study included 128 patients,72 men and 56 women.A total of 600 prescriptions were collected,including 404 prescriptions for PLGC,accounting for 67.33%.The analysis through the ancient and modern medical record cloud platform is as follows:1.The frequency and percentage of TCM syndrome types are as follows:hot and humid syndrome of spleen and stomach(188,31.33%),liver and stomach stagnation and fever(181,30.17%),liver and stomach qi stagnation syndrome(89,14.83%),Yin deficiency syndrome of liver and stomach(62,10.33%),Qi and Yin deficiency syndrome(47,7.83%),Spleen and stomach weakness syndrome(18,3.00%),Liver depression and spleen deficiency syndrome(15,2.50%).2.Sort the frequency and percentage of TCM from high to low.The top 20 Chinese medicine statistics are as follows:hedyotis diffusa(542,90.33%),radix pseudostellaria(530,88.33%),lily(470,78.33%),caulis perillae(426,71.00%),Indian strawberry(426,71.00%),semen coicis(402,67.00%),dandelion(373,62.17%),lindera aggregata(346,57.67%),curcuma zedoary(340,56.67%),pharbitis seed(274,45.67%),cuttlebone(265,44.17%),artemisia annua(251,41.83%),dendrobe(256,42.67%),thunberg fritillary bulb(247,41.17%),fructus forsythiae(238,39.67%),Chinese thorowax root(205,34.17%),radix salviae miltiorrhizae(201,33.50%),notoginseng powder(189,31.50%),pine pollen(169,28.00%,radix paeoniae alba(154,25.67%).Through the analysis of the complex network of traditional Chinese medicine,it was found that there are 12 herbs in the above medicines:radix pseudostellaria,spreading hedyotis herb,lily,caulis perillae,Indian strawberry,semen coicis,dandelion,lindera aggregata,cuttlebone,artemisia annua,dendrobe and pharbitis seedare high-frequency medicines for treating CAG;core Chinese herbal medicine include 6 medicines,such as radix pseudostellariae,spreading hedyotis herb,lily,caulis perillae,Indian strawberry,semen coicis.3.Through correlation analysis of Chinese herbal medicine high-frequency drug pairs(frequency>300 times)are as follows:radix pseudostellariae-spreading hedyotis herb,lily-spreading hedyotis herb,lily-radix pseudostellariae,spreading hedyotis herb-Indian strawberry,spreading hedyotis herb-caulis perillae,radix pseudostellariae-Indian strawberry,spreading hedyotis herb-semen coicis,radix pseudostellariae-caulis perillae,coix seed-radix pseudostellariae,caulis perillae-coix seed,caulis perillae-lily,dandelion-spreading hedyotis herb,Indian strawberry-caulis perillae,lily-lindera aggregata,lily-Indian strawberry,Indian strawberry-coix seed,semen coicis-lily,dandelion-radix pseudostellariae,curcuma zedoary-radix pseudostellariae,curcuma zedoary-spreading hedyotis herb,lindera aggregata-radix pseudostellariae,lindera aggregata-spreading hedyotis herb,dandelion-caulis perillae,dandelion-lily.4.Through cluster analysis,6 core groups of Chinese herbal medicine were obtained,which were:group 1:radix pseudostellariae,spreading hedyotis herb,caulis perillae,semen coicis and Indian strawberry.group 2:lily,lindera aggregata,group 3:fructus forsythia,dandelion,cuttlebone,thunberg fritillary bulb and pharbitis seed.Group 4:Chinese thorowax root,curcuma zedoary,notoginseng powder and dendrobe.Group 5:radix salviae miltiorrhizae,pine pollen and radix paeoniae alba.Group 6:artemisia annua.5.The self-designed prescription or combination of commonly used prescriptions for the treatment of CAG is summarized as follows:(1)The frequency and percentage of the top 15 Chinese Herbs are as follows:Spreading hedyotis herb(328,97.04%),caulis perillae(321,94.97%),semen coicis(309,91.42%),radix pseudostellariae(306,90.53%),lily(289,85.50%),Indian strawberry(283,83.73%),dandelion(247,73.08%),curcuma zedoaiy(199,58.88%),artemisia annua(178,52.66%),fructus forsythiae(173,51.18%),pharbitis seed(170,50.30%),dendrobe(157,46.45%),Chinese thorowax root(141,41.72%),radix salviae miltiorrhizae(118,34.91%),notoginseng powder(107,31.66%).(2)The commonly used prescription:liqi xiaozhang Fang,sini powder,xiangsu powder,huaganjian decoction,Haoqin qingdan decoction,Scutellaria talc decoction,xiaoyao powder,shenling baizhu powder,Yiguanjian decoction and shengmai powder,wubei powder and baihe wuyao decoction,such as unilateral addition or prescription treatment.At the same time,the tutor also added high-frequency or core drugs such as spreading hedyotis herb,caulis perillae,radix pseudostellariae,Indian strawberry,semen coicis and lily according to the condition of common prescription.Conclusion1.In this study,the prescription frequency of CAG belongs to PLGC accounted for 67.33%.The TCM syndrome type of CAG mainly consists of dampness-heat syndrome of spleen and stomach,heat-stasis syndrome of liver and stomach,and Qi stagnation of liver and stomach,while the syndromes of liver and stomach Yin deficiency,Qi and Yin deficiency,spleen and stomach weakness,liver depression and spleen deficiency are relatively few.2.The core Chinese herbs for the treatment of CAG include radix pseudostellariae,spreading hedyotis herb,lily,caulis perillae,Indian strawberry,and semen coicis.Then add dandelion,lindera aggregate,cuttlebone,artemisia annua,dendrobe and pharbitis seed to form high frequency medicine.These high frequency drugs,together with curcuma zedoaiy,thunberg fritillary bulb,fructus forsythiae,Chinese thorowax root,radix salviae miltiorrhizae,notoginseng powder,pine pollen and radix paeoniae alba,constitute the top 20 mostcommonly used Chinese herbs.3.The top 20 mostcommonly used Chinese herbs in frequency form the commonly used 24 groups of drug pairs and 6 core groups through different combinations,which can be selected according to individual conditions.4.The self-designed prescriptions were mostly composed of the commonly used high frequency drugs or the core group drugs,such as spreading hedyotis herb,caulis perillae,semen coicis,radix pseudostellariae,lily,Indian strawberry,dandelion,curcuma zedoary,artemisia annua,fructus forsythiae,pharbitis seed,dendrobe,Chinese thorowax root,radix salviae miltiorrhizae and notoginseng powder.5.The commonly used prescriptions include liqi xiaozhang decoction,sinii powder,xiangsu powder,huaganjian decoction,Haoqin qingdan decoction,Scutellaria talc decoction,xiaoyao powder,shenling baizhu powder,Yiguanjian decoction,shengmai powder,wubei powder and baihe wuyao decoction.