Research On The Medication Experience Of Professor Wang Qingguo In The Treatment Of Cardiovascular Diseases Based On Data Mining

Research purposes:This study intends to use data mining method to analyze the cardiovascular disease records of famous old Chinese medicine professor Wang Qingguo.According to statistics and research results,it clarifies the relationship among diseases,syndromes,symptoms,prescriptions and drugs contained in the medical records,and the compatibility rules of prescriptions and drugs,and summarizes them with charts.It objectively and comprehensively summarizes Professor Wang Qingguo's clinical experience in treating cardiovascular diseases,so as to provide valuable reference for future clinical diagnosis and treatment.Research methods:Professor Wang Qingguo's outpatient cases from January 2014 to June 2019 were collected from the National Medical Hall of Beijing University of Traditional Chinese Medicine,Dongzhimen Hospital,the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine,Dongcheng District Hospital of Traditional Chinese Medicine and Renyi Hall.Outpatient case prescriptions were standardized and unified,and were written by tutors themselves,which truly reflected the tutor's thinking on disease differentiation and syndrome differentiation and prescription medication.Cases were entered into "Microsoft Office Excel" to construct "Professor Wang Qingguo's Outpatient Medical Record System".According to the inclusion criteria and exclusion criteria,a large number of cases of hypertension,coronary heart disease,cardiomyopathy,valvular heart disease and arrhythmia will be selected according to the medical records with Chinese medicine compound as the main treatment method and definite diagnosis,and the names of Chinese medicines involved in the medical records will be standardized based on the national unified textbook of the 9th edition of Chinese Medicine.To determine the correct name of traditional Chinese medicine,to ensure the unity of traditional Chinese medicine names,to prevent the same medicine with different names and different medicines with the same name,to establish a database with each medical record as a constant and the traditional Chinese medicine in the medical record as a variable,and to enter the qualified medical records into the database.The results of data mining are analyzed,and reasonable drug categories are selected,thus providing a statistical basis for Professor Wang's medication experience.Then combined with clinical practice,judge the coincidence degree between the results of data mining and clinical practice,screen out reasonable analysis data,and summarize the commonly used drugs,categories,compatibility rules,etc.of Professor Wang Qingguo in treating the above cardiovascular diseases.Finally,according to the commonness and individuality among them,professor Wang's clinical thinking and experience in treating heart diseases are summarized.Research results:1.Among the 975 patients with cardiovascular diseases,455(46.67%)were male and 520(53.33%)were female.The youngest was 18 years old and the oldest was 95 years old,with an average age of 71.3 years.2.Among the 1031 prescriptions entered,17385 frequency of traditional Chinese medicines were used.In the four aspects of qi,warm and cold drugs were used more frequently,7141 and 5624 respectively.In terms of five flavors,sweet,bitter and pungent are used more frequently,9572,7433 and 6651 respectively.As for meridian tropism,it is arranged from high to low:spleen(7630),heart(7323),lung(7052),liver(6637),kidney(5533),stomach(5458),gallbladder(2557),large intestine(2546),bladder(1614)and small intestine(825).There are 41 drugs with frequency higher than 100,which are listed as follows from high to low:Poria,mix-fried licorice,Radix Astragali,Ramulus Cinnamomi,Fructus Schisandrae Chinensis,Scutellariae Radix,Radix Ophiopogonis,Bupleuri Radix,Concha Ostreae preparata,fried atractylodes,Radix Angelicae Sinensis,Rhizoma Pinelliae Preparata,Saviae Miltiorrhizae Radix,Rhizoma Ligustici Chuanxiong,Herba Agrimoniae,Radix Codonopsis,Radix Aconiti Lateralis Preparata,Bulbus Allii Macrostemi,Radix Paeoniae Alba,Semen Platycladi,Herba Epimedii,Coptidis Rhizoma,Fructus Jujubae,Radix Acanthopanacis Senticosi,Os Draconis preparata,Rhizoma Curculiginis,Zingiberis Rhizoma,Fructus Forsythiae,Radix Puerariae,Pericarpium Citri Reticulatae,Herba Ephedrae preparata,Fructus3.By means of correlation analysis and cluster analysis,the commonly used medicine groups of Professor Wang for treating cardiovascular diseases are obtained:Pericarpium Citri Tangerinae_Massa Medicata Fermentata_parched malt,calcined Os Draconis_calcined Concha Ostreae_Colla Corii Asini,calcined Concha Ostreae_roasted Herba Ephedrae_Herba Asari,Bulbus Allii Macrostemi_Rhizoma Ligustici Chuanxiong_Saviae Miltiorrhizae Radix,Bulbus Allii Macrostemi_Saviae Miltiorrhizae Radix_Prunellae Spica,Cimicifuga foetida_Radix Pseudostellariae_Glehniae Radix,Inulae Flos_Corydalis_Jiaobetel nut,Uncaria_Achyranthis Rhizoma Pinelliae Preparata_Scutellariae Radix_Schisandrae Chinensis_Bupleuri Radix,Radix Rubiae_Radix Angelicae Dahuricae_Fructus Polygoni Orientalis,Radix Rubiae_Radix Angelicae Dahuricae_Sangusorbae,Radix Aconiti Lateralis Preparata_Herba Ephedrae_Asari,Bulbus Fritillariae Thunbergii_Rhizoma Sparganii_Herba Taraxaci,Rhizoma Pinelliae Preparata_Scutellariae Radix_Schisandrae Chinensis_Coptidis;The core prescription obtained by association rules is:(1)costustoot_tangerine peel_aspongopus_medicated leaven_roasted malt(2)calcined keel_calcined oyster_colla corii asini_roasted ephedra_asarum(3)onion bulb_ligusticum wallichii_salvia miltiorrhiza_prunella spike(4)cimicifuga foetida_medicated leaven_fingered citron_radix pseudostellariae_radix glehniae,Inula,corydalis tuber,charred areca nut,belamcanda rhizome,Uncaria,Achyranthes root,gastrodia tuber,epimedium,agrimony,Uncaria,radish seed,gastrodia tuber,motherwort,selfheal,uncaria root,kudzu vine root,alisma rhizome,honey-fried licorice root,scutellaria root,bupleurum root,grassleaved sweetflag rhizome,processed pinellia tuber,schisandra fruit,madder root,dahurian angelica root,polygonum fruit,garden burnet root,aconite root,processed ephedra herb,asarum herb,houttuynia,fritillary bulb,common burreed rhizome,dandelion,dried ginger,tuckahoe,12 processed pinellia tuber,scutellarResearch conclusion:This study included 206 cases of cardiovascular diseases treated by Professor Wang Qingguo who met the inclusion criteria,mainly involving coronary atherosclerotic heart disease,arrhythmia,hypertension,valvular heart disease and other cardiovascular diseases.Under the guidance of the theory of traditional Chinese medicine and in combination with the interview with Professor Wang himself,Professor Wang Qingguo's clinical experience and academic thoughts in treating cardiovascular diseases are finally summarized as follows:1.Professor Wang's Experience in Treating Cardiovascular Diseases1.1 Lingguizhugan Decoction:(1)Prescription and pathogenesis:heart yang deficiency failure causes negative pathological products such as phlegm turbidity,blood stasis and qi stagnation to block the heart system,which should be treated with warm drugs.(2)Symptoms and syndromes:palpitations,chest tightness,chest pain,back cold pain,shortness of breath or accompanied by limb numbness and cardiogenic edema,which are mud-like and can't be depressed,with pale and tender tongue with slippery coating,or with heavy,tight,stringy or knot-like pulse when drinking water on the coating although greasy coating is seen.This has opened up a new way of treatment in addition to the traditional emphasis on the pathogenesis of blood stasis,focusing on removing blood stasis,reducing blood fat,promoting blood circulation and dredging meridians.1.2 Zhenwu Decoction:(1)Prescription and pathogenesis:Zhenwu Decoction is used as a supplement to Linggui Shugan Decoction,which is used when there is less evidence of yin and yang deficiency,heavy limbs and tremor on the basis of the latter prescription,i.e.heart and kidney are treated together(2)Symptom and syndrome:cold hands and feet,aversion to cold back,and loose stool appear on the basis of Linggui Decoction group's "water syndrome";Heavy limbs,even muscle tremor,dizziness,fainting,leg weakness,fat and large tongue,pale and tender tongue,no coating or white and smooth coating,and heavy pulse.1.3 Gualou Xiebai Banxia Decoction:(1)Prescription and pathogenesis:chest yang deficiency and phlegm stagnation.(2)Symptoms and Signs:Chest tightness and pain,involving shoulder and back,greasy coating and wiry and slippery pulse.1.4 Chaihu Guizhi Decoction,the pathogenesis and symptoms of the formula:(1)The formula can be used when cardiovascular patients have symptoms of Chaihu syndrome such as hypochondriac pain,bitter taste,vexation,etc.and cassia twig syndrome such as water-qi uprush,palpitation accompanied by susceptibility to body deficiency,frequent hyperhidrosis,spontaneous fever,etc.;(2)arrhythmia and chest pain due to heart yang deficiency;(3)Patients suffering from digestive system diseases at the same time,such as early liver cirrhosis with syndrome differentiation of Shaoyang stagnation heat and cardinal weakness;(4)Evidence of adverse flexion and extension,soreness and pain,and adverse menstruation and qi in the meridians of the hand and foot and the sun and the shaoyang.1.5 Zhigancao Decoction:(1)Pathogenesis of Prescription Syndrome:Arrhythmia of Heart Yin and Blood Deficiency Type(2)Symptom Syndrome:palpitation,generation of pulse knot,red tongue with little or no coating.1.6 Sanhuang Xiexin Decoction:(1)Pathogenesis of Prescription Syndrome:Fire Excess Moving Wind.(2)Symptoms and syndromes:flushed face,dysphoria,insomnia,dizziness,scanty and red urine,constipation,red tongue with yellow and dry fur,slippery pulse,or hemiplegia,numbness of limbs,etc.(1)Yangxin Decoction for palpitation due to deficiency of both heart,qi and blood;(2)Fuling Shuishui Decoction and Jiming Powder for the Treatment of Cardiac Edema;(3)Chaihu Wendan Decoction for the Treatment of Arrhythmia and Coronary Heart Disease Caused by Phlegm and Heat in Gallbladder Meridian;(4)Sancao Jiangya Decoction is used to treat various types of hypertension.2.Professor Wang's Academic Thoughts on Treating Cardiovascular Diseases2.1 The Eight Cardinal Principles Bring Both Cold and Warm Temperatures Any disease is a process of fighting between pathogenic factors and positive factors.There is no obvious boundary between exogenous and internal injuries.Therefore,besides viscera differentiation,Professor Wang also uses six meridians differentiation,Wei Qi Ying Xue and triple energizer differentiation as his routine differentiation methods.However,the connotations of various syndrome differentiation methods intersect with each other.Professor Wang,guided by the eight principles of syndrome differentiation,comprehensively analyzes the disease situation to determine the exterior and interior of the disease location,the cold and heat of the disease nature,which solid pathogens and which deficiency syndromes are the specimens of each other and which side the main contradiction focuses on,and finally further implements the six meridians,Wei Qi Ying Xue,San Jiao and all viscera and meridians.2.2 Pay Attention to Meridian and Meridian and Grasp Main SyndromeProfessor Wang stressed that the main syndrome is the most critical and decisive syndrome for the patient at present.Identifying the main syndrome can eliminate confusing syndromes,correctly judge the patient's current condition,prognosis and outcome,and thus determine the most favorable treatment for the patient.In order to grasp the main syndrome,attention should be paid to the identification of the outline syndrome before the identification of the prescription syndrome,that is,the identification of the six meridians must precede the identification of the prescription syndrome.When differentiating the six meridians,special attention should be paid to the differentiation of the meridians.The six meridians are inseparable from the meridians.2.3 The ancient and the modern,and the longitudinal integrationProfessor Wang thinks that both classical prescriptions and time prescriptions have their own advantages and limitations,and it is not advisable to favor one side over the other.Only when the two are used together can they learn from each other's deficiencies.It is necessary to identify the time square prescriptions with the thinking of identifying the time square prescriptions,and also to expand the scope of application of classical prescriptions with the thinking of using the time square prescriptions.Only in this way can the two swords be combined and the clinical treatment methods be greatly enriched.2.4 overall grasp of the combination of Chinese and westernProfessor Wang pays attention to the integration of Chinese and western medicine and the combination of disease and syndrome.It is emphasized that the diagnosis of western medicine should be carried out clearly.Under the guidance of the theory of traditional Chinese medicine,reference should be made to the examination of western medicine to determine the pathogenesis and judge the prognosis.And Professor Wang believes that the effective standard of TCM treatment is not only the relief of patients' symptoms,but also the relief of pathological conditions of modern medical diseases and the improvement or even complete restoration of abnormal examination items.However,traditional Chinese medicine and western medicine have their own advantages and disadvantages,which need to be combined closely and effectively.