Research On The Law Of TCM Syndrome And Treatment Of Allergic Rhinitis Based On Modern Medical Records

ObjectiveCollecting and sorting out the medical records of allergic rhinitis treated by traditional Chinese medicine,using a variety of data mining techniques to analyze the medical records data,summarize the common symptoms,syndromes,syndrome elements,prescription medication and disease-symptom-syndrome elements-drug Association of allergic rhinitis,in order to provide reference for clinical syndrome differentiation and treatment.MethodAdvanced searches of CNKI(1979-2020),Wanfang(1900-2020),VIP(1989-2020)from the establishment of the database to January 1,2020 included the medical records of allergic rhinitis treated with traditional Chinese medicine.The retrieved documents were imported into Noteexpress 3.2.0 software for duplicate checking.According to the inclusion criteria and exclusion criteria,the literature was screened by reading the title and abstract,and then Through downloading and reading the full text,the article is screened twice,and finally the documents that meet the requirements are input into excel in turn,the data are extracted,and the medical records database is established.Statistics of symptoms,syndromes,syndrome elements and drugs frequency by using the PivotTable function in Excel,using IBM SPSS statistics 25 software to cluster analysis and factor analysis of symptoms and drugs,and SAS9.2 software to carry out Spearman correlation analysis of drugs,syndrome elements and symptoms,syndrome elements and drugs.Results1.Research on the distribution and combination of TCM symptoms,syndrome/syndrome elements of allergic rhinitis based on modern medical records1.1 Distribution of symptoms? Among the 378 medical cases that meet the inclusion criteria,207 symptoms were obtained after data normalization,and 23 symptoms with the frequency>1%,mainly including:watery nasal dischage,sneezing,nasal obstruction,nasal itching,fatigue,loose stools,afraid cold,anorexia,aversion cold,cool limbs,etc.?According to statistics,24 tongue images were obtained,among which 14 were tongue proper,the tongue color with higher frequency was pale tongue,red tongue and light red tongue,with a cumulative frequency of 65%;the tongue shape with higher frequency was fat tongue and tooth-marked tongue,with a cumulative frequency of 22.83%.There are 10 tongue coats in total,the most frequent ones are white coat and yellow coat,with a cumulative frequency of 50.32%;the most frequent ones are thin coat and greasy coat,with a cumulative frequency of 42.82%.?According to the statistics,17 kinds of pulse are obtained,among which the pulse of weak pulse includes thin pulse,weak pulse and faint pulse,with a cumulative frequency of 31.2%;the pulse of sunken pulse includes sunken pulse and feeble pulse,with a cumulative frequency of 26.02%;the pulse of forceful pulse includes string pulse,slippery pulse,tight pulse,forceful pulse and big pulse,with a cumulative frequency of 19.63%.1.2 Study on the rule of symptom combination? Cluster analysis of symptoms showed that there were 12 types of symptoms,and the results were as follows:C1:red tongue,yellow fur,wiry pulse,rapid pulse,constipation knots,greasy fur,insomnia,dry mouth;C2:cough,itching pharynx,itching eyes,slippery pulse;C3:dizziness;C4:pale tongue,white fur,feeble pulse,loose stool,loss of appetite,fatigue,big fat tongue,dental scar tongue,shortness of breath;C5:white face,weak pulse,cool limbs,sore waist and knee.sunken pulse,thin pulse,fear of cold;C6:waterynasaldischage,sneezing,nasal itching;C7:chill,anemophobia,catching cold easily,sweating;C8:headache,dizziness;C9:pale red tongue;CIO:aversion to wind,sweating,floating pulse,slow pulse,etc.?Factor analysis of symptoms showed that 17 common factors were extracted,and the results were as follows:F1:yellow fur,red tongue,white fur;F2:tenderness of waist and knee,cold of limbs and sunken pulse;F3:toothmark tongue,big fat tongue,shortness of breath;F4:constipation knot,greasy fur,thin fur;F5:loss of appetite,fecal runny,fatigue;F6:watery nasal dischage,sneezing;F7:pharynx itching,cough;F8:spontaneous sweat;F9:thin pulse,floating plse.F10:aversion to wind,sweating,etc.1.3 Distribution of syndrome/syndrome elements? In 378 medical cases,there are 285 medical cases recorded syndrome types.After data normalization,199 syndromes were obtained,and 35 syndromes with frequency?2 were used,mainly including:spleen and lung qi deficiency,Lung meridian latent-heat,lung Wei unfixed,lung qi deficiency,Deficiency of spleen and lung Yang,Yang deficiency and wind cold attack,spleen deficiency and dampness,spleen and lung qi deficiency and wind cold attack,lung Yang deficiency,etc.? A total of 41 syndrome elements were extracted from 285 medical cases,including 20 syndrome elements of disease location,mainly including lung,spleen and kidney,with a cumulative frequency of 64.67%;21 syndrome elements of disease nature,mainly including Qi deficiency,Yang deficiency,wind,cold and fire/heat,with a cumulative frequency of 68.38%.1.4 Research on the combination of syndrome elementsThe association rule analysis of syndrome elements shows that the combination of syndrome elements with high confidence is Qi deficiency-spleen-lung,Qi unfixed-Wei Fen,Qi deficiency-lung,Qi unfixed-lung,cold-lung-wind,spleen-lung,cold-wind,kidney-yang deficiency,fire/heat-lung,etc.1.5 Correlation analysis of syndrome elements and symptoms? In the Speannan correlation analysis of disease location syndrome elements and symptoms,it was found that the symptoms positively correlated with lung were shortness of breath and easy to catch cold;the symptoms positively correlated with spleen were loose stool,fatigue,anorexia,shortness of breath,tooth mark tongue,insomnia,slow pulse,pale tongue and feeble pulse;the symptoms positively correlated with kidney were weak waist and knees,cold limbs,sunken pulse,big fat tongue,aversion to cold,cold fear,white face,thin pulse and loose stools.? In the Spearman correlation analysis of disease nature syndrome elements and symptoms,it is found that the symptoms positively related to Qi deficiency are fatigue,tooth mark tongue,feeble pulse,big fat tongue,shortness of breath,easy to catch cold,self perspiration,thin fur and loss of appetite;the symptoms positively related to Yang deficiency are sunken pulse,cold of limbs,sore waist and knees,white fur,fear of cold,deficiency pulse,aversion to cold,sneezing,thin pulse,loose stool and pale tongue;The symptoms positively correlated with wind were floating pulse,watery nasal dischage,cough,itchy throat and white face;the symptoms positively correlated with cold were cool limbs,nasal obstruction,fear of cold,floating pulse,white face,watery nasal dischage,white moss and pale tongue;the symptoms positively correlated with fire/heat were red tongue,yellow fur,rapid pulse,string pulse,constipation,slippery pulse,insomnia and dry mouth.2.Research on TCM medication rule of allergic rhinitis based on modern medical records2.1 Distribution of drug use? Among the 378 medical cases that met the inclusion criteria,284 drugs were obtained after data normalization.The top 5 drugs were saposhnikoviae radix,magnoliae flos,astragali radix,atractylodis macrocephalae rhizoma and xanthii fructus,with a cumulative frequency of 21.03%.? In the classification and statistics of drug efficacy,the top five drug categories are:wind-cold dispersing medicine,qi-tonifying medicine,heat-clearing medicine,wind-heat dispersing medicine,astringent medicinal,with a cumulative frequency of 73.06%.2.2 Distribution of drug dosageIn the statistics of clinical dosage of drugs,it is found that the commonly used doses include wind-cold dispersing medicine asari radix et rhizoma 3g,aingiberis rhizoma recens 3 tablets,centipedae herba 15g,qi-tonifying medicine astragali radix 30g,glycyrrhizae radix et rhizoma 6g,codonopsis radix/pseudostellariae radix 15g,heat-clearing medicine rehmanniae radix/paeoniae radix rubra/lonicerae japonicae flos 15g,gypsum fibrosum 30g,coptidis rhizoma 6g,dispersive wind-heat medicine cimcugae rhizoma 6g,puerariae lobatae radix 30g/15g,warm-lining medicine cinnamomi cortex 3g,blood-tonifying medicine rehmanniae radix praeparata 15g,water-disinhibiting damp-percolating medicinal poria/coicis semen 15g,calming liver and calming wind medicine tribuli fructus 10g/15g,tonifying yang medicine psoraleae fructus 12g,tonifying Yin medicine Lilii bulbus 15g,the other 59 commonly used doses are 10g.2.3 Distribution of drug taste and meridian tropism? In the statistics of drug taste and meridian tropism,the main drugs were temperature,level and low temperature,the cumulative frequency was 73.38%,and the main drugs were pungent,sweet and bitter,the cumulative frequency was 89.98%.?The main meridians were lung and spleen meridians,with a cumulative frequency of 43.4%.2.4 Research on the law of drug combination?In the study of drug compatibility,the association rule analysis showed that saposhnikoviae radix-atractylodis macrocephalae rhizoma-astragali radix,magnoliae flos-atractylodis macrocephalae rhizoma-astragali radix,atractylodis macrocephalae rhizoma-astragali radix,xanthii fructus-magnoliae flos,paeoniae radix alba-cinnamomi ramulus were closely related.? Cluster analysis showed that there were 21 kinds of copolymerization,the results were as follows:Cl:atractylodis macrocephalae rhizoma,astragali radix,saposhnikoviae radix;C2:Poria,codonopsis radix;C3:bupleuri radix,cimicifugae rhizoms,citri reticulatae pericarpium;C4:Angelicae,chuanxiong;C5:myrobalan;C6:Platycodonis radix,Huoxiang;C7:coicis semen;C8:Comi fructus,rehmannia,rehmanniae radix praeparata,alismatis rhizoma,cinnamomi cortex;C9:gypsum,armeniacae semen amarum;CIO:Scutellaria,mori cortex,etc.?Factor analysis showed that 17 common factors were extracted,the results were as follows:F1:paeoniae radix alba-cinnamomi ramulus-jujubae-zingiberis rhizoma recens;F2:saposhnikoviae radix-atractylodis macrocephalae rhizoma-astragali radix;F3:Corni fructus,rehmannia,rehmanniae radix praeparata,alismatis rhizoma;F4:asarum,ephedra,aconite;F5:Schisandra chinensis,dried ginger;F6:tangerine peel,Shengma,bupleurum;F7:angelica,mint;F8:acorus tatarinowii,magnolia,xanthii fructus;F9:Angelica Chuanxiong;F10:Schizonepeta,etc.? Spearman correlation analysis showed that the drug combinations with strong correlation were astragalus-atractylodes,paeoniae radix alba-cinnamomi ramulu,Comi fructus-rehmannia,jujube-ginger,Magnolia-Xanthii.2.5 Correlation analysis of drugs and syndrome elements? In the Spearman correlation analysis of drugs and syndrome elements of disease location,it was found that the drugs positively related to the lung were astragalus,saposhnikoviae radix,mori cortex and chebula,the drugs positively related to the spleen were codonopsis radix,atractylodis,astragalus,Poria,Cimicifuga,citri reticulatae pericarpium,zingiberis rhizoma,dioscoreae rhizoma and coicis semen,and the drugs positively related to the kidney were aconite,cornus,cinnamon,rehmannia,yam,asari radix et rhizoma,alismatis rhizoma.?In the Spearman correlation analysis of drugs and pathogenic syndrome elements,it was found that the drugs positively correlated with Qi deficiency were Astragalus,Atractylodes macrocephala,saposhnikoviae radix,codonopsis radix,poria cocos,Cimicifuga,Xanthium sibiricum,tangerine peel,yam,coix seed,The positive correlation drugs with Yang deficiency were aconite,asarum,ephedra,cinnamon,dried ginger,corn us officinalis and Rehmanniae radix praeparata.The positive correlation drugs with wind were ephedra,xanthium sibiricum,schizonepeta tenuifolia and saposhnikoviae radix.The positive correlation drugs with cold were ephedra,asarum,aconite and xanthium sibiricum,The drugs positively correlated with fire/heat were scutellaria,gypsum,mulberry white skin,ophiopogon japonicus,rehmannia,coicis semen,almond,moutan cortex and Bombyx Batryticatus.Conclusion? According to the statistical analysis of symptoms and syndrome/syndrome elements,it is found that the common symptoms of allergic rhinitis arewatery nasal dischage,sneezing,nasal obstruction,nasal itching,common tongue like pale tongue,white moss,thin moss,and the common pulse is deficiency pulse and forceful pulse.There are 199 syndromes,41 syndrome elements and 20 disease location syndrome elements are extracted,mainly including lung,spleen and kidney.There are 21 syndrome elements of disease type,which are mainly Qi deficiency,Yang deficiency,wind,cold and fire/heat.Through the analysis of the combination of symptoms and syndrome elements,it is suggested that the common syndromes of allergic rhinitis are spleen lung qi deficiency syndrome,kidney yang deficiency syndrome,wind pathogen attacking lung syndrome,lung qi deficiency cold syndrome,camp Wei Disharmony Syndrome,lung heat syndrome,Wei Qi unfixed syndrome and wind cold attacking lung syndrome.? According to the statistical analysis of drugs,we found that the common drugs for allergic rhinitis are mainly divergent wind cold medicine,Qi tonic medicine,heat clearing medicine,divergent wind heat medicine and astringent medicine,the commonly used dose of drugs is more than 10g,the drug is mainly warm and hot,the taste of drugs is mainly pungent,sweet and bitter,and the meridian is mainly lung and spleen.According to the analysis of drug compatibility law,it is suggested that Yupingfeng powder,Guizhi Decoction,Cangerzi powder,ephedra Fuzi Asarum Decoction and Shenqi Pill are commonly used in the treatment of allergic rhinitis.