Study On The Medication Rules Of Traditional Chinese Medicine For Focal Adenomysis Based On Clinical Data Mining

Objective:In order to explore the law of herb use of focal adenomyosis(Adenomyosis,AM)and that in different age groups,provide a reference basis for the TCM treatment of focal AM,and broaden the idea of conservative treatment of focal adenomyosis,we used the data mining method to study with it.Methods:From 2012 to 2017,the information of outpatients and inpatients who were diagnosed as focal AM by gynecological ultrasound with complete information and treated with herb decoction or granules in the Gynecology Department of Shandong University of traditional Chinese Medicine Affiliated Hospital were extracted.The data mining was carried out by using Microsoft Excel、SPSS Statistics 23.0、SPSS Modeler 14.1 and Liquorice.The incidence rules of focal AM patients were explored by using frequency analysis,complex network,association rules and cluster analysis.And the core prescriptions,high frequency of herb dose,core herb pairs and new prescriptions for the treatment of focal AM were obtained by analyzing the frequency,taste,menstruation,efficacy and dosage.And 20-55-year-old patients were divided into 4 groups by age.was analyzed,and the core prescriptions and herb use trends of each age group were obtained by analyzing the herb use information of patients.Results:A total of 710 patients’s information with focal AM were collected,including 761 prescriptions,15177 items of TCM information,260 herbs,and 810 items of imaging information.①Characteristics of herb use in this disease:frequency analysis showed that high frequency of herbs were vinegar Rhizoma Corydalis,Radix angelicae Sinensis,Radix Rehmanniae,Radix Paeoniae Alba,etc.And the warm herbs were the most frequently used,and the herbs with bitter taste and sweet taste were mainly used.the herb use with the highest frequency of menstruation were the liver meridian,followed by the spleen and kidney meridians.The efficacy of herb was tonifying deficiency,activating blood circulation and removing blood stasis,regulating qi.Complex network analysis showed that the core prescriptions of TCM for focal AM were Vinegar Rhizoma Cyperi,vinegar Rhizoma Corydalis,Radix angelicae Sinensis,Radix Paeoniae Alba,Rhizoma chuanxiong,Cattail Pollen,Motherwort herb,Codonopsis pilosula,oyster,and got three-layer herb combination.The dosage of Rhizoma Cory dal is was the highest,followed by Cattail Pollen and Chuanxiong,and the high-frequency dose of the core prescription herbs were Vinegar Rhizoma Cyperi 11g～20g,vinegar Rhizoma Corydalis 11g～20g,Radix angelicae Sinensis 6g～12g,Radix Paeoniae Alba 11g～15g,Rhizoma chuanxiong 3g～10g,Cattail Pollen 11g～20g,Motherwort herb 9g～15g,Codonopsis pilosula 16g～30g,oyster 16g～30g.Five clustering prescriptions were obtained by cluster analysis of high-frequency herbs.According to the analysis of association rules,the core herb pairs were forsythia-Coix seed,Motherwort herb,Rhizoma chuanxiong-black medicine,vinegar Corydalis-vinegar myrrh.The core efficacy herb pair were qi regulating and warming internal medicine,blood-invigorating medicine-promoting blood circulation analgesic,promoting blood circulation and regulating menstruation medicine-breaking blood and eliminating dysmenorrhea medicine.② Characteristics of herb use in each age group:the age of onset was mainly between 30 and 49 years old.The core prescriptions of 20-29-year-old patients were Rhizoma Corydalis,Rhizoma Euphorbiae,Radix Rehmanniae,Radix angelicae Sinensis,Rhizoma chuanxiong,Radix Paeoniae Rubra,Radix Paeoniae Alba,Radix angelicae Sinensis,Fructus Forsythiae,Fructus Forsythiae.The core prescriptions of 40-49-year-old patients were vinegar Xiangfu,vinegar Corydalis,Angelica,Rhizoma chuanxiong,oyster,Cattail Pollen,Radix Paeoniae Alba,Codonopsis pilosula,Motherwort herb,mainly promoting blood circulation and analgesics,tonifying qi and tonifying blood.The core prescriptions of patients aged 50-55 were oyster,Cattail Pollen,Codonopsis pilosula,Radix Rehmanniae,Radix Astragali,Cortex Phellodendri,Fructus Ligustri,Fructus Ligustri,Rhizoma Ligustri,Rhizoma Ligustri,Fructus Ligustri.As the age grow,the herbs for regulating qi,activating blood circulation and removing blood stasis showed a downward trend,and the herbs for regulating qi reached the peak at the age of 30-39,while those for tonifying qi and Hemostatic herbs reached the highest value at the age of 50-55.The use of herbs for warming the interior gradually decreased with age,while heat-clearing herbs increased gradually;among the four herbs for tonifying deficiency,herbs for tonifying blood and tonifying yang decreased with the increase of age,while the use of herbs for tonifying qi and tonifying yin showed an upward trend.Conclusion:①Focal AM syndrome usually expressed as deficiency and excess mixed syndrome,the pathogenesis is based on deficiency and expressed as excess,and the blood stasis is the core part of the occurrence and development of this disease.The basic treatment is promoting blood circulation and removing blood stasis,regulating qi and relieving pain,supporting vital energy,dispelling pathogens,as well as the soft firmness and loose knots.The treatment should be based on the Liver,and the atase of herbs are bitter and warm.②The core prescriptions for the treatment of focal AM are Vinegar Rhizoma Cyperi,vinegar Rhizoma Corydalis,Radix angelicae Sinensis,Radix Paeoniae Alba,Rhizoma chuanxiong,Cattail Pollen,Motherwort herb,Codonopsis pilosula,oyster.According to the prescription,it was concluded that the main syndrome is qi stagnation and blood stasis.③The painkillers and hemostatic herbs are widely used,thus the most common clinical symptoms of focal AM were dysmenorrhea and menorrhagia,and the common dosecore prescriptions were obtained.④The characteristic treatment methods included warming kidney and dispersing knot,regulating menstruation and hemostasis,invigorating spleen and removing dampness,invigorating qi and relieving pain,replenishing qi and dispersing knot.⑤The age of onset ranged from 30 to 49 years old,with a younger trend.Generally speaking,the syndrome of qi stagnation and blood stasis is the main syndrome of 20-49 year-old patients,and on this basis,20-29 year-old patients had more cold coagulation and blood stasis syndrome.30-39 year-old patients with heat-toxin and blood stasis syndrome,and 40-49 year-old patients had qi deficiency and blood stasis syndrome additionally.And the patients aged 50-55 years old mainly had kidney yin deficiency syndrome,qi deficiency and blood stasis syndrome.The medication of patients changed from excess to deficiency with age,and the type of deficiency syndrome gradually changed from blood and yang deficiency to qi and yin deficiency,The pathogenic factors also changed from cold evil to yin deficiency,and the qi stagnation and blood stasis syndrome changed to qi deficiency and blood stasis syndrome.