Retrospective Study On The Rules Of Traditional Chinese Medicine Treatment For Dilated Cardiomyopathy

Objective:The study is based on the collection and arrangement the cases of dilated cardiomyopathy(DCM)in Henan Provincial Hospital of Traditional Chinese Medicine(The Second Affiliated Hospital of Henan University of Traditional Chinese Medicine(TCM)),the data mining analysis method is used to summarize the medication rules of DCM,which provides certain guidance for clinicians in TCM to treat DCM.Methods:This study collected Henan Provincial Hospital of TCM from January1,2012 to December 31,2019 for the treatment of patients with DCM.Then we selected standard cases according to the inclusion and exclusion criteria,and standardized the treatment of drug names to establish a Microsoft Excel 2010 database.Finally,we used SPSS Modeler and SPSS Statistics software,using frequency analysis,association rules,cluster analysis statistical methods to summarize the TCM of DCM.Results:1.This study included a total of 251 cases of 183 males and 68 females.The ratio of male to female was about 2.69: 1.The incidence of males was significantly higher than that of females.The recorded patients were the oldest 84 years old and the youngest 8 years old with an average age of 47.77±14.39 years old.2.Among the 419 cases included,407 cases were diagnosed first with "heart failure" as the first diagnosis of TCM,and only 12 cases with "palpitation" as the first diagnosis of TCM,including 245 cases with "deficiency of Qi and Yin,stagnation of blood stasis and water",133 cases with "deficiency of Qi and blood stasis,stagnation of water dampness".3.The 419 cases involved 911 traditional Chinese medicine prescriptions,including a total of 213 traditional Chinese medicines.The frequency of drug use totaled 18249 times,and the frequency of occurrence≥30% of the drugs were Licorice,Tinglizi,Zelan,Tea tree root,Alisma,Codonopsis,Poria,Salvia miltiorrhiza,Astragalus,Motherwort,Ophiopogon,Atractylodes,Five-claw dragon,Malt,Shenqu,Huixin herb,Platycodon grandiflorum,Cimicifuga,Hawthorn,Polyporus,Radix paeoniae rubra,Bupleurum.All the drugs can be divided into 18 categories,mainly tonifying deficiency drugs,followed by diuretic drugs,promoting blood circulation and removing blood stasis drugs,digestive drugs and expectorant antitussive and asthma drugs.The main drug properties are cold,warm and mild drugs,while hot and cool drugs are less.In the aspect of medicine taste,sweetness is the main taste,bitterness and acridness are the second,and the proportion of light taste,sour taste,astringent taste and salty taste is obviously on the low side.The meridians belong to the spleen meridian,the lung meridian,the heart meridian,the stomach meridian and the liver meridian,while the other meridians involve less.Through the analysis of association rules,with a minimum support of 35%,a minimum confidence of 90%,a promotion degree greater than 1 and the maximum number of preceding items is 3,a total of 138 eligible rules were obtained.Among them,there are 7 rules for the combination of two flavors,52 for the combination of three flavors,and 79 for the combination of four flavors.5.We performed cluster analysis on the drugs,and obtained 7 pairs of commonly used drugs and 4 groups of three-drug combinations.6.Based on the association rules and cluster analysis results,two commonly used new prescriptions for the treatment of DCM can be obtained in Henan Provincial Hospital of TCM.Conclusion:DCM is often admitted to hospital with "heart failure" as the first diagnosis of TCM,which belongs to the syndrome of deficiency of Qi and Yin,deficiency of Yin and deficiency of yang,which can lead to internal growth of water dampness and blood stasis.The main syndrome differentiation types are "deficiency of both Qi and Yin".Blood stasis and water stagnation syndrome and "Qi deficiency and blood stasis syndrome,water-dampness stagnation syndrome".In the treatment,the basic principle is to nourish Qi,promote blood circulation,and promot diuresis,as well as resolv phlegm,reliev cough,reliev asthma and eliminat diet.By applying association rules,we found that commonly used drug combinations are Motherwort +Alisma + Tinglizi→Zelan,Motherwort + Codonopsis + Tinglizi→Zelan,Motherwort+ Tea Tree Root + Tinglizi→Zelan,Huixin herb + Zelan→Tea Tree Root,Cimicifuga→Astragalus etc.Through cluster analysis,we can combine these two new prescriptions to treat DCM: Radix paeoniae rubra,Ophiopogon;Cimicifuga,Bupleurum,Platycodon grandiflorum,Astragalusi,Five-claw dragon,Huixin herb;Poria,Atractylodes,Tinglizi,Alisma,Zelan,Licorice,Tea tree root,Codonopsis,Motherwort.