Correlation Between Melasma Syndrome And Skin Lesions And Data Mining Of Traditional Chinese Medicine Intervention

ObjectivesThrough the collection of clinical data of patients with chloasma,this study preliminously discussed the distribution of TCM disease site syndrome elements and disease syndrome elements,as well as the internal combination rules among the syndrome elements,and analyzed the correlation between facial lesions of patients with chloasma and TCM syndrome elements.Using data mining technology to explore the clinical medication rules of Professor Zhang Fengchuan's treatment of chloasma,in order to provide theoretical basis and syndrome differentiation reference for clinical diagnosis and treatment of chloasma.Materials and Methods1.By investigating the literature on the etiology,pathogenesis and syndrome differentiation of chloasma,the research progress of traditional medicine on the etiology,pathogenesis and syndrome differentiation of chloasma since ancient times was reviewed as a whole,and the clinical questionnaire of chloasma was designed in combination with the Syndrome Differentiation Syndrome Syndrome Syndrome Scale of "Syndrome Differentiation Syndrome".2.Randomly collected during September 2018 to December 2020,in the Beijing university of Chinese medicine east hospital dermatology clinics,a total of 207 patients with chloasma,chloasma western medicine diagnostic criteria:refer to the Chinese society of combining traditional Chinese and western medicine skin disease epidemiology group of professional committee of pigment chloasma therapy expert consensus of the People's Republic of China(2015 edition),skin lesions in patients with photo records,collect patients general data,four diagnostic information related to syndrome factor,skin manifestations and Chinese traditional medicine prescription.3.All the contents of the survey were input into Excel,and SPSS software was used for statistical analysis and data mining to explore the distribution characteristics of chloasma syndromes and their correlation with the manifestations of chloasma lesions;This paper analyzed and discussed the characteristics of various formulae in the treatment of chloasma by Professor Zhang Fengchuan.Results1.Results of TCM syndrome elements:(1)Location syndrome elements:in order of frequency from high to low,the distribution is liver,kidney,spleen,heart,small intestine,gallbladder,stomach,lung,chest and diaphragm(upper Jiao),lesser abdomen(lower Jiao),surface,inner part,and half surface and half inner part.The complex frequency(?10)from high to low was:kidney+liver,spleen+kidney,spleen+liver,heart+kidney,heart+liver.(2)Disease syndromes:in order of frequency distribution from high to low:Blood stasis,Yang deficiency,Qi stagnation,Yin deficiency,Dampness,Phlegm obstruction,Qi deficiency,Fire(Heat),Jin deficiency,Poison,Internal wind,Yang hyperactivity,Blood heat,Blood deficiency.The incidence of deficiency and deficiency was mostly mixed,and the frequency(?20)from high to low is Blood stasis+Yang deficiency,Qi stagnation+Blood stasis,Blood stasis+Yin deficiency,Blood stasis+Dampness block,Qi stagnation+Yin deficiency,Blood stasis+Phlegm block.(3)Syndrome element combination rule:disease syndrome element?disease site syndrome element,blood stasis? kidney and liver(SUP 46.602%,CON 97.959%)confidence is the highest;The highest degree of confidence was from kidney to Yang deficiency(SUP 48.544%,CON 74.627%).Among the syndrome elements,the highest confidence was from blood stasis to qi stagnation(SUP 47.087%,CON 97.980%).Liver to kidney(SUP 47.573%,CON 69.504%)had the highest confidence among disease loci.(4)Correlation between syndrome elements and lesions:the total score of MASI was dominantly correlated with the kidney and spleen at the disease sites,while there was no statistical significance between the total score of MASI and the disease sites of liver,heart,small intestine,gallbladder,stomach,lung,chest and diaphragma(upper coke)and lower coke(lower coke).There was a dominant correlation between the total score of MASI and the disease of qi stagnation,blood stasis,Yin deficiency,phlegm obstruction,Yang deficiency,fluid deficiency,fire(heat),poison,blood deficiency and water stagnation,while there was no statistical significance between the disease of qi deficiency,water obstruction,internal wind,Yang hyperactivity,blood heat,cold,water flooding,dryness,external wind and the MASI score.2.Application rules of traditional Chinese medicine:Among the 207 included prescriptions,50 herbs with frequency?20 were used,and the top 8 herbs with high frequency were tangerine peel,mother of pearl,rose,rhodiola,Chinese rose,cuscuta,silkworm and angelica.Correlation analysis of 26 drug pairs was obtained,such as "Lilium-Albiza sinensis".The complex network analysis showed that the top 8 traditional Chinese medicines frequently appeared,as well as milkwart seed and peony bark,together constituted the core drugs for the treatment of chloasma by Professor Zhang Fengchuan.The clinical prescription was based on the individual condition of the patient.Cluster analysis was conducted to obtain four groups of cluster prescriptions containing at least four herbs,namely Gardenia jasminoides,Divine Comedy,Ligusticum chuanxiong,Atractylodes ractyloides.Conclusion1.By extracting TCM syndrome elements of chloasma,it can be known that its pathogenesis involves Yin,Yang,surface,interior,cold,heat,deficiency and solid.Blood stasis is the important pathogenesis of chloasma,and the disease sites and syndromes are mainly in liver and kidney.The various pathogenesis is complicated,the deficiency and the deficiency are mixed,and the syndromes are varied.Common witness types include blood stasis syndrome(kidney deficiency and blood stasis,liver,liver stagnation and blood stasis,qi stagnation and blood stasis,etc.),kidney deficiency syndrome(kidney-yang deficiency,kidney-yin deficiency,kidney-essence deficiency,etc.),liver stagnation and qi stagnation,liver and kidney-yin deficiency syndrome,and concurrent syndrome may include spleen-kidney-yin deficiency syndrome,heart-kidney non-interflow syndrome,wind attack and surface thinning syndrome,etc.The statistical analysis results of this study showed that there was a certain correlation between the distribution of TCM syndromes and the severity of skin lesions in patients with chloasma.Chloasma is a common clinical disease with prolonged and difficult healing and complicated pathogenesis.In clinical treatment,multiple factors should be combined for overall syndrome differentiation,so as to effectively guide clinical treatment and improve efficacy.2.In the traditional Chinese medicine treatment of chloasma,the medicinal properties of traditional Chinese medicine are mainly cold and warm;The taste of medicine is mainly sweet,bitter and spicy;The main meridians are liver,spleen,lung,stomach,kidney,heart,bladder.In the treatment of chloasma,Professor Zhang Fengchuan takes tonifying the kidney and strengthening the body,promoting blood circulation and removing blood stasis as the main treatment methods,and clearing heat and cooling the blood,relieving depression and calming the mind as the common clinical treatment methods.Professor Zhang is not limited to a single method in the clinical treatment,but based on the whole,detailed syndrome differentiation,flexible medication,and pays attention to the regulation of the patient's mood,sleep,constitution and other aspects.3.The shortcomings of this study are that the source of sample data is relatively single and the number is small.In the future,large-sample and multi-center data research is still needed.Masi score is affected by subjective factors to a certain extent.The next step is to introduce objective evaluation tools(such as dermoscopy,etc.)and use computer image analysis and processing to further examine the correlation between TCM syndromes and chloasma lesions.Future research can use animal laboratory methods to study the main drugs at the molecular level.