Analysis Of Professor Zhang Fuli’s Prescriptions For The Treatment Of Chronic Atrophic Gastritis

Objective:In this paper,through collecting medical records related to the treatment of patients with chronic atrophic gastritis by Professor Fu Lizhang,and with the help of the software system of the Chinese Medicine Heritage Computing Platform(V3.0),we discover the pattern of Professor Fu Lizhang’s clinical treatment of chronic atrophic gastritis and further summarize Professor Fu Lizhang’s academic thinking and the characteristics of his medicine in the treatment of chronic atrophic gastritis with the help of my usual study experience of the disease under my teacher,with a view to better serving The aim is to better serve clinical practice.Methods:According to the corresponding inclusion criteria as well as exclusion criteria,a total of147 medical records of patients with chronic atrophic gastritis who attended the clinic of Prof.Fu Lizhang of the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine between November 2018 and November 2021 were collected,with the main contents being name,age,gender,chief complaint,tongue and pulse,prescription of Chinese medicine,and date of consultation.The collected information was uniformly entered into the Excel sheet provided by the platform,standardised and pre-processed,and uploaded to the TCM Heritage Computing Platform(V3.0)software system.The software was used to carry out frequency analysis,correlation analysis and K-means cluster analysis on the entered information,and combined with the experience of the followers to refine the characteristics of Professor Fu Lizhang’s medication,prescription rules and identification ideas in the treatment of chronic atrophic gastritis,and treatment experience,etc.Results:1.Among 147 patients with chronic atrophic gastritis,104 were females,accounting for 70.74% of the total patients;43 were males,accounting for 29.26% of the total patients,with a higher prevalence in females than in males.2.In terms of tongue signs,yellowish tongue coating appeared 69 times and red tongue coating appeared 48 times at most,and the combination of red and yellowish tongue coating appeared most frequently,up to 10 times.The combination of red tongue and yellow tongue coating occurs most frequently,up to 10 times.The pulse were sunken and stringent up to 40 times.3.Analysis of the TCM disease names showed that gastric gangrene occurred 91 times(61.90%),noisiness occurred 41 times(27.89%)and stomach pain occurred at least 15 times(10.20%).Among the TCM symptoms,those with a single symptom occurring more than 20 times include liver and stomach heat,liver and stomach qi stagnation,and damp heat of spleen and stomach,with frequencies of 24,23 and 21.The top three compound symptoms were liver and stomach qi stagnation combined with blood heat,liver and stomach heat combined with yin injury,and stomach yin deficiency combined with heat stagnation.4.The results of the four qi and five flavors were as follows: for the four qi,cold drugs appeared the most frequently at 914 times,warm drugs at 820 times and flat drugs at495 times,ranking the top three.In terms of the five flavors,bitter,sweet and pungent medicines were the top three,appearing 1282 times,1216 times and 826 times respectively;in terms of the attribution of medicines to the spleen meridian,the top three were 1316 times,1116 times for the lung meridian and 1086 times for the stomach meridian.The drug efficacy showed that tonifying drugs for the deficiency,clearing heat and relieving symptoms appeared most frequently in the prescriptions,with 775,419 and 394 times respectively.5.In the association rule analysis,the "number of support" was set to 123(83.7% of the total prescriptions)and the "confidence level" was set to 0.9,resulting in a total of 22 drug combinations,with the core prescriptions being: Maidong(OPHIOPOGONIS RADIX),Gancao(GLYCYRRHIZAE RADIX ET RHIZOMA),Shengjiang(ZINGIBERIS RHIZOMA RECENS),Fusheng(PORIA),Dihuang(REHMANNIAE RADIX),Baishao(PAEONIAE RADIX ALBA).6.In the analysis of the formula grouping pattern,the "number of clusters" was set to 8,and the k-means algorithm was used to obtain 8 core drug combinations,n amely,Group 1:Gancao(GLYCYRRHIZAE RADIX ET RHIZOMA),Maidong(OPHIOPOGONIS RADIX),Shengjiang(ZINGIBERIS RHIZOMA RECENS),Fushen(PORIA),Banxia(PINELLIAE RHIZOMA),Baishao(PAEONIAE RADIX-ALBA),Dihuang(REHMANNIAE RADIX),Sangjisheng(TAXILLI HERBA);Gr oup 2: Fusheng(PORIA),Maidong(OPHIOPOGONIS RADIX),Shengjiang(ZINGIB-ERIS RHIZOMA RECENS),Gancao(GLYCYRRHIZAE RADIX ET RHIZOMA),Baizhi(ANGELICAE DAHURICAE RADIX),Sangjisheng(TAXILLI HERBA),Banxia(PINELLIAE RHIZOMA),Dihuang(REHMANNIAE RADIX);Group3: Shengjiang(ZINGIBERIS RHIZOMA RECENS),Maidong(OPHIOPOGO-NIS RADIX),Fushen(PORIA),Gancao(GLYCYRRHIZAE RADIX ET RHI-ZOMA),Baizhu(ATRACTYLODIS MACROCEPHALAE RHIZOMA),Sangjisheng(TAXILLI HERBA),Dihuang(REHMANNIAE RADIX),Danggui(ANGELICAE SINENSIS RADIX);and Group 4: Banxia(PINELLIAE RHIZOMA),Shengjiang(ZIN-GIBERIS RHIZOMA RECENS),Maidong(OPHIOPOGONIS RADIX),Dihuang(REHMANNIAE RADIX),Sangjisheng(TAXILLI HERBA),Baizhu(ATRA-CTYLODIS MACROCEPHALAE RHIZOMA),Fusheng(PORIA),Gancao(GLYCY-RRHIZAE RADIX ET RHIZOMA);Group 5: Gancao(GLYCYRRHIZAE RADIX ET RHIZOMA),Maidong(OPHIOPOGONIS RADIX),Shengjiang(ZINGIBERIS RHIZOMA RECENS),Baishao(PAEONIAE RADIX ALBA),Beish ashen(GLEHNIAE RADIX),Sharen(AMOMI FRUCTUS),Muli(OSTREAE CONCHA),Baibiandou(LABLAB SEMEN ALBUM);Group 6: Shengjiang(ZINGIB-ERIS RHIZOMA RECENS),Maidong(OPHIOPOGONIS RADIX),Fushen(PORIA),Gancao(GLYCYRRHIZAE RADIX ET RHIZOMA),Dihuang(REHMANNIAE RADIX),Muli(OSTREAE CONCHA),Baishao(PAEONIAE RADIX ALB A),Sangjisheng(TAXILLI HERBA);Group 7: Luxiancao(PYROLAE HERBA),Shengjiang(ZINGIBERIS RHIZOMA RECENS),Maidong(OPHIOPOGONI-S RADIX),Dihuang(REHMANNIAE RADIX),Fushen(PORIA),Gancao(GLYCYRRHIZAE RADIX ET RHIZOMA),Jingjie(SCHIZONEPETAE HERBA),Banxia(PINELLIAE RHIZOMA);Group 8: Muli(OSTREAE CONCHA),Sangye(MORI F-OLIUM),Shengjiang(ZINGIBERIS RHIZOMA RECENS),Maidong(OPHIO-POGONIS RADIX),Banxia(PINELLIAE RHIZOMA),Yujin(CURCUMAE RADIX),Huangqin(SCUTELLARIAE RADIX),Baishao(PAEONIAE RADIX ALBA).Conclusions.1.Aspects of drugs: coldness and warmth predominate;bitter,sweet and pungent flavours are common;commonly used drugs in the order of meridians are spleen,lung,stomach,liver,heart and kidney;deficiency tonic drugs,heat-clearing drugs and symptomatic drugs are commonly used.Symptoms: the top three single symptoms are,in order,liver-stomach stagnation and heat,spleen-stomach damp-heat and liver-stomach qi stagnation;the c ompound symptoms are,in order,liver-stomach qi stagnation combined with blood-h eat,liver-stomach stagnation and heat combined with yin injury,and stomach-yin def iciency combined with stagnation and heat.The core ingredients are: Maidong(Op hiopogon japonicus(Linn.f.)Ker-Gawl),Gancao(Glycyrrhiza uralensis Fisch.),Shengjiang(Zingiber officinale Roscoe),Fusheng(Poria cocos(S chw.)Wolf),Dihuang(Rehmannia glutinosa Libosch.),Baishao(Paeonia lactijlora Pall.).2.In the treatment of chronic atrophic gastritis,Professor FuLizhang often applies the combined treatment of Qi,Blood and Meridians,emphasizing that the imbalance of Qi and Qi-transformation in the five viscera is the key cause of CAG,and that Damp-Heat is an important causative factor,while Yin deficiency and dishonour in the stomach ligament is its fundamental pathological change,therefore,in the clinical treatment,the main focus is on regulating the Qi of the five viscera and nourishing the stomach ligament,while at the same time dispelling Dampness and clearing Heat and controlling Yang with Yin.