Chinese Abstract Study On Origin And Clinical Application Of Traditional Chinese Medicine (TCM) In Treating Bulge And Distension From "Spleen"

Objective: Bulging is one of the four difficult diseases in traditional Chinese medicine(tcm),which is complicated and difficult to cure.In this study,through sorting out the thoughts and clinical experience of treating bulge from“Spleen”,the origin and development of treating bulge from“Spleen” in traditional Chinese medicine,collecting clinical syndrome types,symptoms,physical signs,prescriptions and medicines of treating bulging syndrome from“Spleen”,and combining with data mining technology,exploring and analyzing the regularity and characteristics of treating bulging syndrome from“Spleen” in traditional Chinese medicine,to provide reference and new ideas for clinical treatment and research of bulging..Methods: Through online Chinese databases such as cnki,wanfang database,VIP and other Chinese databases,reading show search platform.The Guangxi University of Chinese Medicine Library and the Guangxi Zhuang Autonomous Region Library can be consulted offline for the collection of paper books,and the clinical medical records on the treatment of bulging and distension from the point of view of the spleen can be collected for summarization and collation,the data needed in the medical record were entered into Microsoft Excel form,and the database was constructed.Using statistical software for frequency analysis,Association rules,cluster analysis,medical records of the syndrome,symptoms,signs,drugs and other content of data analysis,combined with the thought of treating bulge from spleen by ancient and modern doctors,the clinical application law of treating bulge from spleen was discussed.Results: 1.To succinctly synthesize the perspectives and practices of medical practitioners both past and present in addressing splenic enlargement,as well as to provide an overview of traditional Chinese medicine’s approach to this ailment.2.Data mining results:(1)Frequency analysis results: 181 symptoms were examined,whereby symptoms that occurred more than 50 times included abdominal distension,fatigue,loss of appetite,lower limb edema,loose stools,and scanty urination;Regarding the tongue and pulse signs,the pale tongue with white greasy coating and the pale red tongue with white greasy coating were the most commonly observed tongue signs,showing a frequency of 6.71%;The most frequent pulse type observed was chordal pulse,accounting for 15.53% of the cases.This was followed by sunken pulse,which accounted for 11.80% of the cases;A total of 189 types of evidence were collected,which could be standardized into 14 types.The most frequently observed evidence types,ranked by frequency,were:water-dampness trapped in the spleen,damp-heat contained in the spleen,spleen deficiency and dampness,liver depression and spleen deficiency,spleen-yang deficiency,spleen-spleen deficiency and water stasis;The study involved 274 types of drugs,out of which Atractylodes macrocephala,Poria,Zedoary,and Chen Pi had a frequency of at least 90,while large belly skin,Poria,Hou Pu,licorice,and Astragalus had a frequency of over 60.Most of the drugs facilitate water retention,while the secondary effects include tonifying qi and regulating vital energy.Regarding drug attribution,the liver meridian had the highest frequency with 114 occurrences,followed by the spleen meridian with 102 occurrences.In terms of drug odor,sweet and bitter tastes were the most frequent,followed by flat,warm,and cold properties.(2)Association Rules Analysis: We applied a symptom association rule algorithm,setting the support threshold to be greater than 10% and the confidence threshold to be greater than 80%.The maximum number of antecedent symptoms was set to 5.Our analysis resulted in a total of 52 symptom association rule sets,including 13 second-order,21 third-order,17fourth-order,and 1 fifth-order association.Of the sets obtained,the association between loss of appetite and abdominal distension was found to be the strongest.In order to identify potential drug targets for the treatment of splenomegaly,we conducted a data mining analysis using a pre-defined set of parameters.Specifically,we set the support threshold to be greater than 20%and confidence threshold to be greater than 80%,with a maximum of 5antecedents.We obtained a total of 35 association sets,comprising 14second-order associations,17 third-order associations,and 4 fourth-order associations.Notably,the strongest association was found between Poria and Baijiao.These findings suggest that Poria-Baijiao combination therapy may hold promise as a potential treatment for splenomegaly.(3)Results of cluster analysis:Systematic clustering of frequently occurring drugs(≥15)and symptoms(≥10)yielded 6 distinct and clinically meaningful cluster combinations for each category.Conclusion(s): In this study,we conducted a comprehensive review of traditional Chinese medicine(TCM)literature to gather information on the treatment of spleen bulging.Through a systematic analysis of symptoms frequency,association rules,and cluster analysis,we identified that spleen deficiency is the central pathomechanical characteristic of bulging,accompanied by damp-heat,water retention,blood stasis,liver depression,and blood deficiency.These findings reveal the intricate and diverse relationship between swelling and the spleen.Our evidence suggests that most physicians treating spleen bulging acknowledge the physiological malfunction of the spleen and endorse the doctrine,"all dampness,swelling,and fullness belong to the spleen",which aligns with the reality of bulging and its pathological mechanisms.Our prescriptions focus on strengthening the spleen,promoting water metabolism,improving Qi flow,resolving phlegm,and regulating body heat to balance deficiency and reality,and enable the spleen to carry out its function properly.We also aim to identify and remove the cause of spleen malfunction,improving its ability to transform water and grain into essence and maintain organ moisture.Overall,our findings emphasize treating spleen bulging from a holistic perspective,taking into consideration both the fundamental issues of spleen functioning and the underlying pathological mechanisms.