Experience Of Zhang Zhen In Treating Functional Dyspepsia Based On Data Mining And Semi-structured Interview

ObjectiveTo summarize the experience of Chinese medicine master Zhang Zhen in the treatment of functional dyspepsia(FD)by using data mining and semi-structured interview.Professor Zhang Zhen’s thought of syndrome differentiation and treatment was extracted to provide guidance for the development of TCM general practice diagnosis and treatment,so as to improve the level of syndrome differentiation and treatment of TCM general practitioners.MethodsTo establish the medical record data table of functional dyspepsia treated by Zhang Zhen,a master of Chinese medicine,and to use the ’data analysis’ module of the Famous Doctor Inheritance Platform(Fang Net)to mine the core and auxiliary drugs in the prescription,Chinese medicine-Chinese medicine correlation,symptom-drug correlation,and drug clustering.Combined with semi-structured interviews,analysis of Professor Zhang Zhen’s understanding of functional dyspepsia disease,pathogenesis,disease location,characteristics of syndrome differentiation and treatment,diet,etc.in order to systematically summarize Professor Zhang Zhen’s experience in the treatment of functional dyspepsia.Results1.Data mining:(1)Basic information: A total of 303 patients were included,including 123 male patients(40.59% of the total)and 180 female patients(59.41% of the total).The minimum age is 18 years old,the maximum age is 88 years old,and the largest number of patients is 20-39 years old.(2)166 kinds of traditional Chinese medicine were used in 303 medical records,and 33 kinds of core drugs were used: Gancao,Chaihu,Baishao,Muxiang,Chuanxiong,Zisugeng,Yujin,Xiangfu,Houpo,Bohe,Zhiqiao,Danshen,Zhishi,Sharen,Fuling,Chenpi,Yehehua,Fabanxia,Shanyao,Zhuru,Xiakucao Guya,Shenqu,Shichangpu,Yiyiren,Gouteng,Cangzhu,Fangfeng,Yanhusuo,Doukou,Wuyao,Xiaohuixiang,Maiya.(3)core prescription: Gancao,Chaihu,Baishao,Muxiang,Chuanxiong,Zisugeng,Yujin,Xiangfu,Houpo,Bohe,Zhiqiao,Danshen.(4)In addition to the same core prescription drugs,seven drug pairs were obtained: Xuduan and Sangjisheng,Yanhusuo and Xiangfu,Maiya and Guya,Manjingzi and Heye,Houpo and Doukou,Yanhusuo and Chuanxiong,Doukou and Zisugeng.(5)Symptoms-drug correlation:stomachache: Chaihu,Chuanxiong,Yujin,Houpo,Bohe,Doukou;inappetence: Muxiang,Maiya,Sharen,Guya,Danshen,Shenqu,Jineijin;sleeplessness: Yehehua,Yanhusuo,Gouteng,Fushen,Suanzaoren,Shichangpu,Jiujiechangpu,Lianzi,Shouwuteng;bitter taste:Zhuru,Zhishi,Chenpi,Fabanxia,Xiakucao,Fuling;dry mouth: Zhuru,Xiakucao,Maidong,Tianhuafen;stomach pain: Muxiang,Yujin,Houpo,Doukou.(6)Cluster analysis of core drugs obtained 10 combinations:(1)Gancao,Chaihu,Baishao,(2)Chuanxiong,Xiangfu,Bohe,Zhiqiao,Danshen,(3)Gouteng,Fushen,Jineijin,Jiujiechangpu,Pangdahai,(4)Fuling,Shanyao,Yiyiren,Cangzhu,Lianzi,(5)Fangfeng,Foshou,Chantui,Suanzaoren,Yinyanghuo,(6)Zhishi,Chenpi,Yehehua,Fabanxia,Zhuru,(7)Doukou,Maiya,Sharen,Guya,(8)Shenqu,Shichangpu,Fenge,Xuduan,Sangjisheng,(9)Muxiang,Zisugeng,Yujin,Houpo,(10)Wuyao,Xiaohuixiang.2.Semi-structured interview: Professor Zhang Zhen,Professor Tian Chunhong and Professor Zhang Xiaolin were interviewed once each,with an average time of 42 minutes and 32 seconds,a total of more than 2.64 thousand words,and 11129 words of literature were selected as supplements.The grounded theory was used to study the three-level coding interview to encode the transcribed text data of the interview,and 520 open coding and 10 axial coding were obtained,including disease understanding,etiology,disease location,pathogenesis,diagnosis method,treatment method and prescription selection,clinical classification,empirical medication,life adjustment and other information.Selective coding 1,for Chinese medicine master Zhang Zhen’s treatment of functional dyspepsia experience.Conclusion1.Professor Zhang Zhen believes that the basic pathogenesis of FD belongs to the disorder of qi movement in middle energizer,which is mainly caused by the disorder of spleen and stomach qi movement caused by liver failure.It is believed that the main specific syndromes are liver qi invading stomach syndrome and liver qi invading spleen syndrome.The core syndrome is qi,and the basic syndrome is qi stagnation.Combined with the difference of disease location in liver,spleen and stomach,the specific syndromes of liver qi invading stomach syndrome and liver qi invading spleen syndrome are analyzed.It is emphasized that the disease is in the process of dynamic progress,and the trend of pathogenesis transformation is analyzed in combination with primary syndrome,secondary syndrome and concurrent syndrome to guide clinical treatment.2.The main treatment methods of Professor Zhang Zhen in the treatment of FD are soothing and regulating qi,soothing liver,regulating spleen and harmonizing stomach.The medication is mainly based on Shutiaohezhong Decoction.The drug composition is:Chaihu,Yujin,Muxiang,Xiangfu,Zisugeng,Houpo,Zhiqiao,Baishao,Chuanxiong,Danshen,Bohe,Gancao.3.The academic characteristics of Professor Zhang Zhen’s treatment of FD are as follows:(1)syndrome differentiation follows the ’two-state three-three configuration law’of TCM syndrome;(2)The treatment adheres to the therapeutic thought of ’one body with two wings,regulating qi movement’,mainly regulating qi movement,harmonizing middle energizer,regulating spleen and stomach,and regulating center.4.Professor Zhang Zhen’s thought of syndrome differentiation and treatment is helpful to improve the ability of syndrome differentiation and treatment of general practitioners of traditional Chinese medicine and guide the development of general practice of traditional Chinese medicine.