Knowledge Discovery Of Li Sai-mei In Treating Diabetic Insomnia Based On Attribute Partial Order Structure Diagram Theory

ObjectiveInsomnia and diabetic insomnia are the common clinical diseases.Since Inner Canon of Yellow Emperor(Huangdi Neijing),there are many records in ancient Chinese Medicine classics of insomnia from the aspects of etiology,pathogenesis,diagnosis and treatment.Traditional Chinese Medicine(TCM)has already made a lot of progress in treating insomnia and diabetic insomnia.Nowadays,the literature research on insomnia and diabetic insomnia are still insufficient,and the academic thought research of insomnia on Treatise on Febrile and Miscellaneous Diseases(Shanghan Zabing Lun)is still inadequate.This research aims to summarize the discussion of insomnia on ancient TCM classics and Zhang Zhong-jing’ s treatment for insomnia comprehensively,and expects that could benefit the clinical practice.Academic thought and clinical experience of famous TCM experts are mainly exist in the form of tacit knowledge,which is very valuable.While,the tactic knowledge is always difficult to capture,define and express.In the inheritance of famous TCM experts’ academic experience,the tacit knowledge is continuously losing.Under this urgent situation,it is necessary to protect and inherit the academic experience.Professor Li Sai-mei is a famous TCM expert,who is very experienced in treating diabetic insomnia by using classical prescriptions.In order to inherit professor Li Sai-mei’ s academic thought and clinical experience,this research intends to using a new knowledge discovery method,which is based on the attribute partial order structure diagram(APOSD)theory,to fully mining the clinical experience and medication principle of professor Li Sai-mei using classical prescription in treating diabetic insomnia.MethodsFully collect TCM classics from the Changsha Mawang Dui of Han Dynasty to Qing Dynasty,and summarize ancient TCM experts’ experience of treating insomnia systematically.Moreover,research the insomnia treating method of Treatise on Febrile and Miscellaneous Diseases extensively.This research collect the diabetic insomnia medical records from professor Li Sai-mei’s clinic during the period from January 1,2013 to December 31,2014.Then,standardize data,based on the syndrome differentiation of six channels theory,apply the new method of APOSD to extract syndrome distribution and symptom characteristics,and summarize the prescription and medication principle of professor Li Sai-mei.Furthermore,discuss the research results fully,and expect that could discover the tacit knowledge of professor Li Sai-mei using classical prescription in treating diabetic insomnia.ResultsThe ancient TCM classics have plenty records of the name,etiology,pathogenesis,diagnosis and treatment for insomnia,each of them possesses an unique times feature.Among Treatise on Febrile and Miscellaneous Diseases,there exists eight methods for treating insomnia,including yin-nourishing and heat-clearing to tranquilize mind method(such as nourishing kidney-yin,liver-yin,heart-yin or lung-yin),yang-warming and hyperactivity-subduing to tranquilize mind method,yang-warming and qi-generating to tranquilize mind method,dispersing stagnated heat to tranquilize mind method,heat-purging and free bowels to tranquilize mind method,relieving distension and harmonizing stomach to tranquilize mind method,phlegm-eliminating and water-removing to tranquilize mind method,promoting the circulation of qi and blood to tranquilize mind method.Professor Li Sai-mei based on the syndrome differentiation of six channels theory to diagnose and treat diabetic insomnia.This research discovered that diabetic insomnia with Taiyang Syndrome,always accompanied with Shaoyin Syndrome;and the clinical symptoms mainly including dry mouth,skin numbness,aversion to cold,blurred vision,sweating,waist soreness,dreaminess,cough,red tongue with thin white or yellow coating,and floating pulse.Accordingly,choose Guizhi Decoction and its associated prescriptions based on different symptoms,such as Guizhi Jia Gegen Decoction,Guizhi Jia Longgu Muli Decoction,Gegen Decoction,Guizhi Decoction.Meanwhile,based on different condition of patient,combined with Sini Powder,Four Tonifying Kidney Herbs(Gouqi Zi,Tusi Zi,Bugu Zhi,Yinyang Huo),Si Junzi Decoction,Fuzi Lizhong Decoction.The high frequency of herbs for diabetic insomnia with Taiyang Syndrome are Guizhi,Zhi Gancao,Dazao and Baishao.Diabetic insomnia with Yangming Syndrome,less accompanied with any other syndrome;and the clinical symptoms mainly including dry mouth,dry stool,skin numbness,bitter mouth,dark urine,red tongue with thick yellow coating,and forceful pulse.Accordingly,based on different symptoms choose Gegen Huangqin Huanglian Decoction,Sini Powder,Taohe Chengqi Decoction.Meanwhile,based on different condition of patient,Gegen Huangqin Huanglian Decoction and Taohe Chengqi Decoction always combined with Sini Powder.The high frequency of herbs for diabetic insomnia with Yangming Syndrome are Zhi Gancao and Huanglian.Diabetic insomnia with Shaoyang Syndrome,always accompanied with Taiyang Syndrome,Yangming Syndrome,Taiyin Syndrome,and Shaoyin Syndrome;and the clinical symptoms mainly including dry mouth,bitter mouth,skin numbness,dark urine,dry stool,sweating,aversion to cold,dizziness,red tongue with yellow coating,and forceful pulse.Accordingly,choose Chaihu Decoction and its associated prescriptions based on different symptoms,such as Chaihu Guizhi Decoction,Xiao Chaihu Decoction,Chaihu Jia Longgu Muli Decoction,Chaihu Guizhi Ganjiang Decoction,Guizhi Jia Gegen Decoction,Sini Powder.Meanwhile,based on different condition of patient,combined with Sini Powder,Gegen Huangqin Huanglian Decoction,Siwu Decoction,Wuling Powder,Four Tonifying Kidney Herbs.The high frequency of herbs for diabetic insomnia with Shaoyang Syndrome are Chaihu,Zhi Gancao,Shu Dangshen,Huangqin,Fa Banxia and Dazao.Diabetic insomnia with Taiyin Syndrome,always accompanied with Shaoyang Syndrome,Liver Qi Stagnation Syndrome;and the clinical symptoms mainly including dry mouth,bitter mouth,sweating,aversion to cold,dark urine,dreaminess,skin numbness,blurred vision,pale tongue with white coating,feeble pulse.Accordingly,based on different symptoms choose Fuzi Lizhong Decoction,Sini Powder,Chaishao Liu Junzi Decoction,Gegen Huangqin Huanglian Decoction,Lizhong Decoction.The high frequency of herbs for diabetic insomnia with Taiyin Syndrome are Zhi Gancao,Shu Dangshen and Fuling.Diabetic insomnia with Shaoyin Syndrome,always accompanied with Yin Deficiency of Liver and Kidney Syndrome,Taiyin Syndrome;and the clinical symptoms mainly including dry mouth,sweating,skin numbness,blurred vision,dark urine,dreaminess,bitter mouth,aversion to cold,joint pain,pale tongue with thin white coating,feeble pulse.Accordingly,based on different symptoms choose Four Tonifying Kidney Herbs,Fuzi Lizhong Decoction,Qiju Dihuang Decoction,Chaishao Dihuang Decoction,Maiwei Dihuang Decoction,Mahuang Fuzi Xixin Decoction.Meanwhile,based on different condition of patient,combined with Jingui Shenqi Pill.The high frequency of herbs for diabetic insomnia with Shaoyin Syndrome are Fuling and Yinyang Huo.Diabetic insomnia with Jueyin Syndrome,always accompanied with Taiyang Syndrome,Liver Qi Stagnation Syndrome,Taiyin Syndrome;and the clinical symptoms mainly including dry mouth,skin numbness,dark urine,sweating,bitter mouth,version to cold,pale tongue with thin white coating,feeble pulse.Accordingly,based on different symptoms choose Sini Powder,Danggui Shaoyao Powder.Meanwhile,based on different condition of patient,combined with Si Junzi Decoction,Lizhong Decoction,Four Tonifying Kidney Herbs.The high frequency of herbs for diabetic insomnia with Shaoyin Syndrome are Zhi Gancao,Fuling and Danggui.ConclusionThe ancient TCM classics have plenty records about insomnia during Han Dynasty to Qing Dynasty,which can provide beneficial advises in treating insomnia today.Although there is no chapter for insomnia in Treatise on Febrile and Miscellaneous Diseases;eight methods for treating insomnia are included.From the point of Zhongjing Theory,deficiency,heat,phlegm,blood stasis and fu-viscera excess can lead to insomnia,and due to different pathogenesis,take measures of replenish deficiency or purge redundance to reach the balance of yin and yang,the insomnia will disappeared.Based on the new method of knowledge discovery,this research mining the clinical experience of professor Li Sai-mei in treating diabetic insomnia.The results discovered that the pathogenesis of diabetic insomnia with Taiyang Syndrome is overabundance of pathogen,the treatment lies in strengthening body resistance to eliminate pathogenic factors and regulating ying-qi and wei-qi;the pathogenesis of diabetic insomnia with Yangming Syndrome is interior excessive of heat and stagnation,the treatment lies in clearing heat and purging excessive;the pathogenesis of diabetic insomnia with Shaoyang Syndrome is obstruction of pivot,the treatment lies in mediating pivot,eliminating stagnation and regulating triple energizer;the pathogenesis of diabetic insomnia with Taiyin Syndrome is deficiency of spleen-yang and accumulation of cold-damp,the treatment lies in tonifying spleen-yang and removing cold-damp;the pathogenesis of diabetic insomnia with Shaoyin Syndrome is deficiency of heart and kidney,and imbalance of yin and yang,the treatment lies in nourishing yin and tonifying yang;the pathogenesis of diabetic insomnia with Jueyin Syndrome is complicated,the treatment is decided by the clinical syndrome to reach the balance of yin and yang.