Exploration Research On Diagnosis And Treatment Experience Of Famous TCM Expert Based On Multidimensional Analysis Of Ancient And Modern Epilepsy Medical Records

ObjectiveThis topic aims to collect and sort out the existing ancient books and documents,as well as the medical cases related to primary epilepsy of Yu Ying’ao and Yan Xiaocheng,which are famous old traditional Chinese medicine(TCM)doctors,and establish relevant databases through the standardization of medical cases,so as to objectively present the idiopathic epilepsy syndrome treatment rules and TCM application theories reflected in ancient medical cases and two famous TCM doctors’ cases.By exploring the law of syndrome and treatment of ancient cases,this paper explores the exploration mode in the process of sorting out the experience of famous old TCM doctors,and reveals the effective path of inheritance and innovation of famous old TCM doctors’ experience.Provide reference for similar research in the future.MethodIn this study,three standardized databases of medical record information were established,and individual databases were established respectively to facilitate accurate mining.In terms of the standardization of TCM names,the synonyms of TCM were unified into positive names,the medicine parts of TCM that do not affect the efficacy due to different medicine parts were simplified,and the compound medicine was divided into single medicines.In addition,the ancient gender names were standardized,and the terms of pulse,tongue,face color and symptoms were standardized.Using the methods of literature analysis,mathematical analysis,correlation analysis and complex network analysis,and comprehensively using the methods of quantitative analysis and qualitative evaluation,this paper excavates and analyzes the principles and prescriptions in the ancient medical cases of primary epilepsy,the medical cases of Yu Ying’ao and Yan Xiaocheng.Through literature analysis,understand the general information of primary epilepsy in ancient diagnosis and treatment,and understand the relationship between medical records and the disease.Using mathematical analysis to analyze and compare the frequency,frequency and dispersion of research objectives,so as to understand the mathematical differences of things as a whole.The association analysis method was used to explore the relationship between treatment and medicine,and the complex network analysis algorithm was used to mine the core prescriptions of ancient medical records and the core prescriptions of two famous old TCM doctors.The "multidimensional comparison analysis method of ancient and modern Prescriptions" was used to compare the similarities and differences of ancient and modern medical cases in syndrome medicine correlation,treatment principles and methods,TCM set,classification of medicine efficacy,medicine meridian tropism and medicine dispersion.ResultsAfter reasonable inclusion and exclusion criteria,this paper finally included 129 ancient medical cases,145 diagnosis times and 132 prescriptions.70 cases,213 diagnosis times and 231 prescriptions of Yu Ying’ao medical case.And 39 cases,228 diagnosis times and 230 prescriptions of Yan Xiaocheng medical case.The following results were obtained.1.In ancient medical records,"phlegm" was the main cause,including"phlegm heat(fire)","wind phlegm","phlegm dampness" and so on."Phlegm" was not only a pathological factor,but also a pathological product,which plays an important role in the pathogenesis evolution of epilepsy.Among all medicines,Arisaema cum Bile(Dannanxing)ranks first in high-frequency traditional Chinese medicine,and poria cocos and Rhizoma Pinelliae Praeparatum(F abanxia)rank second and third respectively.The medicine properties were mostly warm and cold,which reflects the medicine characteristics of ancient doctors who paid attention to the combination of cold and temperature and mild medicine properties in the treatment of primary epilepsy.Six core prescriptions were selected by complex network analysis.①The core prescriptions of traditional Chinese medicine in medical records:Radix Angelicae Sinensis(Danggui),Radix Paeoniae Alba(Baishao),Poria(Fuling),Atractylodes macrocephala(Baizhu),Panax ginseng(Renshen),Radix Et Rhizoma Glycyrrhizae(Gancao),Arisaema cum Bile(Dannanxing),Citrus reticulata Blanco(Juhong),Ramulus Uncariae cum Uncis(Gouteng),Fushen,Rhizoma Pinelliae Praeparatum(Fabanxia),Cinnabar(Zhusha),Alum(Baifan),Radix Polygalae(Yuanzhi),Rhizoma Acori Tatarinowii(Shichangpu);②Primary epilepsy-phlegm-fire harassing the spirit syndrome core prescription:Arisaema cum Bile(Dannanxing),Coptis chinensis(Huanglian),Citrus reticulata Blanco(Juhong),Rhizoma Pinelliae Praeparatum(Fabanxia),Cinnabar(Zhusha),Ramulus Uncariae cum Uncis(Gouteng),Fructus Gardeniae(Zhizi),Fushen,Rhizoma Acori Tatarinowii(Shichangpu),Fructus Aurantii Immaturus(Zhishi),Radix Et Rhizoma Glycyrrhizae(Gancao),Radix Angelicae Sinensis(Danggui),Radix Polygalae(Yuanzhi),Zhuli,Alum(Baifan),Pericarpium Citri Reticulatae(Chenpi),Radix Paeoniae Alba(Baishao),Radix Curcumae(Yujin),Antelope horn(Lingyangjiao),Salvia miltiorrhiza(Danshen),Caulis Bambusae in Taenia(Zhuru);③Primary epilepsy-wind-phlegm closing orifices syndrome core prescription:Arisaema cum Bile(Dannanxing),Bombyx Batryticatus(Jiangcan),Ramulus Uncariae cum Uncis(Gouteng),Chuan Fritillaria,Poria(Fuling),Radix Curcumae(Yujin),Rhizoma Gastrodiae(Tianma),Rhizoma Acori Tatarinowii(Shichangpu),Trichosanthes kirilowii(Gualou),Fructus Aurantii Immaturus(Zhishi),Caulis Bambusae in Taenia(Zhuru),Fushen,Rhizoma Pinelliae Praeparatum(Fabanxia);④Primary epilepsy-deficiency of both heart and spleen syndrome core prescription:Panax ginseng(Renshen),Astragalus membranaceus(Huangqi),Atracty lodes macrocephala(Baizhu),Radix Angelicae Sinensis(Danggui),Poria(Fuling),Radix Polygalae(Yuanzhi),Rhizoma Pinelliae Praeparatum(Fabanxia),Radix Paeoniae Alba(Baishao),Radix Rehmanniae Praeparata(Shudihuang),Radix Et Rhizoma Glycyrrhizae(Gancao);⑤Primary epilepsy-liver and kidney yin deficiency syndrome core prescription:Radix Rehmanniae Praeparata(Shudihuang),Rhizoma Pinelliae Praeparatum(Fabanxia),papaya(Mugua),Cortex moutan(Mudanpi),Arisaema cum Bile(Dannanxing),Pericarpium Citri Reticulatae(Chenpi),Radix Paeoniae Alba(Baishao),Rhizoma Dioscoreae(Shanyao),rhizoma alismatis(Zexie),Poria(Fuling);⑥Primary epilepsy-blood deficiency and wind movement syndrome core prescription:Panax ginseng(Renshen),Ziheche,Atractylodes macrocephala(Baizhu),Astragalus membranaceus(Huangqi),Radix Paeoniae Alba(Baishao),Fushen,Radix Rehmanniae Praeparata(Shudihuang),Poria(Fuling),Radix Angelicae Sinensis(Danggui),Rhizoma Chuanxiong(Chuanxiong),Radix Et Rhizoma Glycyrrhizae(Gancao).2.The diagnosis and treatment of primary epilepsy by Yu Ying’ao,a famous old TCM doctor:Professor Yu Ying’ao takes the principle of purging excess and tonifying deficiency,and purging more than tonifying.To calm the mind,invigorate the spleen,regulate the liver,moisten the internal organs,reconcile the middle,and invigorate the qi,etc.The core prescription groups mined through the complex network method are:Raw Concha Ostreae(Shengmuli),Radix Curcumae(Yujin),Alum(Baifan),longchi,Salvia miltiorrhiza(Danshen),Caulis Bambusae in Taenia(Zhuru),Semen armeniacae amarum(Kuxingren),Semen Persicae(Taoren),Arisaema cum Bile(Dannanxing)and Amber(Hupo).In the prescription,Raw Concha Ostreae(Shengmuli)and Radix Curcumae(Yujin)were king medicines and also high-frequency medicines,all of which were cold medicines.Yu Ying’ao’s clinical dosage of Alum(Baifan)was between 1.5～3g,and the curative effect was enhanced by decocting it first to remove its anger.Yu Ying’ao’s clinical high-frequency medicines are:Raw Concha Ostreae(Shengmuli),Radix Curcumae(Yujin),Alum(Baifan),Salvia miltiorrhiza(Danshen),Longchi,Semen armeniacae amarum(Kuxingren),Semen Persicae(Taoren)and Arisaema cum Bile(Dannanxing).Most of the high-frequency medicines were cold medicines(such as Shengmuli,Yujin,Baifan,Kuxingren,etc.).3.The diagnosis and treatment of primary epilepsy by Yan Xiaocheng,a famous old TCM doctor:the principles and methods of treatment were to soothe the liver,relieve depression,clear away heat and dissipate phlegm.Through the core medicine mining of 230 prescriptions in 228 diagnosis times of primary epilepsy,it was found that the core components were Rhizoma Gastrodiae(Tianma),Ramulus Uncariae cum Uncis(Gouteng),Fructus Gardeniae(Zhizi),Radix Scutellariae(Huangqin),Fushen,Rhizoma Acori Tatarinowii(Shichangpu),Bombyx Batryticatus(Jiangcan),Radix Bupleuri(Chaihu),Periostracum Cicadae(Chantui),Rhizoma Pinelliae Praeparatum(Fabanxia),Concretio Silicea Bambusae(Tianzhuhuang),Pericarpium Citri Reticulatae(Chenpi)and Radix Et Rhizoma Glycyrrhizae(Gancao).They were the addition and subtraction of Gastrodia elata Uncaria Decoction and Erchen decoction.After the mining of syndrome-core medicines of traditional Chinese medicine,they were also based on these two prescriptions.Through analysis,it can be seen that the commonly used high-frequency traditional Chinese medicine in the experimental cases of primary epilepsy in Yan Xiaocheng’s clinical experience collection of epilepsy was mainly Ramulus Uncariae cum Uncis(Gouteng),Rhizoma Gastrodiae(Tianma),Rhizoma Acori Tatarinowii(Shichangpu),Bombyx Batryticatus(Jiangcan)and Rhizoma Pinelliae Praeparatum(Fabanxia).Among them,the reuse of Shichangpu was the choice of Yan’s clinical experience.Conclusion1.This study used the methods of literature analysis,mathematical analysis,correlation analysis and complex network analysis,excavated and analyzed the ancient medical cases of primary epilepsy and the principle-method-recipe-medicines in the medical cases of primary epilepsy by Yu Ying’ao and Yan Xiaocheng,and compared and analyzed the ancient and modern prescriptions from the five dimensions of syndrome medicine relationship,treatment principle,treatment method,TCM set,medicine meridians and medication dispersion,This paper explored the exploration mode in the process of sorting out the experience of famous old TCM doctors.2.The age of onset of primary epilepsy in ancient and modern times was mostly before the age of 20,and it was mostly in children and adolescents.The accumulation of surviving cases has led to an increase in the incidence of middle-aged groups.The affected population was generally characterized by more men than women,and women often have irregular menstruation.If they get sick in childhood,it was easy to delay menarche.3.The etiology of primary epilepsy was mainly "phlegm" and "wind",and the forms include "phlegm heat(fire)","wind-phlegm" and"phlegm-dampness".On the whole,the disease is more positive than deficiency syndrome,and the main location of the positive disease is liver,which was closely related to the heart,stomach and gallbladder;Deficiency syndrome was mainly located in the spleen,which was closely related to the heart,liver and kidney.The pathogenesis related to phlegm was mostly mixed syndrome of deficiency and excess,involving phlegm dampness blocking orifices,startling phlegm into collaterals,excessive phlegm due to spleen deficiency,excessive cold phlegm and so on."Phlegm" was not only a pathological factor,but also a pathological product,which plays an important role in the pathogenesis and evolution of epilepsy.4.The top ten treatment methods in ancient medical records of primary epilepsy were resolving phlegm,calming and nourishing,eliminating phlegm,calming the liver,calming the wind,clearing heat,eliminating phlegm,inhibiting the liver,regulating qi and opening and lowering,which also reflects the importance of "phlegm" and "wind" in the diagnosis and treatment of primary epilepsy.The two famous old Chinese doctors inherited the essence of diagnosis and treatment of ancient medical records,and made innovations in treatment and medicine compatibility.In the whole process of diagnosis and treatment of primary epilepsy,both doctors attach importance to the treatment of "phlegm".Professor Yu Ying’ao attach importance to the treatment of "phlegm with blood stasis",who takes "suppressing epilepsy,resolving phlegm and dredging collaterals" as the main method,and Professor Yan Xiaocheng pays attention to the treatment of phlegm with wind,who takes "soothing liver and relieving depression,clearing heat and resolving phlegm" as the main method.5.The research on the diagnosis and treatment experience of famous old TCM doctors should be established in three dimensions:time,space and doctors,including comparison between ancient and modern times,comparison between different regions,comparison between doctors,so as to get more effective information.