Analysis Of Children Narcolepsy Clinical Syndromes And Symptoms Based On Association Rules And Apriori Algorithm

Objective: TCM database of children narcolepsy was built up with the application of the Traditional Chinese Medicine inheritance support system(TCMISS).Then the characteristics of core clinical symptoms and syndromes were analysed by using data mining association rules Apriori algorithm from the Traditional Chinese Medicine perspective,and the children narcolepsy pathogenesis of TCM was summarized,and TCM syndromes and distribution was concluded.Methods: The medical information of patients with children narcolepsy was collected who has seen a doctor in The First Affiliated Hospital of Henan University of TCM.Then Children Narcolepsy Case Report Forms were filled in.According to the Chinese Medicine Thesaurus and Differential Diagnosis of TCM Symptoms,the clinical signs and symptoms were standardized.TCM database of children narcolepsy was built up with the application of the TCMISS.Firstly,gender,BMI,age of onset,visiting age,history of past illness and family medical history was analysed.Then the core clinical manifestations including excessive daytime sleepiness(EDS),onset of cataplexy and nocturnal sleep disorder were analysed.Then TCM symptom patterns were extracted by the application of data mining association rules Apriori algorithm,and the core TCM symptoms were summarized and displayed by the complex network.According to the Symptom Integral Correspondence Table and Diagnosis Units Integral Table,the diagnosis units integral of every patient was achived,and the Syndrome Element database of children narcolepsy was built up with the application of the TCMISS.The association rules of diagnosis units were extracted by the using of Apriori algorithm and displayed by the complex network.Then the children narcolepsy pathogenesis of TCM was summarized,and the characteristics of TCM syndromes and distribution was concluded.Results: 102 cases were collected in all.67 were male patients and 35 were female patients.95 cases were early-onset patients and 7 were late-onset patients.The age of onset undulates to 5~17 years old,and the mean age of onset was 9.99 ± 2.11 years old.The history of past illness shows statistically dystocia history accounted for7.84%,expired history 8.82%,history of nervous system infection 3.92% and 79.41%patients had no clear past history.2 patients have the clear family history of narcolepsy.Among the 102 patients with children narcolepsy,29 patients was the initial visit for narcolepsy,and 73 patients had visited doctors for narcolepsy.Among the 73 patients,32 patients had been diagnosed correctly and other 41 patients had been diagnosed as other diseases,such as encephalitis,epilepsy and asthenic bulbar paralysis.With regarding to the core symptoms,all the 102 patients had manifested with EDS and cataplexy,while some patients had emerged nocturnal sleep interruption,increased arousal,sleep paralysis,hallucination,nightmare and REM sleep behavior disorder.All the patients with children narcolepsy manifested with some mental and behavioral disorders and psychological symptoms and 69 patients showed gentlely dizziness headache.102 cases involved 125 TCM symptoms,which were used to diagnosis units diagnosis.The symptoms which have the frequency more than 20 are 43,and the top 10 are as following: somnolence,dreaminess,spiritlessness,poor sleep,lassitude,gallbladder timidity and susceptibility to fright,depression or irritability,no desire to speak,tastelessness.The symptoms patterns were analysed by association rules and Apriori algorithm with Support 40% and Confidience 0.8 and 6 patterns were induced,and the top three are as following:spiritlessness?somnolence(Confidence=0.981481481),lassitude?somnolence(Confidence=0.955555556),no desire to speak?somnolence(Confidence=0.953488372).The core TCM symptoms which were used for syndrome differentiation were somnolence,dreaminess,poor sleep,spiritlessness,no desire to speak,lassitude,pale white complexion.Diagnosis units of 99 cases had been diagnostic establishment and 12 kinds of diagnosis units were involved.5 kinds of diagnosis units about disease location are as following: spleen,kidney,heart spirit,liver and gallbladder.Deficiency character of diagnosis units are as following:deficiency of yang,deficiency of yin,deficiency of qi,deficiency of blood.Excess character of diagnosis units are as following: fireball plasma,damp evil,phlegm.The3 top-frequency are spleen,deficiency of yang and fireball plasma.By using association rules and Apriori algorithm,32 patterns and 52 association rules ofdiagnosis units were induced with the Support 8% and Confidence 0.6 and the 3top-frequency are as following: spleen and deficiency of yang,spleen and damp evil,damp evil and deficiency of yang.Displayed by complex network,the combinations with strong relevance are as following:(1)spleen,damp evil,deficiency of yang;(2)kidney,spleen,deficiency of yang;(3)fireball plasma,phlegm,heart spirit;(4)deficiency of yin,kidney,heart spirit,fireball plasma;(5)gallbladder,fireball plasma,liver.Conclusions: 1.The gender ratio of 102 patients with children narcolepsy shows male are more than female patients.The peak age of onset is 7~11years old and the period from onset to confirmed diagnosis of children patients is shorter that of the adult patients.Most of the children patients with narcolepsy manifestated with overweight,obesity,etc.The early-onset patients are always misdiagnosed as other diseases.2.Except for excessive daytime sleepiness,cataplexy and nocturnal sleep disorder,patients with children narcolepsy also manifest with obesity and mental disorder,etc.Symptoms of early-onset patients are more serious than that of late-onset patients.3.TCM symptoms including somnolence,dreaminess,poor sleep,spiritlessness,no desire to speak,lassitude,pale white complexion are indispensable to the syndrome differentiation and diagnosis units.The diagnosis units of children narcolepsy are 12 kinds,which include spleen,deficiency of yang,fireball plasma,damp evil,kidney,heart spirit,phlegm,deficiency of yin,liver,gallbladder,deficiency of qi,deficiency of blood.4.Syndromes of children narcolepsy are 6 kinds.According to the occurrence ratio from high to low,the 5 syndromes are as following: damp abundance due to splenic asthenia,asdthenic splenonephro-yang,phlegm-heat attacking the heart,imbalance between heart-yang and kidney-yin,fireball plasma of liver and gallbladder.5.Characters of children narcolepsy is complexity and root vacuity and tip repletion.The root vacuity refers to deficiency of spleen-yang,deficiency of kidney-yang,deficiency of kidney-yin,while the tip repletion refers to damp evil,phlegm and fireball plasma.Disease location includes spleen,kidney,heart spirit,liver and gallbladder.The TCM pathogenesis is that mental is disturbed,and sleeping or awakening is unregulated by the imbalance of yin and yang,disharmony of ying and wei and the dysfunction of the viscera.