Analysis On The Prescription Regularity In Treating Peripheral Facial Paralysis Cases Of Professor Zhuang Lixing Based On Data Mining

ObjectiveBased on data mining techniques such as Case series analysis,Word cloud,Hierarchical clustering of agglomeration,Apriori algorithm Association rules and Complex network,we retrospectively studied Professor Lixing Zhuang’s diagnosis and treatment of peripheral facial paralysis cases to explore the rules of his prescription and medication choices.To fill in the blank of summary of Professor Lixing Zhuang’ s academic experience in treating peripheral facial paralysis,to provide academic exper:ience for clinical diagnosis and treatment of peripheral facial paralysis,and to better inherit and develop the academic ideas and valuable clinical experience of famous Chinese medicine doctors,this research explored the combination mode of data mining technology and famous Chinese medicine doctors’ experience inheritance.MethodsFrom February 25,2009 to September 14,2018,clinical cases of Professor Lixing,Zhuang,a famous Chinese medicine doctor in First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine in Guangdong Province,was selected from the outpatient cases of peripheral facial paralysis in the Department of Acupuncture and Moxibustion in First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine.After screening the cases according to inclusion and exclusion criteria,the prescription information was extracted and the prescription database was constructed.According to the disease stages,the data were divided into four groups:overall prescription data,prescription data in acute stage,prescription data in convalescence,prescription data in sequelae.These four groups of data were respectively modeled and analyzed by RStudio,Gephi,Spyder and MS-Excel data mining technologies in Case series analysis,Word cloud nephogram,Hierarchical clustering of agglomeration,Apriori algorithm Association rules,complex network and else.Results(1)Case series analysisProfessor Lixing Zhuang’s treatment of peripheral facial paralysis cases included in this study is 685 cases times in total,acute period accounting for 3.65%,recovery phase accounting for 25.40%,sequelae period accounting for 70.95%.317 patients were involved,their ages were relatively concentrated between 20 and 59 years old.Four patients’ consultation peak time are March,July,August and October.1.There are 685 prescriptions in whole,involving 120 kinds of traditional Chinese herbal medicines,and the total cumulative frequency of prescribing medicine is 6608 times.Among them,26 kinds were used ≥ 42 times,the cumulative frequency was 5971,the cumulative frequency was 90.36%.The utilization rate of Licorice(Gan Cao),Caulis Spatholobi(Ji Xue Teng),Bombyx Batryticatus(Jiang Can),Angelica Sinensis(Dang Gui),Rhizoma Chuanxiong(Chuan Xiong),Radix Fici(Wu Zhi Mao Tao),Pheretima(Di Long)and Radix Paeoniae Alba(Bai Shao)was>50%,ranking the top 7.2.The high-frequency prescribed herbal medicines in acute stage is Chrysanthemum(Ju Hua),Mint(Bo He),Periostracum Cicadae(Chan Tui),Radix Peucedani(Qian Hu),Fructus Arctii(Niu Bang Zi),Honeysuckle(Jin Yin Hua),Coix Seed(Yi Yi Ren)and else.Analyzing the natures and flavors and channel entry of drugs In acute stage the natures and flavors are mainly cold,sweet,acrid and bitter,and the channels are the foot jueyin liver channel,the foot yangming stomach channel and the hand taiyin lung channel.3.The high-frequency medication prescribed in recovery period is Caulis spatholobus(Ji Xue Teng),Bombyx Batryticatus(Jiang Can),Chrysanthemum(Ju Hua),Periostracum Cicadae(Chan Tui),Radix Saposhnikoviae(Fang Feng),Radix Paeoniae Rubra(Chi Shao),Radix Rehmanniae(Sheng Di),Caulis Bambusae in Taenia(Zhu Ru),Pinellia Ternata(Ban Xia),Licorice(Gan Cao),Angelica Sinensis(Dang Gui),Codonopsis Pilosula(Dang Shen)and else.In recovery period,the medicinal properties are warm and neutral supplemented by mild cold medicines and the medicinal taste is sweet and bitter in pair with acrid and salty.The channels are the foot jueyin liver channel,the foot yangming stomach channel,the hand taiyin lung channel and the foot taiyin spleen channel.4.The high-frequency medication prescribed in sequelae period is Licorice(Gan Cao),Radix Fici(Wu Zhi Mao Tao),Caulis spatholobus(Ji Xue Teng),Angelica sinensis(Dang Gui),Bombyx Batryticatus(Jiang Can),Ligusticum chuanxiong(Chuan Xiong),Pheretima(Di Long),Paeonia Lactiflora(Bai Shao),Scorpio(Quan Xie)and else.In sequelae period,the medicinal properties are mainly warm and neutral supplemented with mild cold.The main medicinal property is mainly sweet,secondly acrid and salty.Meridian tropism is mainly liver meridian and spleen meridian.The channels are the foot jueyin liver channel and the foot taiyin spleen channel.(2)Hierarchical Clustering by Condensation Method1.Overall prescription medications are classified in clustering into six categories.The first is Gallbladder-Warming Decoction(Wen Dan Tang)variants.The second is Qi-invigorating drugs+Wind-Extinguishing and spasm-relieving drugs.The third is wind-cold dispelling drugs.The fourth is wind-heat dispelling drugs+heat-clearing and blood-cool ing drugs+urination and edema promoting drugs.The fifth is blood-activating,collateral-invigorating and qi-invigorating drugs.The sixth is blood-activating,blood-invigorating and collateral-dredging drugs.The classification of overall prescriptions includes three stages of medication characteristics.2.Prescription drugs in acute period are classified into five categories.The first is heat-clearing and detoxification drugs.The second is blood-tonifying,wind-eliminating and spasm-stopping drugs.The third is Two Matured Substances Decoction(Er Chen Tang)variants+urination promoting and rectifying qi drugs.The fourth is exterior-releasing,dissolving phlegm and cough-relieving drugs.The fifth is Lonicera and Forsythia Powder(Yin Qiao San)variants+Pueraria root(Ge Geng)and cicada slough(Chan Tui).3.Prescription drugs in recovery period were classified into five categories.The first is blood-activating and blood-invigorating and collateral-dredging drugs.The second type is clearing heat and dredging wind drugs.The third is dredging wind,cooling blood,dredging collaterals and promoting urination and edema drugs.The fourth is Gallbladder-Warming Decoction(Wen Dan Tang)variants.The fifth is blood-activating,pain-relieving and collateral-dredging drugs.4.Prescription drugs in sequelae period are classified into six categories.The first is expelling wind drugs.The second is Qi-invigorating drugs.The third is cooling blood,dredging wind and dredging collaterals drugs.The fourth is activating blood,tonifying blood and dredging collaterals drugs.The fifth is dredging collaterals and relieving pain drugs.The sixth is tonifying blood,invigorating blood and dredging collaterals drugs.(3)Association Rules of Apriori Algorithm1.Association rules analysis showed that 12 herb pairs and groups which are combined by 4 herbs:Caulis Spatholobi(Ji Xue Teng),Bombyx Batryticatus(Jiang Can),Angelica Sinensis(Dang Gui)and Licorice(Gan Cao)in the whole prescription data.2.Association rules analysis showed that 9 herb pairs and groups which are combined by 6 herbs:Fructus Arctii(Niu Bang Zi),Periostracum Cicadae(Chan Tui),Licorice(Gan Cao),Chrysanthemum(Ju Hua),Radix Peucedani(Qian Hu)and Roughhaired Holly Root(Gang Mei Geng),in the prescription data of acute stage.3.Association rules analysis showed that 10 herb pairs and groups which are combined by 6 herbs:Bombyx Batryt.icatus(Jiang Can),Pheretima(Di Long),Licorice(Gan Cao),Angelica Sinensis(Dang Gui),Caulis Spatholobi(Ji Xue Teng)and Rhizoma Chuanxiong(Chuan Xiong),in the prescription data of convalescence4.Association rules analysis showed that 16 herb pairs and groups which are combined by5 herbs:Bombyx Batryticatus(Jiang Can),Radix Fici(Wu Zhi Mao Tao),Licorice(Gan Cao),Angelica Sinensis(Dang Gui)and Caulis Spatholobi(Ji Xue Teng),in the Prescription data of sequelae.(4)Complex NetworkFour groups of network are conformed to the characteristics of small world and scale-free feature,network connectivity is better.1.There are 120 herb nodes and 1808 edges in the whole prescription data network.The top five rankings of degree is:Licorice(Gan Cao),Rhizoma Chuanxiong(Chuan Xiong),Radix Paeoniae Alba(Bai Shao),Caulis Spatholobi(Ji Xue Teng)and Angelica Sinensis(Dang Gui).The top five rankings of eigenvector centrality is:Licorice(Gan Cao),Rhizoma Chuanxiong(Chuan Xiong),Radix Paeoniae Alba(Bai Shao),Caulis Spatholobi(Ji Xue Teng)and Angelica Sinensis(Dang Gui).The top five rankings of betweenness centrality is:Licorice(Gan Cao),Radix Paeoniae Alba(Bai Shao),Rhizoma Chuanxiong(Chuan Xiong),Caulis Spatholobi(Ji Xue Teng)and Angelica Sinensis(Dang Gui).When Modularity Measure Q=0.102,the Network was divided into 4 communities.There are 36 key nodes,561 edges and 3 communities,with K setted as 25.2.There are 54 herb nodes and 459 edges in the prescription data in acute period network.The top five rankings of degree is:Chrysanthemum(Ju Hua),Licorice(Gan Cao),Mint(Bo He),Coix Seed(Yi Yi Ren)and Periostracum Cicadae(Chan Tui).The top five rankings of eigenvector centrality is:Chrysanthemum(Ju Hua),Licorice(Gan Cao),Mint(Bo He),Coix Seed(Yi Yi Ren)and Periostracum Cicadae(Chan Tui).The top five rankings of betweenness centrality is:Chrysanthemum(Ju Hua),Licorice(Gan Cao),Mint(Bo He),Coix Seed(Yi Yi Ren)and Honeysuckle(Jin Yin Hua).When Modularity Measure Q=0.149,the Network was divided into 5 communi ties.There are 24 key nodes,208edges and 4 communities,with K setted as 13.3.There are 95 herb nodes and 1135 edges in the prescription data in convalescence network.The top five rankings of degree is:Licorice(Gan Cao),Caulis Spatholobi(Ji Xue Teng),Radix Paeoniae Alba(Bai Shao),Bombyx Batryticatus(Jiang Can)and Rhizoma Chuanxiong(Chuan Xiong).The top five rankings of eigenvector centrality is:Licorice(Gan Cao),Caulis Spat holobi(Ji Xue Teng),Bombyx Batryticatus(Jiang Can),Rhizoma Chuanxiong(Chuan Xiong)and Angelica Sinensis(Dang Gui).The top five rankings of betweenness centrality is:Licorice(Gan Cao),Caulis Spatholobi(Ji Xue Teng),Radix Paeoniae Alba(Bai Shao),Bombyx Batryticatus(Jiang Can)and Rhizoma Chuanxiong(Chuan Xiong).When Modularity Measure Q=0.118,the Network was divided into 5 communities.There are 29 key nodes,375 edges and 2 communities,with K setted as 21.4.There are 83 herb nodes and 997 edges in the prescription data in sequelae network.The top five rankings of degree is:Licorice(Gan Cao),Radix Fici(Wu Zhi Mao Tao),Angelica Sinensis(Dang Gui),Rhizoma Chuanxiong(Chuan Xiong)and Radix Paeoniae Alba(Bai Shao).The top five rankings of eigenvector centrality is:Licorice(Gan Cao),Radix Fici(Wu Zhi Mao Tao),Angelica Sinensis(Dang Gui),Rhizoma Chuanxiong(Chuan Xiong)and Radix Paeoniae Alba(Bai Shao).The top five rankings of betweenness central ity is:Licorice(Gan Cao),Radix Fici(Wu Zhi Mao Tao),Radix Paeoniae Alba(Bai Shao),Angelica Sinensis(Dang Gui)and Rhizoma Chuanxiong(Chuan Xiong).When Modularity Measure Q=0.023,the Network was divided into 4 communities.There are 27 key nodes,323 edges and 3 communities,with K setted as 20.ConclusionData mining technology is feasible in the inheritance of famous TCM doctors’ experience.Part of professor Lixing Zhuang’ s medication rules for treating peripheral facial paralysis are as follows.(1)Treatment by differentiating periods1.Acute period:prescribing drugs to soothe wind,clear heat,cool blood and dredge collaterals or to soothe wind,cool blood and dredge collaterals in pair with dampness-drying and phlegm-dissolving drugs,mostly used are Lonicera and Forsythia Powder(Yin Qiao San),Mulberry Leaf and Chrysanthemum Beverage(Sang Ju Yin),Bupleurum and Pueraria Muscle-Resolving Decoction(Chai Ge Jie Ji Tang)variants in pair with Two Matured Substances Decoction(Er Chen Tang).2.Convalescence period:prescribing blood-activating and collateral-invigorating drugs,in pair with wind-dredging and exterior-releasing drugs,also with rectifying qi and dissolving phlegm drugs.Fresh Four Substances Decoction(Sheng Si Wu Tang)in pair with Lonicera and Forsythia Powder(Yin Qiao San)and Gallbladder-Warming Decoction(Wen Dan Tang)variants are commonly used.The deficiency of blood is added with Radix Angelicae Sinensis(Dang Gui)and Caulis Spatholobi(Ji Xue Teng).3.Sequelae period:prescribing based on invigorating Qi and blood,added with dredging wind and collaterals drugs and insect drugs.Four Substances Decoction(Si Wu Tang),Four Gentlemen Decoction(SiJun Zi Tang),Eight-Gem Decoction(Ba Zhen Tang)and Symmetry-Correcting Powder(Qian Zheng San)variants,emphasizing invigorating qi and blood using Radix Fici(Wu Zhi Mao Tao)and Astragalus Membranaceus(Huang Qi)are often used.(2)The common prescribing groups were Angelica Sinensis(Dang Gui)and Caul is Spatholobi(Ji Xue Teng),Bombyx Batryticatus(Jiang Can)and Pheretima(Di Long),Caul is Spatholobi(Ji Xue Teng)and Radix Fici(Wu Zhi Mao Tao).(3)To suit local conditions,the treatment.and prescribing have Lingnan(Southeast of China)regional characteristics;(4)Emphasizing the use of mind-regulating method on chronic diseases and difficult and complicated diseases,being the same as its mind-regulating needling method.(5)In terms of the quantity of the flavors and numbers of the prescription,the construction is precise and appropriate,the prescribing choice is rigorous.