Summarization Of Tian Jian Hui’s Medication Pattern For Gynecological Cancer Based On Data Mining

ObjectiveTo discover Professor Tian Jian Hui’s Traditional Chinese Medicine(TCM)prescription patterns and characteristics in treating gynecological cancers by using data mining method,summarize his underlying academic views to promote the inheritance of TCM in the treatment of the stated diseases,hoping to provide basis for clinical usage and for further clinical trials.MethodWe collected 157 cases of cervical cancer(CC),100 cases of ovarian cancer(OVC)and 50 cases of endometrial cancer(EC),in total of 307 cases and 1,133 prescriptions,treated by Prof.Tian Jianhui.We then standardized the patients’ basic information and herbal names,and created databases according to each disease.Microsoft Excel was used to analyze the western medicine diagnosis,age,clinical stages,pathological types and previous treatment methods of the patients.TCMISS was used as the main data mining tool to preform frequency,association rules and entropy clustering analysis on the main core prescriptions,meridians and four scents,special dosage of herbs,usage of animal-related medicines,complications from comprehensive treatment,and symptoms.Results were further analyzed to discover underlying theories for treating gynecological cancer.Results1.Most of CC patients aged around 30-59 years,with stage Ⅰ～Ⅱ being the most common,accounting for 82.2%,prevalently presented with squamous cell carcinoma(73.2%);the average time between diagnosis to Prof.Tian’s clinic was 90 days to 1 year;54.8% of the patients had undergone surgery + radiotherapy +chemotherapy;most commonly found complications include lymphedema(52 cases),myelosuppression(36 cases)and radiation enteritis(24 cases),respectively.Most of OVC patients aged around 40-69 years;67.0% were diagnosed with stage Ⅲ～Ⅳ,77.7% presented with serous cell carcinoma;85.0% of the OVC were treated with surgery + chemotherapy;myelosuppression(30.0%)and neurotoxicity(25.0%)weremost commonly found complications.EC patients age center around 50-69 years,with stage Ⅰ and Ⅲ accounting for 54.0% and 26.0%,respectively,and mostly presented with endometrioid adenocarcinoma(70.0%);most common types of treatment undergone from EC patients were surgery + chemotherapy and surgery + radiotherapy+ chemotherapy,each accounting for 36.0%;myelosuppression was the most commonly found complications.2.Core prescription pattern includes Radix Rehmanniae Praeparata,Fructus corni,Cortex Moutan,Poria Cocos,Rhizoma Alismatis,Rhizaoma Dioscoreae,Astragalus Membranaceus,Cuscuta seed,Solanum Lyratum,Rhizoma Smilacis Glabrae,Solanum Nigrum,Curcuma Zedoaria Rosc,Cortex Dictamni,Patrinia Villosa,Venticuli-Galli Mucosa,Rice grain sprout,Semen Zizyphi Spinosae,Fructus Ziziphi Jujubae,and Radix Glycyrrhizae Preparata,in total of 19 different herbs.Prof.Tian’s special dose usage of herbal products include 30-36 g of Radix Rehmanniae Praeparata and Rhizoma Atractylodis,30 g of Rhizoma Alismatis,Cortex Moutan and Rhizoma Anemarrhenae,12 g of Radix Gentianae,60 g of Humus Flava Usta,Astragalus Membranaceus and Polygonum Filiforme,30-45 g of Cortex Lycii radices,and 90 g of Mother of pearl.Commonly used formulated pills are Kangsaidi Capsule(23.1%),Yangzheng Xiaoji Capsule(19.9%)and Shendan Sanjie Capsule(10.1%).Animal-related products re-known for their tonifying effects include antlers,turtle shells and tortoise shells,while those well-known for attacking are gecko and dry toad skin,beehives,centipedes,scorpions and leeches.3.Prescription patterns targeting complications from comprehensive treatments:Pyrrosia Lingua,Rhizoma Polygonati,Chinese Wolfberry,Radix Sanguisorbae and Agrimonia Pilosa are commonly used in patients with myelosuppression;prescriptions for radiation enteritis or targeted drugs causing diarrhea include Radices Saussureae,Gambier,Rhizoma Coptidis,Humus Flava Usta,Kangfuxin liquid and Peifei Kang capsule;peripheral neurotoxicity causing limb numbness uses Xiewu capsule,Phcnostelma Paniculatum,Rhizoma Curcumae,viper,Tuberculate Speranskia;joint pain from neurotoxicity often uses Cassia Twig,Cum Radice,Futokadsura Stem,Radix Clematidis,Radix Aconite Agrestis;presented with urinary retention often uses Calcined Concha Ostreae,Ootheca Mantidis,Rhizome Acori Graminei,Cassia Twig,Monkshood and Rhizoma Zingiberis,or presented with urinary tract infection uses Polygonum Filiforme,Dianthus Superbus,Specktone;nausea and vomiting caused by digestive tract reaction were treated with Gingered Pinellia Ternata,GingeredBambusae Caulis,Fructus Aurantii,Magnolia Officinalis;radiation cystitis or cancer itself causing abnormal vaginal discharge is treated with Angelica Root,Radix Ampelopsis,Flos Celosiae Cristatae,Dandelion;lymphedema were treated with Yuzhou Radix Rhapontici,Angelica Sinensis,Pinellia Ternata,Rhizoma Arisaematis,leeches and peach kernel.4.Prescription pattern for treating CC include the combination of Radix Rehmanniae Praeparata,Rhizoma Dioscoreae,Fructus Corni,Cortex Moutan,Rhizoma Alismatis,Curcuma Zedoary,Dulcamara and golden cypress,a prescription aims at tonifying liver and kidney,clearing away heat and dampness,detoxifying and anti-cancer.The most common manifestations of CC are deficiency of liver and kidney yin followed by deficiency of spleen and kidney yang,and damp heat in lower Jiao.Most herbs enter liver,kidney,and spleen meridian.ConclusionUnder the guidance of Professor Liu Jiaxiang’s theory system of "Fuzheng and Treating Cancer",Prof.Tian pointed out that deficiency of both liver and kidney and the imbalance of Chong,Ren,Du and Dai Meridiens were the underlying cause of gynecological cancer;while phlegm and dampness,blood stasis and cancer toxin are the main pathogenic side of the disease.As for Prof.Tian’s point of view in treatment,he pointed the importance of integrated medicine,giving priority to syndrome and disease differentiation,focusing on strengthening Qi while appropriately eliminating toxic;and considering the prevention and treatment of complications caused by systematic treatment.There are two reasons as to why Prof.Tian preferably use “flesh and blood sentimental products”: 1)those re-known for tonifying are excellent in filling eight channels of strange meridians 2)those re-known for attacking are perfect for clearing poisons.It is also advocated that the prevention and treatment of gynecological cancer should be based on achieving patient’s "Tong" state,physically,of Qi,and mentally.This study verifies Prof.Tian’s medication pattern for gynecological cancer through statistical data,enriches the medication system of "treating different diseases with the same treatment" and "eight channels of strange meridians" in TCM,and emphasizes the academic viewpoint of “treating cancer with Tong therapy”...