| Objective: 1.The purpose of this academic dissertation was to study the TCM syndrome types and body constitution distribution characteristics of dry eye disease,and to explore the correlation between TCM syndrome type,body constitution,age and gender,combined with Chinese medicine theory,in order to provide useful reference for the differentiation and prevention of dry eye disease.2.Based on the traditional Chinese medicine inheritance platform system(V2.5),the traditional Chinese medicine treatment of dry eye medication rules,extraction of drug law,mining new drug combinations and new prescriptions,provide reference and new ideas for clinical treatment of dry eye disease.3.This paper discusses the characteristics and distribution of TCM syndrome elements in dry eye,and discusses its essence and relevance from the perspective of syndromes,It is expected to provide reference for clinical dry eye syndrome differentiation and diagnosis.Methods: 1.According to the inclusion and exclusion criteria,270 patients with dry eye were enrolled,and the clinical data of patients with dry eye were collected.Refer to the Standards for Diagnosis and Treatment of TCM Disorders,TCM Ophthalmology,TCM Constitution and Judgment,and determine the TCM syndrome differentiation of patients.Type,TCM constitution type.Establish a database,apply SPSS 22.0 for chi-square test,Fisher test,Kruskal-Wallis H test and other statistical methods to study the dry eye TCM syndrome type and constitution distribution law,and explore the correlation between TCM syndrome type and body constitution.2.Using computer to search China National Knowledge Infrastructure,Weipu,Wanfang database and China Biology Medicine disc,the search time is from 1989 to 2018,search Chinese words for "dry eye","dry eye syndrome","dry keratoconjunctivitis","dry eye disease","Bai se disease","shen shui jiang ku","corneal conjunctival dryness".A total of2,926 articles were searched,and 2,083 articles were obtained by Note Express software.According to the literature inclusion and exclusion criteria,a total of 224 articles were used for syndrome research and 471 articles were used for the study of traditional Chinese medicine.The syndromes and prescriptions included in the literature were entered into the Excel spreadsheet and the statistical analysis of the Chinese medicine inheritance platform system(V2.5).Results:1.Among the 270 patients with dry eye,91 were male and 179 were female,including the youngest 16 years old and the largest 86 years old,with an average age of 49.96 ± 15.42 years old.there is 74 cases of normal constitution.only 27.41%,and there is 196 cases of biased constitution,72.59%,in the patient’s physical type,constitution of yin-yang harmony(27.41%)>constitution of yin asthenia(20.74%)>constitution of yang asthenia(17.78%)> constitution of qi asthenia(11.85%)> constitution of damp-heat(7.04%)>constitution of qi stagnation(5.93%)>constitution of blood stasis(2.59%)>allergic constitution(0.74%).Qi-Yin deficiency(83cases)> Liver-Kidney deficiency(79cases)> Lung-Yin deficiency(58cases)>syndrome of yin deficiency and dampness-heat(50cases).There was significant difference in age distribution of dry eye syndrome types(P<0.05),and there was no difference in gender among dry eye syndrome types(P>0.05).The constitution distribution of different age groups was different(P<0.05).The constitution of Qi deficiency,Yang deficiency and blood stasis were more common in the elderly,while the constitution of phlegm-dampness and damp-heat was more common in the young.There was no gender difference in constitution distribution(P >0.05).Chi-square test 2 = 232.304,P=0.000 < 0.05 shows that there is a significant difference in the distribution of constitution of TCM syndromes.Dry eye patients with Yin deficiency and dampness-heat syndrome are mostly damp-heat,phlegm-dampness and calmness;dry eye patients with liver and kidney deficiency syndrome are mainly Yang deficiency,calmness and Yin deficiency;Qi deficiency,Yang deficiency and yin deficiency are the most common types of patients with Qi deficiency,Yang deficiency and Yin deficiency;and constitution types of patients with lung-yin deficiency syndrome are mostly calm and Yin deficiency.2.A total of 1039 syndromes of 17 categories were included in 224 articles,of which 497 were disease-location syndromes,including 172 liver,148 kidneys,100 lungs,51 spleens and 26 stomachs.There are altogether542 types of etiology and pathogenicity syndrome elements,which are 288 times of Yin deficiency,85 times of fire and heat,49 times of dampness,44 times of Qi deficiency,22 times of Qi stagnation,14 times of blood stasis,12 times of phlegm,9 times of dryness,8 times of blood deficiency,6 times of Yang deficiency,3 times of wind and 2 times of Yang hyperactivity.Disease location syndrome elements are mainly liver,kidney and lung,syndrome type syndrome elements are mainly Fire-heat and dampness,deficiency syndrome elements are mainly Yin deficiency and Qi deficiency.A total of 415 types of syndromes were obtained,and the standardized names of syndromes were divided into three categories: deficiency syndrome,excess syndrome and mixture of deficiency and excess syndrome.Kruskal-Wallis H test showed that the overall distribution of each syndrome type was different(2 = 346.000,P = 0.000),indicating that the proportion of each syndrome type in dry eyes was different.Deficiency of liver and kidney accounted for 33.98%,deficiency of lung-yin accounted for20.48%,deficiency of both qi and Yin accounted for 6.02%,deficiency of yin and dampness-heat accounted for 5.54%.The rest were dampness-heat of spleen and stomach,deficiency of spleen,deficiency of spleen-qi,phlegm and blood stasis,dampness-heat of spleen and lung,stagnation of liver meridian,retention of pathogenic heat,excessive injury of yin,stagnation of liver and spleen,disharmony.3.471 relevant literatures were obtained and 535 prescriptions were screened,involving 194 Chinese medicines.The cumulative frequency of medicines reached 5333 times,and the frequency of medication was 40 times or more.The top ten Chinese medicines were Ophiopogon japonicus,Lycium barbarbarum,Chrysanthemum,Radix Rehmanniae,Licorice,Radix Paeoniae Alba,Radix Rehmanniae Rehmanniae,Peony Bark,Poriae,Angelicae,and more than40 times of Chinese medicines.A total of 35 flavors,high-frequency medicines in the use of deficiency drugs.Four odors and five flavors analysis showed that the maximum cold was 2418(47.47%),the temperature was 168(22.93%)and the flatness was 1105(21.69%).It was concluded that the four gases were mainly cold and temperate,accounting for 92.09%,cool 385(7.56%)and hot 18(0.35%).Sweet taste was 3737 times(44.87%),bitter taste was 2346 times(28.17%)and bitter taste was 1322 times(15.87%).It was concluded that the five main flavors were bitter and sweet,accumulating 88.91%,sour taste 516 times(6.20%),salty taste 265 times(3.18%)and astringent taste 143 times(1.72%).The main meridians were liver meridian 2694 times(20.87%),kidney meridian 2313 times(17.82%),lung meridian 2232 times(17.29%),heart meridian1690 times(13.09%),spleen meridian 1603 times(11.50%)and stomach meridian1484 times(11.50%),accounting for 93.8% of the total meridians. Drug pattern and new prescription analysis based on complex entropy hierarchical clustering: 35 common combinations,149 core combinations of 2medicines,72 core combinations of 3 medicines,16 core combinations of 4medicines,6 core combinations of 5 medicines,2 core combinations of 6medicines,1 core combination of 7 medicines and 15 new ones were obtained.Conclusion: 1.There is a correlation between the constitution of dry eye and TCM syndromes,and the constitution type has a certain tendency to dry eye syndromes.Yin deficiency is more common in liver and kidney deficiency,Qi and Yin deficiency,and damp-heat is more common in Yin deficiency and damp-heat.Damp-heat quality is more common in young and middle-aged people,Yin deficiency,Yang deficiency and Qi deficiency are more common in middle-aged and old people.2.The application of traditional Chinese Medicine Inheritance assistant platform system(V2.5)to analyze the rule of drug use in the treatment of dry eye,and the new prescription can be used as the basis for clinical treatment of dry eye in the future. |
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