Research On The Experience Of Professor Zhaoren Cheng In Differention And Treatment For Insomnia Based On Data Analyzing And Mining

ObjectiveOn the basis of sorting out the experience of ancient doctors in treating insomnia,this study retrospectively analyzed the insomnia medical records of Professor Cheng Zhaoren,a famous old Chinese medicine doctor,by using data mining method.By digging the information in the medical record,including symptoms,drugs,syndrome type,frequency of prescription,the rule of syndrome-symptom,prescription-syndrome,prescription-drug,drug-syndrome,drug group and drug pair.Based on the results from objective data to sum up the experiences of professor Cheng`s clinical treatment of insomnia.MethodsWe collected 378 cases of insomnia recorded by Professor Zhaoren Cheng during the outpatient clinic from January 2014 to December2020.Standardize symptoms,syndrome types,drugs and so on,according with TCM standard terms,and complete data information cleaning.Frequency analysis was carried out on the medical record information,and it was imported into WEKA3.7.12.Methods such as association rules and cluster analysis were used for data mining.Finally,Cytoscape 3.80 software was used for network analysis,and the core drugs network diagram were drawn to show the medication rules of Professor Zhaoren Cheng in the treatment of insomnia.ResultsThrough data mining,378 cases of insomnia were screened.General information showed that there were 116 male patients and 262 female patients.Male: female =1:2.25,the number of female patients was higher than that of male patients.The age characteristics of patients showed that the average age was 45.6 years old,and patients aged 40-59 accounted for a high proportion,up to 48.41% of the total number.Distribution of syndrome types: There were 354 symptom descriptions in all the medical records,including 309 general symptoms and 45 tongue and pulse symptoms,among which dry mouth,bitter mouth,epigastrium puffiness,irritability and palpitation ranked in the top 5.Location of disease: Insomnia is mainly in the heart,involving stomach,liver,spleen,gallbladder,kidney and other viscera.The main pathological factors of insomnia are deficiency,heat and phlegm.Professor Cheng ’s treatment of insomnia is generally divided into 8 syndromes.The syndromes with higher frequency are phlegm heat disturbance and spleen deficiency phlegm dampness,the cumulative frequency is more than 44.45%,which can be considered as the core syndromes in Professor Cheng ’s treatment of insomnia.Distribution of the formulas:(1)Drug use: 238 kinds of drugs were used,with a total frequency of 6943 times.The main medicinal properties are mild,little cold and warm.The taste of medicine is sweet,bitter and pungent.The main channels of medicine are the heart,spleen and liver.The largest number of drugs in the category of drugs is the deficiency class of drugs,followed by tranquilizing drugs,antipyretic drugs,damp-clearing drugs.(2)Formulas use:Huanglian Wendan Decoction,Suanzaoren Decoction,Kong Sheng Zhizhongdan Decoction and Baihe Dihuang Decoction had the highest frequency.The frequency of the four prescriptions was more than 50 times,and the cumulative frequency was more than 80%.Rules of prescription and syndrome: The main prescriptions corresponding to the 8 syndrome types of insomnia treated by Professor Cheng were analyzed,and the core prescription distribution results were as follows:(1)Huanglian Wendan Decoction was often used to increase or decrease phlegm-heat internal disturbance syndrome.(2)Shengyang Yiwei Decoction,Xiangsha Liujunzi Decoction,Shenling Baizhu Powder and other additives are often used for syndrome of spleen deficiency and phlegm dampness.(3)Suanzaoren decoction,Kongsheng Zhenzhong Dan and Baihe Dihuang decoction are often used for internal heat syndrome of blood deficiency.(4)The heart and kidney do not cross syndrome often choose Tianwang Buxin Dan,Guizhi plus Longgu Muli Decoction,Jiaotai Wan,etc.(5)Shaoyang disease syndrome often use Chaihu Jia Longgu Muli Decoction,Xiaochaihu Decoction,etc.(6)Liver depression forming fire syndrome often choose to add and subtract Jieyu Hehuan Decoction and Dan Zhi Xiaoyao powder.(7)Guipi Decoction,Bazhen Decoction and Renshen Yangrong wan are often used for addition and subtraction of deficiency of heart and spleen.(8)Liver stagnation Qi stagnation syndrome often choose Chaihu Shugan powder,Xiaoyao wan,Sini powder and other addition and subtraction;It was found that Suanzaoren Decoction,Baihe Dihuang Decoction and Kongsheng Zhengzhong Dan were the most commonly used concomitant prescriptions in the treatment of insomnia by Professor Cheng.In most syndrome types,Spina Date Seed,Poria cocos,Poria with hostwood and Caulis Polygoni Multiflori were the basic drugs for the treatment of insomnia.Drug pair and Drug group: fried malt + fried hawthorn,bamboo shavings+Pinellia tuber,Spina Date Seed + Suberect Spatholobus Stem + Salvia miltiorrhiza,stone calamus + Tortoise Shell + Polygala tenuifolia,Spina Date Seed + Medicated leaven + fried hawthorn + fried malt,Pinellia tuber + stone calamus + bamboo shavings.On the basis of drug association,the complex network diagram of high frequency drug use was drawn,which indicated that there was strong correlation among Spina Date Seed,Poria cocos,Poria with hostwood,Caulis Polygoni Multiflori and Tangerine peel.ConclusionThrough data mining,Professor Cheng’s clinical experience is summarized as follows:(1)The combination of diseases and syndromes: The professor Cheng respects Zhong Jing,pays attention to the combination of disease differentiation and syndrome differentiation.On the basis of overall syndrome differentiation,the disease was involved.Addition and subtraction with the syndrome,by following the medication carefully.Generally,the main prescription is selected to distinguish the syndrome type according to the core symptoms.At the same time,the product of tranquillizing the mind is added,and the medication is added to the basic disease or local syndrome differentiation,so as to grasp the disease syndrome as a whole.(2)To make good use of the classical prescription to treat insomnia: In the treatment of insomnia,make good use of the classical prescription to expand the application range of the classical prescription.And the professor Cheng pay attention to the liver and spleen,regulating emotion.The prescriptions for treating insomnia and abnormal emotion are divided into three categories:Xiao Chaihu class,Sini San class,and other emotional diseases class.Often add polygala,Cortex albiziae,Albizia Flower,Bupleurum,Radix Curcumae,Cyperus rotundus,Rhizoma Corydalis,Salvia miltiorrhiza and other drugs to disperse stagnated liver qi to relieve depression.(3)To protect the spleen and stomach: Praises Dongyuan Li’s academic thought of spleen and stomach,and pays special attention to invigorating the spleen and stomach in the differentiation and treatment,often choosing Poria coco,tangerine peel,Pinellia tubers,prepared liquorice,Fructus aurantii,white peoniae paeoniae,rhizoma atractylodes and other drugs for syndrome differentiation.(4)The changes of three factors for cure: Professor Cheng paid attention including the combination of region,time and constitution specificity.