| Objective:To study the distribution of etiology,symptoms and TCM state of polycystic ovary syndrome(PCOS),to explore the systematic classification method of PCOS symptoms and TCM state,and to explore the intervention scheme for etiology and TCM state.Results it can provide reference for the etiology and pathogenesis of PCOS,TCM state identification,prevention and control of metabolic syndrome and TCM intervention.Through understanding the etiology and pathogenesis of polycystic ovary syndrome and changing the habits and habits,reducing the incidence rate of polycystic ovary syndrome,the results of PCOS classification of Chinese medicine and the intervention plan of Chinese medicine can provide reference for clinical intervention of Chinese medicine.Methods:1.Literature research method(1)Etiological literature collection and collation: search ancient books database,modern journals and doctoral dissertation database,super star books database,and systematically analyze the etiology of PCOS.(2)Syndrome standard literature collection: retrieve from CNKI database the literature related to TCM state identification of polycystic ovary syndrome(PCOS)from the establishment to March 2019,including journals,doctoral dissertation,conferences,newspapers,patents,etc.Then,the TCM syndrome standards of PCOS(including the reference standards and self-made standards)quoted in the literatures that meet the search conditions are consulted one by one,and the reference information of syndrome standards is extracted.According to the source information of syndrome standard,the TCM syndrome standard texts of polycystic ovary syndrome are obtained from literature databases such as How Net,VIP,Wanfang and Chaoxing books,as well as the books collected by the school,and entered into word documents according to the format for collation to form the syndrome standard texts of this study.(3)Collection of intervention texts of traditional Chinese medicine: from the above-mentioned journals and doctoral papers,select the literatures with intervention of traditional Chinese medicine,and extract the text of intervention scheme of traditional Chinese medicine.2.Database methodMicrosoft Access 2010,a relational database management platform,is used for management.Documents,syndromes,TCM Intervention and other texts are input into the database according to the format,and syndrome standard source data table,syndrome standard data table and TCM intervention data table are constructed.At the same time,the number of cases corresponding to syndrome was extracted from the literature with case number records.3.Text mining(1)Standardization of syndrome terminology: the original syndrome terminology is based on the syndrome name in the classification and code of TCM disease syndromes,while the ones not in the standard are based on the syndrome naming principle.(2)Text segmentation and term specification: mark the text of symptoms,traditional Chinese medicine and syndromes by manual segmentation,extract the terms of symptoms,traditional Chinese medicine and documents(from syndrome name decomposition)by sas9.4 software programming,output them to access database for specification,build the synonym list of symptoms,traditional Chinese medicine and documents to standardize the term name.(3)Term classification: systematic classification of standardized terms,secondary classification of symptoms with reference to the international primary medical classification(ICPC)system,and preparation of ICPC code;secondary classification of traditional Chinese medicine with reference to the efficacy classification method in the textbook of traditional Chinese medicine;systematic classification of documents according to disease location,disease nature(including virtual and real,cold and heat)and pathological factors.(4)Text frequency statistics: the frequency and proportion of symptoms,syndromes,documents and traditional Chinese medicine terms are classified according to terms.(5)Statistics of cases of syndromes and documents: use SQL query statements to standardize the frequency and percentage of cases of syndromes and documents.(6)Analysis of the relationship between TCM state and TCM Intervention: Apriori algorithm was used to analyze the relationship between TCM state of obesity(disease location,disease and pathological factors)and TCM.The correlation of frequency,confidence degree,reverse confidence degree and average confidence degree was calculated.The average confidence degree of baoliuping was more than 40%.The above text segmentation,term extraction and statistical analysis are all conducted on sas9.4 platform.Results:1.The main causes of PCOS are deficiency of kidney yang(QI)due to congenital deficiency;eating disorder impairs the spleen and stomach qi mechanism;emotion is not smooth,and Qi is accumulated in the liver.2.Analysis of TCM symptoms of polycystic ovary syndrome(1)According to the statistical results of TCM symptoms of PCOS classified by ICPC: female reproductive system(other symptoms and complaints of female reproduction(232),menstrual delay(196),menorrhagia / oligomenorrhea(109),vaginal secretions(106)),skeletal muscle system(hypochondriac / subaxillary symptoms,complaints(106),lumbar symptoms complaints(77)),comprehensive non-specific system(general weakness)/Fatigue(100),chills(55)),skin system(skin color change(76),other skin symptoms(76)),pregnancy,childbirth and family planning system(infertility / low fertility women(94)),nervous system(vertigo / dizziness(77)).(2)Symptom frequency results: amenorrhea(114 times),less menstruation(108 times),infertility(94 times),late menstruation(82 times),chest and flank fullness(75 times),dizziness(71 times),dense hair(58 times),waist acid(54 times),obesity(49 times).(3)Pulse frequency results: pulse sink(76),pulse string(64),pulse fine(63),pulse slippery(41),pulse number(38),pulse astringency(33).(4)The frequency of tongue image: White(63),yellow(26),greasy(43),little(20),light(55),purple(38),red(36),ecchymosis(36),fat(31).3.Systematic classification of TCM state and intervention analysis of TCM in polycystic ovary syndrome(1)Quoting results of PCOS TCM Syndromes1)Statistical results of references of TCM standard syndromes and documents:The frequency of references of standard syndrome(frequency in brackets,percentage): kidney deficiency and phlegm dampness syndrome(36,21.43);phlegm dampness syndrome(35,20.83);kidney deficiency and blood stasis syndrome(28,16.67);liver depression and kidney deficiency syndrome(14,8.33);spleen deficiency and phlegm dampness syndrome(8,4.76);kidney deficiency syndrome(14,8.33).The frequency of documents cited(frequency in brackets,percentage): kidney deficiency(94,55.95%);phlegm dampness(85,50.06%);blood stasis(38,22.62%);liver qi depression(22,13.1%);spleen deficiency(11,6.55%).2)Statistical results of the number of TCM standard syndromes and documentary cases:The frequency of reference cases of standard syndrome(frequency in brackets,percentage): kidney deficiency and phlegm dampness syndrome(1257,17.82%);phlegm dampness syndrome(1059,15.01%);kidney deficiency and blood stasis syndrome(939,13.31%);liver depression and kidney deficiency syndrome(700,9.92%),spleen deficiency and phlegm dampness syndrome(663,9.4%).The frequency of cases cited in documents(frequency in brackets,percentage): kidney deficiency(3474,49.26%);phlegm dampness(3171,44.96%);blood stasis(1408,19.96%);liver qi depression(1025.14.53%);spleen deficiency(774,10.97%).(2)Correlation between TCM syndromes and TCM symptoms of polycystic ovary syndrome1)Standard syndrome and TCM symptom frequency and confidence resultsSyndrome of liver dampness and heat: pruritus of vulva(9,73.06);premenstrual breast pain(10,66.97);infrequent menstruation(11,63.20);premenstrual breast distention(10,62.03);constipation(12,61.04);strong body(7,60.00);facial acne(12,57.86);menstrual disorder(11,57.03);dense hair(12,53.20);yellow urination(7,50.00);little menstruation(12,48.41);amenorrhea(11,44.11);swelling of limbs(5,42.86))It is found that there are many subbands(9,41.15),yellow tongue coating(14,76.93),red tongue(9,44.65),number of veins(13,63.54),and chords(13,56.59).Syndrome of spleen deficiency and phlegm dampness: obesity(10,60.21);excessive amount of band(9,54.00);lassitude(6,46.67);dizziness(8,45.64);chest and flank fullness(8,45.56);late menstruation(8,44.88);infertility(8,44.26);amenorrhea(8,43.51);greasy tongue coating(9,55.47);fat tongue body(8,52.91);pulse smoothness(9,55.98).Kidney deficiency syndrome: thin meridian(11,68.50);tinnitus(12,58.92);soft knee(11,56.79);dizziness(12,54.61);waist acid(11,52.69);light meridian(10,51.98);late menarche(7,47.52);little meridian(11,47.41);late menstruation(10,44.56);amenorrhea(10,42.85);chills(7,42.84);dull complexion(6,41.83);thin tongue coating(10,50.09);fine pulse(9,41.76).2)Syndrome of documents and symptom frequency and confidence results of traditional Chinese MedicinePhlegm dampness: obesity(34,82.90);fullness of chest and flank(32,72.34);excessive amount of belt(29,70.04);late menstruation(29,62.21);mental fatigue(22,62.09);excessive phlegm(18,60.33);nausea(14,60.10);lassitude(14,60.10);amenorrhea(29,54.14);infertility(26,52.02);dizziness(20,42.90);less menstruation(22,42.52);palpitation(7,41.28);greasy tongue coating(33,84.84);fat tongue(19,62.84)22);tongue coating white(23,52.38);tongue coating thick(9,42.16);pulse slippery(32,87.69);pulse moistening(7,48.35).Kidney deficiency: low back acid(26,68.47);low amount of band(12,65.51);tinnitus(23,63.23);thin meridian(12,56.86);soft knee(18,54.03);dizziness(22,52.95);low amount of meridian(24,52.67);amenorrhea(23,48.95);late menstruation(19,45.73);fear of cold(11,45.24);apathy of sexual desire(10,43.91);infertility(19,42.99);thin tongue coating(14,45.92);fine pulse(21,54.06).Blood stasis: there are blood clots(15,67.26);dark red(15,65.28);dysfunctional(6,53.97);petechiae(22,90.74);purple dark(19,74.77);ecchymosis(10,68.52);astringency(16,79.63).(3)Classification and statistics of traditional Chinese medicine in patients with polycystic ovary1)Results: Angelica(131),tuckahoe(112),dodder(108),Xiangfu(96),Rehmannia(83),liquorice(82),tangerine peel(81),Atractylodes macrocephala(70),Danshen(69),pinellia(65),paeony(64),Chuanxiong(61),wolfberry(58),Epimedium(56),Atractylodes macrocephala(54).2)Statistical results of efficacy classification frequency of traditional Chinese medicine: tonifying yang medicine(323),tonifying blood medicine(290),regulating qi medicine(250),tonifying Qi medicine(240),promoting blood circulation and regulating menstruation(237),promoting water and eliminating swelling(146),tonifying Yin medicine(121),warming cold phlegm(103),3)Statistical results of classification frequency of four Qi of traditional Chinese medicine: the main flavor of traditional Chinese medicine is warming medicine and calming medicine.(4)The analysis of traditional Chinese medicine state and traditional Chinese medicine usage of polycystic ovary1)The main pathogenesis of PCOS is liver,and its pathological factors are phlegm,dampness,blood stasis and qi stagnation.Disease is divided into deficiency and excess,cold and heat,mainly kidney deficiency and spleen deficiency.2)Analysis results of TCM state,TCM frequency and confidence:Kidney deficiency syndrome: Cuscuta(66,73.75);Angelica(63,65.11);Cyperus(48,56.24);rehmannia officinalis(48,65.06);Poria Cocos(41,43.96);Lycium barbarum(40,60.21);Chuanxiong(37,54.42);Danshen(36,52.37);Epimedium(33,53.65);Cornus officinalis(33,60.85);liquorice(32,40.84);Paeonia alba(30,45.16).Phlegm syndrome: Poria Cocos(67,74.07);tangerine peel(58,76.56);Atractylodes macrocephala(58,81.30);Pinellia ternata(55,79.35);Cyperus(50,60.25);Angelica sinensis(39,41.61);Cuscuta chinensis(35,40.28);liquorice(35,45.84);Salvia miltiorrhiza(25,37.20);Atractylodes macrocephala(25,40.92);Ligusticum chuanxiong(22,33.10);dannanxing(22,60.92);Fructus aurantii Immaturus(20,47.62).Blood stasis syndrome: Cuscuta(24,49.70);Angelica(23,45.70);rehmannia(20,46.18);Salvia miltiorrhiza(16,38.53);Ligusticum chuanxiong(16,38.79);Lycium barbarum(16,39.34);Epimedium(15,38.68);white peony(13,31.96);dogwood(11,30.77);red flower(11,40.58).Liver qi depression syndrome: Angelica(17,55.24);paeony(17,63.26);Bupleurum(15,65.11);Cuscuta(14,46.67);Poria(12,39.46);rehmannia(10,35.72);liquorice(9,31.43).Conclusion:(1)PCOS polycystic ovary syndrome(PCOS)is mainly characterized by kidney deficiency,phlegm dampness,blood stasis,liver depression and spleen deficiency due to genetic,dietary and emotional factors.(2)The TCM symptoms of PCOS were classified and counted by ICPC classification standard.The characteristics of symptom distribution were as follows: in addition to reproductive system symptoms,it mainly involved skeletal muscle system,comprehensive non-specific system,skin system,pregnancy,childbirth and family planning system,spiritual / psychological system,etc.(3)The TCM status of PCOS was classified by disease location,disease nature and pathological factors.The distribution characteristics of medical status were as follows: the main disease location of PCOS was liver;the pathological factors were phlegm,dampness,blood stasis and qi stagnation.Deficiency and excess of disease are mainly deficiency,kidney deficiency and spleen deficiency.(4)The application rules of Chinese medicine efficacy of PCOS are: Cuscuta,epimedium,Dipsacus,Morinda officinalis are the main tonic drugs;Angelica,rehmannia,white peony are the main tonic drugs;licorice,Atractylodes macrocephala,yam are the main tonic drugs;wolfberry and Ligustrum lucidum are the main tonic drugs.Herbs for regulating Qi are mainly Cyperus,tangerine peel and Fructus aurantii;herbs for promoting blood circulation and regulating menstruation are mainly Salvia miltiorrhiza,safflower,chuanniuxi,peach kernel,motherwort,Zelan and Caulis Spatholobi;herbs for promoting water and swelling are mainly Poria cocos and Alisma orientalis,and herbs for warming and cold phlegm are mainly Pinellia ternata and gannanxing.(5)The results of correlation analysis between PCOS and traditional Chinese medicine showed that the intervention rules of traditional Chinese medicine were: Cuscuta,angelica,Cyperus,rehmannia root,Poria cocos,wolfberry fruit,chuanxiong,Danshen,epimedium and Cornus.The main drugs related to phlegm dampness syndrome are Poria cocos,tangerine peel,Atractylodes macrocephala,Pinellia ternata,Xiangfu,angelica,dodder,liquorice,Salvia miltiorrhiza,Atractylodes macrocephala,Ligusticum chuanxiong,dannanxing,Fructus aurantii.The blood stasis syndrome is mainly composed of Cuscuta,angelica,rehmannia,Danshen,chuanxiong,wolfberry,epimedium,white peony,dogwood and safflower.The related drugs of liver depression syndrome are mainly angelica,white peony,bupleurum,Cuscuta,tuckahoe,rehmannia,liquorice,mint and green skin.Spleen deficiency syndrome mainly includes Poria cocos,Pinellia ternate,Atractylodes macrocephala,Cyperus,liquorice,tangerine peel,dangshen,Amomum villosum and woody fragrance. |
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