| Objective: Study the distribution rules of obesity’s etiology,symptoms and TCM status,explore the systematic classification methods of obesity symptoms and TCM status,and the intervention plan for the etiology and TCM status.The results can provide a reference for the research on the etiology and pathogenesis of obesity,the identification of Chinese medicine status,the prevention and control of concurrent metabolic syndrome and the intervention of traditional Chinese medicine.Through the understanding of the etiology and pathogenesis of obesity,changes in living habits,reducing the incidence of obesity,the classification of Chinese medicine status of obesity and the results of traditional Chinese medicine intervention programs can provide reference for clinical Chinese medicine intervention of the disease.Methods:1.Literature research(1)Collection and sorting of etiological documents: searching ancient books database,modern journals and Ph.D.thesis database,superstar book database,systematically analyzing and analyzing the causes of obesity.(2)Collection of syndrome standard documents: Retrieve the relevant literature on the identification of TCM status of obesity from CNKI database since the establishment of the database to March 2019,including journals,doctoral and master theses,conferences,newspapers,patents and other documents.Then,one by one,consult the obesity TCM syndrome standards(including citation standards and self-made standards)cited in the documents that meet the search criteria,and extract the reference information of the syndrome standards.According to the source information of the syndrome standard,obtain the standard text of TCM syndromes of obesity from the literature databases such as How Net,Weipu,Wanfang,Chaoxing books,and school collection books,etc.,and enter it as a word document according to the format,and carry out collation to form this time.Standard texts of research syndromes.(3)Collection of TCM intervention texts: From the above-mentioned journals and Ph.D.thesis literatures,the literatures with TCM interventions are screened and the texts of TCM intervention programs are extracted.2.Database methodAdopt the relational database management platform Microsoft Access2010 to manage,input the document source,syndrome,Chinese medicine intervention and other texts into the database according to the format,construct the syndrome standard source data table,syndrome standard data table,Chinese medicine intervention data table.Enter the number of syndrome cases: extract the number of cases corresponding to syndromes from the literature and enter it into the database.3.Text mining and data analysis(1)Specification of syndrome term: the original syndrome term is based on the syndrome name of "Classification and Code of TCM Disease Syndrome",and the syndrome name that is not in the standard is prepared according to the principle of syndrome naming.(2)Text word segmentation and terminology specification: manual word segmentation and marking of texts such as symptoms,traditional Chinese medicine,and syndromes,and the use of SAS9.4 software to programmatically extract terms such as symptoms,traditional Chinese medicines,and documents(decomposed from the syndrome name),Export to the Access database for standardization,construct a synonym list of symptoms,traditional Chinese medicines,and documents to standardize term names.(3)Terminology classification: systematically classify the standardized terminology,the symptoms refer to the international primary medical classification(ICPC)system for secondary classification,and write the ICPC code;Chinese medicine refers to the efficacy classification method of "Chinese Medicine" textbook for secondary classification;The documents are systematically classified according to the disease position,disease nature(including deficiency and truth,cold and heat)and pathological factors.(4)Text frequency statistics: statistics on the frequency,proportion and proportion of symptoms,syndromes,documents and traditional Chinese medicine terms according to the classification of terms.(5)Statistics on the number of cases of syndromes and documents: SQL query statements are used to standardize the frequency and percentage of cases of syndromes and documents.(6)Correlation analysis of the relationship between the state of traditional Chinese medicine and intervention of traditional Chinese medicine: Apriori algorithm is used to analyze the association rules of the relationship between different traditional Chinese medicine states of obesity(position,disease and pathological factors)and traditional Chinese medicine,and the frequency,confidence,and reverse confidence Degree and average confidence,and keep the relationship with the average confidence greater than 40%.The above text segmentation,term extraction,and statistical analysis are all performed on the SAS9.4 platform.Results:1.Etiology research results: The main cause of obesity is due to phlegm and dampness of the body,deficiency of qi or yang,or eating disorder,restlessness,and sickness,injury to the seven emotions,etc.,resulting in damage to the spleen and stomach,loss of water and moisture,and loss of fluid The temperature is blocked,the accumulation of dampness is phlegm,and the ointment of phlegm is contained.2.Analysis results of obesity TCM symptoms:(1)Statistical analysis by ICPC classification: general and non-specific(systemic weakness / tiredness(339),other systemic symptoms / complaint(191)),digestive system((stool / defecation changes(126),oral / Tongue / lip symptoms / complaint(183),other symptoms of the digestive system / complaint(316)),nervous system(vertigo / dizziness(119)),endocrine,metabolic and nutritional(obesity(256)),urinary system(Other symptoms of urine / complaint(127)).(2)Results of statistical analysis of symptoms: physical obesity(215),dizziness(72),fatigue(fatigue(51),drowsiness(48),fatigue(44),fatigue(44),burnout(32),weakness(31),heavy limbs(72)),dry mouth(66),abdominal distension(43),frequent constipation in stool(65),loose stool(78),women can see irregular menstruation(45)or even amenorrhea(28),Males can see impotence(23).3.Statistical results of tongue and pulse(1)Obesity pulse frequency statistics(only pulses with a percentage> 5 are listed): pulse fineness(45.72),pulse slip(30.68),pulse string(30.68),pulse sinking(25.37),pulse number(23.6).(2)Statistics on the frequency of obese tongue images(only those with a percentage> 5): red tongue(19.17),light red tongue(6.49),dark red tongue(5.01),fat tongue(17.7)There are teeth marks on the tongue(12.68)4.The classification of obesity TCM status system and analysis results of Chinese medicine intervention(1)Result of reference to obesity TCM syndrome1)Statistical results of the number of reference documents of TCM standard syndromes and documents:Reference frequency of standard syndromes(frequency and percentage in brackets): spleen deficiency dampness syndrome(14,41.18),spleen and kidney yang deficiency syndrome(9,26.47),qi stagnation and blood stasis syndrome(8,23.53),spleen and stomach dampness syndrome(4,11.76).Document citation frequency(frequency and percentage in brackets):spleen deficiency(24,70.59),phlegm dampness(20,58.82),spleen yang deficiency(9,26.47),kidney yang deficiency(9,26.47),blood stasis(8,23.53),liver qi stagnation(6,17.65)2)Statistical results of standard syndromes and number of single cases of traditional Chinese medicine:Distribution of standard syndrome cases(cases,percentages in brackets): spleen deficiency dampness syndrome(471,27.72),spleen and stomach dampness syndrome(288,16.95),spleen and kidney yang deficiency syndrome(159,9.36),liver qi stagnation syndrome(141,8.3),Qi stagnation and blood stasis syndrome(114,6.71),spleen and kidney deficiency syndrome(110,6.47)Distribution of the number of documentary cases(number of cases in brackets,percentage): spleen deficiency(815,47.97),phlegm and dampness(650,38.26),liver qi stagnation(258,15.19),damp heat(186,10.95),spleen yang deficiency(159,9.36),kidney-yang deficiency(159,9.36)(2)Correlation between obesity TCM syndromes and TCM symptoms1)Standard syndrome and TCM symptom frequency and confidence statistics(frequency in brackets,average confidence)Spleen deficiency dampness syndrome: physical obesity(21,42.50),limb weight(17,42.50),oliguria(12,41.43),pulse(21,44.74),pulse(13,43.53)Liver depression and stagnation syndrome: multiple dreams(18,72.47),full stomach(14,69.33),irregular menstruation(20,66.21),insomnia(17,65.29),amenorrhea(17,61.96),dark tongue Red(14,71.61),white tongue coating(17,43.92),pulse string(23,61.74),pulse fine(18,45.34)Qi stagnation and blood stasis syndrome: physical obesity(16,45.92),amenorrhea(11,45.12),irregular menstruation(11,41.45),pulse string(14,43.99)Damp-heat injury stomach syndrome: dry mouth(16,62.70),Xiao Gu Shan Hung(13,56.10),Xiyin(10,49.77),burnout(10,47.38),obesity(14,47.09),bad breath(8,46.06),heavy limbs(11,42.23),head swelling(8,41.67),red tongue(16,62.31),greasy tongue coating(14,50.62),pulse number(15,56.37),pulse slip(15,54.23)Damp-heat syndrome: dry mouth(16,62.70),Xiaogu hunger(13,56.10),happy drinking(10,49.77),burnout(10,47.38),physical obesity(14,47.09),bad breath(8,46.06),Heavy limbs(11,42.23),head swelling(8,41.67),red tongue(16,62.31),greasy tongue coating(14,50.62),pulse number(15,56.37),pulse slip(15,54.23)Spleen and kidney yang deficiency syndrome: cold limbs(14,53.00),chills(10,42.73),obesity(19,42.53),white tongue(21,50.61),pale tongue(18,46.59),pulse sinking(21,54.36)Spleen and kidney deficiency syndrome: impotence(13,67.78),weakness(11,49.55),fatigue(11,43.36),obesity(13,41.33),white tongue coating(14,46.92),pulse precipitation(14,49.41)2)Frequency and confidence results of single syndrome and TCM symptoms(frequency in brackets,average confidence)Spleen deficiency: loss of appetite(30,71.83),heavy limbs(26,66.75),loose stools(35,66.24),fatigue(29,64.09),weakness(23,60.57),oliguria(18,56.92),edema(14,54.69),physical obesity(45,53.91),impotence(14,52.12),fatigue(16,48.87),abdominal distension(20,46.88),burnout(8,42.62),chest tightness(10,41.15),tongue There are tooth marks on the edges(17,58.02),greasy tongue coating(9,57.03),pale tongue(33,56.91),pale red tongue(16,54.61),fat tongue(23,49.92),white tongue coating(32,46.62),pulse sink(35,56.51),pulse pulse(15,53.39),pulse weak(9,52.03),pulse fine(40,51.87),pulse slow(18,51.57)Phlegm dampness: heavy limbs(27,81.14),oliguria(16,57.61),obesity(33,54.00),edema(12,52.14),burnout(9,51.89),loss of appetite(18,50.98),Loose stools(21,48.95),fatigue(18,47.67),drowsiness(12,41.91),tongue marks(13,50.07),fat tongue(19,49.56),pale tongue(22,47.59),Greasy tongue coating(7,47.43),greasy tongue coating(20,46.61),pulse(15,59.96),pulse(27,46.85),pulse(21,43.11),slow pulse(13,42.94)Liver Qi depression: irregular menstruation(24,73.00),dreams(18,68.16),stomach fullness(14,61.47),insomnia(17,60.11),amenorrhea(17,56.73),dark red tongue(14,66.33),white tongue coating(22,50.35),pulse string(31,72.47),pulse fine(19,40.44)Spleen Yang deficiency: cold limbs(14,58.44),chills(10,49.41),obesity(19,45.92),white tongue(21,56.19),pale tongue(18,52.98),fat body(13,44.06),pulse sinking(21,59.50),pulse weakness(10,45.00),pulse fineness(16,40.25)Kidney Yang deficiency: cold limbs(14,58.44),chills(10,49.41),obesity(19,45.92),white tongue(21,56.19),pale tongue(18,52.98),fat body(13,44.06),pulse sinking(21,59.50),pulse weakness(10,45.00),pulse fineness(16,40.25)(3)Statistics on classification of traditional Chinese medicine for interventional treatment of obesity with traditional Chinese medicine1)Statistical results of frequency of traditional Chinese medicine(frequency and percentage in parentheses): Poria(110,53.4%),Atractylodes macrocephala(85,41.26%),Alisma(76,36.89%),licorice(75,36.41%),orange peel(53,25.73%),hawthorn(49,23.79%),pinellia(42,20.39%),rhubarb(40,19.42%),white peony(36,17.48%),Cangzhu(34,16.5%),Bupleurum(33,16.02%),lotus leaf(32,15.53%),Magnolia officinalis(32,15.53%),citrus aurantium(30,14.56%),coix seed(29,14.08%),astragalus(28,13.59%),Chuanxiong(25,12.14%),Codonopsis(24,11.65%),Scutellaria(24,11.65%),Guizhi(23,11.17%).From the analysis of the frequency of drug use,Poria has the highest frequency of use among all drugs.2)Statistical results of the frequency of classification of the efficacy of traditional Chinese medicine: the use frequency of diuretic wetting medicine(278)and tonic deficiency medicine(415)is high,and the drugs with favorable water infiltrating efficacy include poria(110)and Alisma(76),Coix seed(29);the frequency of drugs with supplementary deficiency effects is higher including Atractylodes macrocephala(85),licorice(75),and astragalus(28),suggesting that spleen deficiency dampness is an important pathogenesis of obesity.Followed by heat-clearing drugs(196),qi-regulating drugs(162)and humidifying drugs(133),promoting blood circulation and removing blood stasis drugs(84),suggesting that liver qi stagnation,qi and blood stasis,Yin deficiency internal heat and damp heat internal resistance are obese The main pathogenesis.3)The statistical results of the four-classification frequency of traditional Chinese medicine: the traditional Chinese medicine tastes more common in warm,mild or mild medicines,and cold and cold medicines are rare.(4)Analysis results of the relationship between obesity TCM status and Chinese medicine use1)Obesity is mainly caused by liver,spleen,and intestine;pathological factors are mainly qi depression,dampness,food,phlegm,and blood stasis;disease is mainly caused by deficiency,including lung deficiency,liver deficiency,spleen deficiency,and kidney deficiency.Mainly due to spleen deficiency,the main disease is cold.2)Analysis results of the relationship between the state of traditional Chinese medicine and traditional Chinese medicine(frequency in brackets,average confidence):Spleen deficiency syndrome: Atractylodes macrocephala(48,67.58),Alisma(33,48.76),licorice(29,43.11),orange peel(23,40.55),atractylodes(20,45.81),coix seed(17,43.25),astragalus(17,44.29),Codonopsis(14,40.64)Spleen deficiency cold: Poria(13,49.36),aconite(12,71.58),cinnamon(6,53.34)Kidney deficiency: Poria(15,51.07),Fuzi(14,78.02),cinnamon(7,59.48),Rehmannia glutinosa(6,42.65)Sputum: Poria(21,45.93),Pinellia(17,49.55),Araceae(3,55.17),Scallion(2,53.45),Alum(2,53.45)Wet: Poria(28,44.08);Atractylodes(26,44.19);Coix seed(15,42.53);Astragalus(14,40.56);White lentils(8,48.89);Winter melon skin(4,44.45);Polygala(3,40.84);mung bean(2,52.22);purslane(2,52.22)Qi Yu: Bupleurum(20,71.97),Baishao(16,55.56),Citrus aurantium(12,53.57),Xiangfu(12,62.50),Yujin(6,55.36),Hehuahua(2,54.17).Conclusion:(1)Obesity is not a chronic disease caused by a single factor.Many factors such as spleen deficiency,phlegm dampness,spleen deficiency cold,kidney deficiency cold,liver qi depression,etc.are caused by endowment constitution,diet,exercise,drugs and mental emotions.It is manifested as physical obesity,dizziness,fatigue,abnormal changes in stool,etc.,pulses are more common in fine veins,slippery veins,chord veins,Shen veins,and number veins;Tongues are more common in the white and greasy tongue,red tongue,fat body,and tooth marks on the edge of the tongue.(2)The ICPC classification standard is used to classify and count the symptoms of obesity in traditional Chinese medicine.Its symptom distribution characteristics are: in addition to endocrine,metabolic and nutritional symptoms,its symptoms also involve general and non-specific,digestive system,nervous system,Urinary system and many other systems.(3)The disease status,pathology,and pathological factors are used to classify the TCM status of obesity.The distribution characteristics of TCM status are: spleen deficiency,phlegm dampness,dampness,stomach heat,spleen yang deficiency,kidney yang deficiency,blood Stasis and Qi depression.The disease mainly involves the liver,spleen,and intestine;pathological factors are mainly qi depression,dampness,food,phlegm,and blood stasis;the disease is mainly due to deficiency,including lung deficiency,liver deficiency,spleen deficiency,kidney deficiency,and spleen deficiency.It is more common,and the pathological cold and heat are mainly heat.(4)The application rules of the Chinese medicine efficacy for obesity are: diuresis and dampness medicines and tonic deficiency medicines.Among the tonic medicines,the effect of invigorating qi is mainly used,and most of them are tonic spleen,and the sexual taste is warm,slightly warm,Ping is the main;the characteristic taste of Lishui osmotic medicine is mainly cold and cold,suggesting that the deficiency syndrome is mainly spleen qi deficiency,and the evidence is mainly dampness and heat internal resistance,qi and spleen strengthening,and Lishui osmosis is the main treatment for obesity.(5)The correlation analysis results of obesity TCM status and Chinese medicine show that the TCM intervention rules of TCM status are: spleen deficiency with Poria,Atractylodes,Alisma,Licorice,Tangerine,Atractylodes,Coix Seed,Astragalus,Codonopsis,Guizhi,Amomum,Wood Fragrant,white lentils,lotus seeds,ginseng,Yizhiren,Taizishen,Shayuanzi,mung beans,walnut kernels,white mustard seeds,etc.are the core medications;spleen deficiency and cold syndrome are based on Poria,aconite,cinnamon,etc.;kidney deficiency and cold syndrome are based on Poria,Aconite,Cinnamon,Rehmannia glutinosa,etc.are the core medicines;the phlegm syndrome is Poria,Pinellia,Tiannanxing,Scallion,alum,etc.;the wet syndrome is Poria,Atractylodes,Coix Seed,Astragalus,White Lentil,Winter Melon Skin,Polygala Mung bean and purslane are the core medications;Qi Yu syndrome is based on Bupleurum,Radix Paeoniae Alba,Citrus aurantium,Xiangfu,Turmeric,and Hehuahua. |
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