Discussion On The Medication Rule Of Professor Chen Bin In Treating Multiple Myeloma On Data Mining Technology

Objective:Based on data mining technology,this study explored Professor Chen Bin’s medication experience in the treatment of multiple myeloma,and explored core drug pairs and prescriptions.On the basis of clinical experience,this paper summarizes Professor Chen Bin’s academic thoughts on the treatment of multiple myeloma,in order to provide more thoughts on the treatment of multiple myeloma with traditional Chinese medicine.Method:（1）From September 2019 to January 2022,51 patients with multiple myeloma who were treated in the outpatient and inpatient departments of Professor Chen Bin of Hubei Provincial Hospital of Traditional Chinese Medicine were selected,with a total of 157 visits.A database of patient information was established with Excel spreadsheet to count the relevant data,including name,gender,age,diagnosis and staging in Western medicine,TCM syndrome type,symptoms,tongue and pulse,and prescription.Standardize the names of traditional Chinese medicines according to "Chinese Pharmacology" and "Pharmacopoeia of the People’s Republic of China"（2020edition）,and create a database of traditional Chinese medicines.（2）The ancient and modern cloud medical record platform（V2.2.3）software was used to structure the electronic medical record.The age,gender and frequency of traditional Chinese medicine of the patients were analyzed using statistical methods,and the drug attributes,such as four-qi,five-taste,meridian tropism and efficacy,were counted.Carry out drug association rule analysis and drug hierarchical clustering analysis.Results:（1）A total of 51 patients were included in this study,including 30 male patients and 21 female patients,with a male-to-female ratio of about 1.43:1.Age statistics take 60 to69 years old as the high incidence age group,accounting for43.13%.（2）According to the type of M protein secretion,we have counted one patient with Smoldering multiple myeloma type and50 patients with active type.Among them,there were 26 cases of Ig G type,18 cases of Ig A type and 6 cases of light-chain type.According to DS staging,there were 17/28/5 patients in stage III/II/I and 15 patients in subtype B respectively.There were 36 cases of initial diagnosis and 15 cases of recurrence.（3）Statistics of TCM symptoms showed that the main symptoms of multiple myeloma were fatigue（111 times）,lumbago（48times）,limb numbness（37 times）,cough（33 times）,edema（25times）,poor sleep（20 times）,dry stool（18 times）,anorexia（18 times）,abdominal distension（18 times）,and chest tightness（17 times）.（4）According to the statistics of tongue and pulse,the most frequent and pathological tongue symptoms are: dark tongue,thick white coating,red tongue,little coating,pale tongue.The pulses that appear more frequently are: deep and thin pulse,deep pulse,thin pulse,thin pulse,thin pulse.（5）According to the syndrome statistics,they were ranked in order: mutual accumulation of phlegm and blood stasis（106times）,deficiency of liver and kidney yin（23 times）,deficiency of spleen and kidney yang（21 times）,deficiency of qi and blood（5 times）,and exuberant heat toxin（3 times）.（6）A total of 190 Chinese medicines were involved in the study,and the cumulative medication frequency was 2105 times.The top 10 users were Cyathulae（102 times）,Radix Salviae Miltiorrhizae（101 times）,Radix Glycyrrhizae（98 times）,Pericarpium Citri Reticulatae（94 times）,Semen Coicis（94times）,Radix Scutellariae（88 times）,Oldenlandia（83 times）,Poria（76 times）,Radix Codonopsis（64 times）and Radix Angelicae Sinensis（54 times）.（7）There are 26 kinds of traditional Chinese medicines used more than 20 times,which can be divided into 8 categories according to the efficacy of traditional Chinese medicines.The top three kinds of medicines used frequently are deficiency-tonifying drugs（431 times）,heat-clearing drugs（270 times）and drugs for promoting blood circulation（235times）.（8）Statistics of nature,taste and meridian tropism of drugs show that the top three drugs in terms of utilization are:warm drugs were used 733 times,accounting for 34.82%;neutral drugs were used 530 times,accounting for 28.59%;cold drugs were used 602 times,accounting for 25.18%;The top three uses of the five drugs were: sweet 1161 times,accounting for 36.59%,bitter 1009 times,accounting for 31.79%,and pungent 622 times,accounting for 1119%.The top three meridians for drug administration were spleen meridian（48.98%）,liver meridian（40.81%）and lung meridian（38.68%）（9）According to the analysis of association rules of high-frequency drugs,the top five confidence percentile ranking are:lycopodium clavatum–Cyathulae（0.95）,sandalwood–Teasel（0.9）,Shancigu–Radix Salviae Miltiorrhizae（0.88）,Shancigu–Cyathulae（0.84）,and Herba lycopi–Cyathulae（0.82）.The top five supporters of percentile ranking were Cyathulae– Radix Salviae Miltiorrhizae（0.51）,Cyathulae – Semen Coicis（0.44）,Radix Salviae Miltiorrhizae–Semen Coicis（0.43）,Herba Hedyotis – Cyathulae（0.41）,and Radix Scutellariae –Semen Coicis（0.4）.（10）Clustering analysis was performed on high-frequency drugs and four clustering formulae were formed in total.The first group: Radix et Rhizoma Glycyrrhizae,Pericarpium Citri Reticulatae,and Poria.Group 2: Radix Cyathulae,Radix Salviae Miltiorrhizae,Semen Coicis,Herba Hedyotis,and Radix Scutellariae.The third group: Radix Codonopsis,Rhizoma Dioscoreae,Radix Astragali seu Hedysari,and Rhizoma Atractylodis Macrocephalae.Group IV: Radix Angelicae Sinensis,Rhizoma Ligustici Chuanxiong,Herba Taraxaci,Bulbus Fritillariae Thunbergii,Alismatis Rhizoma,Rhizoma Atractylodis,Shancigu,Radix Aucklandiae,Radix Linderae,Eucommiae Cortex,Radix Dipsaci,Herba lycopi,Herba lycopi,and Radix Paeoniae Alba.（11）The analysis of commonly used traditional Chinese medicines found that the ones with high similarity with the classic prescriptions are: Sanbi Decoction,Taishan Panshi Powder,Shiquan Dabu Decoction,Tuoli Disu Powder,and Daqinjie Decoction.Conclusion:In this study,based on the 157 clinical prescriptions’ data mining,Professor Chen Bin’s prescription and medication rules for the treatment of multiple myeloma were summarized,and Professor Chen Bin’s clinical experience for many years was combined,it was concluded that the main syndrome differentiation types of patients with multiple myeloma were phlegm and blood stasis.The general therapeutic principles include regulating and tonifying liver and kidney,activating blood,clearing heat and resolving phlegm,and paying attention to protecting the function of spleen and stomach.