A Data Mining Study Of Professor Wang Sumei's Experience In Treating TS Comorbid ADHD

Objective:At present,co-morbid Tourette syndrome with attention deficit hyperactivity disorder is very common in clinical practice.This study used the Traditional Chinese Medicine Inheritance Support System(V2.5)to mine and analyze the clinical data of Professor Wang Sumei in treating children with comorbidity of TS and ADHD,so as to summarize Professor Wang Sumei’s medical experience,and explore Professor Wang’s understanding of the disease and treatment ideas,which is clinically significantMethods:We collect and screen the clinical cases of children with comorbidity of TS and ADHD in Professor Wang Sumei’s outpatient clinic from August 2019 to January 2021,and enter the relevant information into the Traditional Chinese Medicine Inheritance Support System(V2.5)after standardized processing for data.Statistical analysis on the general information of children was performed,such as gender ratio and age;for prescription information,we use frequency analysis statistics,association rule analysis,entropy clustering and improved mutual information methods,etc.,to obtain the distribution of syndromes and the four qi,five flavors and the frequency of drugs,for the purpose of unearthing the association rules and prescription rules between the drugs,and combining the clinical practice to summarize the drug rules of Professor Wang Sumei on the treatment of TS co-existing ADHD,and exploring Professor Wang Sumei’s understanding of the disease and treatment ideas.Results:1.48 children were collected,including 44 boys and 4 girls.The male to female ratio was about 11:1.The prevalence rate of boys was significantly higher than that of girls.The visiting age was from 5 to 15 years old,mainly from 6 to 10 years old,accounting for 77.1%of the total number.2.There are five types of TCM syndromes involved in this study:TCM syndrome types and frequency are:116 times of spleen deficiency and liver hyperactivity syndrome,15 times of spleen deficiency and phlegm gathering syndrome,13 times of yin deficiency and wind movement syndrome,and 7 times of phlegm-fire disturbing mind syndrome,and 3 times of liver fire flaring up.Among them,spleen deficiency and liver hyperactivity syndrome accounted for the largest number,accounting for 75.3%.3.The statistical analysis of the medicines(166 drugs)used by Professor Wang to treat the disease showed that:in terms of the four qi,Professor Wang clinically used warm,cold and flat medicines,among which warm medicines were the most.The five flavors are mainly pungent,sweet,and bitter,and the pungent was the most.Regarding the meridians,the liver meridians and spleen meridians are the main ones,and the lung meridians,stomach meridians,heart meridians,and kidney meridians are also more common.In terms of frequency of use,the top 20 drugs used are grassleaf sweetflag rhizome,dried tangerine peel,tall gastrodia tuber,common clubmoss herb,kudzuvine root,Chinese thorowax root,gambir plant nod,processed pinellia tuber,stiff silkworm,Indian bread,sharp-leaf glangal fruit,scorpion,divaricate saposhnikovia root,pipewort flower,tree peony root bark,Sichuan lovage rhizome,milkwort root,platycodon root,debark peony root,earthworm.4.By analyzing the prescription rule analysis of the drug,we obtained 46 drug models and 6 association rules.The common combinations are mainly processed pinellia tuber-dried tangerine peel,gambir plant nod-grassleaf sweetflag rhizome,kudzuvine root-common clubmoss herb,and 16 core drugs,which are among the most frequently used drugs5.New prescription analysis on all prescriptions were performed,and we obtained 34 core drug combinations and 17 potential new prescriptions.Conclusion:1.Professor Wang Sumei believes that the pathogenesis of comorbidity of TS and ADHD is mainly spleen deficiency and liver hyperactivity and upper hyperactivity of liver yang.The disease is mainly caused by the liver and spleen,and can also impacted the heart,lungs and kidneys,which means the disease can involve the five internal organs.The main pathological products are the wind and phlegm.2.Professor Wang’s core treatment method for treating this disease is to invigorate the spleen and suppress hyperactive liver,and to calm endogenous wind and resuscitation.Professor Wang utilizes the heterophylly falsestarwort root,dried tangerine peel,processed pinellia tuber,ispel bread to invigorate the spleen and dissipating phlegm,debark peony root to calm the liver and soften the liver and reconcile yin and yang,tall gastrodia tuber and gambir plant nod to calm endogenous wind and zhijing,suppress hyperactive liver and subside yang,divaricate saposhnikovia root to ispel pathogenic wind and zhijing,Sichuan lovage rhizome to regulate the qi movement of the body,and at the same time,it is supplemented with grassleaf sweetflag rhizome,sharp-leaf glangal fruit,milkwort root to resuscitation and tranquillization,taking into account the treatment of TS and ADHD.If the course of the disease is long,stiff silkworm,scorpion,and earthworm are used to search the wind to dredge the collaterals.3.Professor Wang pays attention to the combination of syndrome differentiation and disease differentiation,and take treatment methods based on the holism and syndrome differentiation.If the disease persists to the heart,lung,and kidney,the treatment should be flexible,and the medication should be added or subtracted according to the syndrome.