ObjectiveTo analyse Professor Wang BiQin’s medication prescription pattern and to conclude Professor Wang’s clinical experience in the treatment of endometriosis by performing a variety of data mining techniques using a data mining system for promoting the inheritance of her experience.Methods84 paper-based medical records of endometriosis patients,with a total of 322 consultation visits,dated between January 2016 and December 2020,were selected according to the inclusion and exclusion criteria from Professor Wang BiQin’s outpatient services in Dongzhimen Hospital,Beijing.The data analysed include:patients’ general information,four-diagnostic clinical information,Traditional Chinese Medicine(TCM)diagnosis and prescription.Data mining techniques such as frequency analysis,association rule,cluster analysis,and complex network analysis were applied by using Microsoft Excel and the Ancient and Modern Medical Case Cloud Platform.Results1.The age distribution of patients was concentrated in the 28-41 age group,of which the majority was in the 28-34 age group(51.19%).2.The most common clinical symptoms were cold intolerance,poor sleep,lower abdominal pain,loose stools,and backache,with a cumulative proportion of 41.13%.The most common menstrual conditions were blood clots,abdominal pain,dark coloured,backache and breast distention,with a cumulative proportion of 73.41%.The most common TCM diagnosis were infertility,abdominal mass,dysmenorrhoea,prolonged menstruation,abdominal pain and hypomenorrhoea,with a cumulative proportion of 84.16%.The most common tongue observed were red tongue(65.17%)and thin white coating(82.43%).The most common pulse obtained was fine pulse(42.28%).3.A total of 573 prescriptions of Chinese medicine formula and 165 kinds of Chinese medicine were included in this research.The most frequently prescribed basic formula was Lianggu Decoction(40.85%).The 14 most frequently prescribed(>40%)medicines were Angelica,prepared Rehmannia,Pilose Asiabell,Motherwort,Teasel,Dodder,Wolfberry,Epimedium,Achyranthes,Sargentgloryvine,Szechuan Lovage,prepared Astragalus,Yam and dry-fried Atractylodes.The natures were mainly warm and neutral.The flavours were mainly sweet,pungent and bitter.The meridians were mainly liver,kidney and spleen.The functions were mainly tonifying liver and kidney,clearing heat and detoxifying,tonifying kidney-Yang,promoting blood circulation and regulating menstrual cycle.4.Based on association rules,the most frequently prescribed medicine pairs were prepared Rehmannia-Angelica,Pilose Asiabell-Angelica,Szechuan Lovage-Motherwort,Szechuan Lovage-prepared Rehmannia,Szechuan Lovage-Angelica,Dodder-Angelica,Wolfberry-Angelica,Wolfberry-Dodder,Epimedium-Dodder,Epimedium-Angelica.Based on cluster analysis,the medicines were divided into four categories:blood-nourishing and blood-circulation-promoting,blood-circulation-promoting and mass-dissipating,kidney-tonifying and spleen-strengthening,liver-nourishing and kidney-tonifying.Based on complex network analysis,a core formula,consisting of prepared Rehmannia,Angelica,Motherwort,Dodder,Wolfberry,Teasel,prepared Astragalus,Sargentgloryvine,Pilose Asiabell,Epimedium,Achyranthes and Szechuan Lovage,was obtained.5.The 15 most frequently prescribed(>75%)medicines during menstruation were Motherwort,Sargentgloryvine,Eupatorium,Salvia,Red Peony,Safflower,prepared Rehmannia,Semen Persicae,Szechuan Lovage,Cyathula,Angelica,Sparganii,Curcuma,leech and Pilose Asiabell.The natures were mainly warm and neutral.The flavours were mainly bitter and pungent.The meridians were mainly liver and spleen.The functions were mainly clearing heat and detoxifying,promoting blood circulation and regulating menstrual cycle,dissipating blood stasis and relieving pain.6.The 12 most frequently prescribed(>80%)medicines during the follicular phase were Dodder,Epimedium,Angelica,Teasel,Motherwort,Ligustrum,prepared Rehmannia,Szechuan Lovage,Wolfberry,Polygonatum,Pilose Asiabell and Achyranthes.The natures were mainly neutral and warm.The flavours were mainly sweet and pungent.The meridians were mainly liver and kidney.The functions were mainly strengthening the bones and muscles,nourishing liver and tonifying kidney.7.The 15 most frequently prescribed(>90%)medicines during ovulation were Sparganii,Dodder,Angelica,Achyranthes,Salvia,Notopterygium,Pilose Asiabell,Motherwort,Teasel,Wolfberry,Eupatorium,Honeylocust,Fluoritum,leech and Asarum.The natures were mainly warm and neutral.The flavours were mainly sweet and pungent.The meridians were mainly liver and kidney.The functions were mainly strengthening the bones and muscles,tonifying liver and kidney,promoting blood circulation and regulating menstrual cycle.8.The 14 most frequently prescribed(>50%)medicines during the luteal phase were Angelica,prepared Rehmannia,Dodder,Raspberry,Epimedium,Teasel,Morinda,Wolfberry,Cynomorium,Achyranthes,Yam,prepared Astragalus,Pilose Asiabell and Psoralen.The natures were mainly warm and neutral.The flavours were mainly sweet and pungent.The meridians were mainly kidney and liver.The functions were mainly strengthening the bones and muscles,tonifying kidney-Yang,tonifying liver and kidney.9.Based on cluster analysis,the medicines used in different phases were divided into three categories each.Blood-nourishing and blood-circulation-promoting,Qi-invigorating and pain-relieving,blood-circulation-promoting and menstrual-cycle-regulating for menstruation.Liver-and-kidney-tonifying,blood-circulation-and-menstruation-promoting,Qi-tonifying and spleen-strengthening for the follicular phase.Yin-and-Yang-tonifying,blood-breaking and mass-dissipating,Qi-tonifying and spleen-strengthening,Qi-tonifying and Qi-invigorating for ovulation.Kidney-tonifying and spleen-strengthening,blood-circulation-promoting and cold-dispelling,Yang-and-Yin-tonifying for the luteal phase.ConclusionAccording to the results of data mining,Professor Wang’s understanding of the fundamental aetiology and pathogenesis of endometriosis was clarified to be Yang deficiency of the spleen and liver and blood stasis,with cold coagulation,phlegm retention,Qi stagnation and damp heat.Professor Wang’ s general principles of treating endometriosis were concluded to be tonifying and warming kidney and spleen,nourishing kidney and liver,nourishing and promoting blood circulation,and to be attaching importance to tonifying and purging in combination and treating both symptoms and root causes.Professor Wang’s treatment of endometriosis was discovered to be based upon both the disease/syndrome differentiation and the characteristics of the different phases of menstrual cycle.Different treatment methods were applied for different phases,i.e.promoting blood circulation,dissipating mass and relieving pain during menstruation,nourishing kidney-Yin and warming kidney-Yang during the follicular phase,nourishing Yin,warming Yang,promoting blood circulation and menstruation during ovulation,tonifying kidney-Yang and spleen-Qi during the luteal phase.This study systematically summarised Professor Wang’s medication prescription patterns for the treatment of endometriosis by using data mining technology. |