Constructing A "Disease-syndrome-symptom" Framework For Digital Research On Improving The Ability Of TCM Syndrome Differentiation And Treatment Of Chronic Heart Failure Based On Data Mining

Purpose:In this study,we collected the treatment experience and medical case data of modern Chinese medicine practitioners with chronic heart failure,used various mathematical and statistical methods to fully explore the relationship between evidence and symptoms,and used a structural tree to construct a "disease-evidence-symptom" framework,so as to improve the digital diagnosis and treatment ability and provide new ideas for the clinical diagnosis and treatment of chronic heart failure in Chinese medicine.Methods:The clinical literature on the treatment of chronic heart failure contained in the full-text database of Chinese academic journals(CNKI),Wanfang journal database and Wipu full-text database of Chinese science and technology journals were collected and collated from December 2021,and the cases of chronic heart failure treated by TCM were selected.Data mining techniques were used to conduct statistical analysis and explore the "evidence-syndrome" relationship in the treatment of chronic heart failure in Chinese medicine.Based on the data mining results,a structural framework diagram is used to visualise the "disease-evidence-symptoms" framework.Results:The top seven types of symptoms with the highest proportion of cases were stagnation of blood and stagnation of blood,deficiency of heart and kidney,deficiency of yang and water,deficiency of qi and blood,deficiency of qi and yin,deficiency of yang and blood,and water and qi overwhelming the heart.The most frequent symptom is shortness of breath,followed by oedema of the lower limbs,chest tightness,palpitations,fatigue,poor urination,poor appetite,difficulty in breathing,inability to lie down at night,coughing and poor sleep;the most frequent tongue symptom is a pale red tongue,followed by a dark red tongue,white and greasy moss,thin white moss and a fat tongue;the most frequent pulse symptom is a thin pulse,followed by a sunken pulse,a stringent pulse,a weak pulse and a knotted pulse.The most frequent symptoms were heart,kidney,spleen and lung,and the most frequent symptoms were deficiency,blood stasis,phlegm and water;the most frequent treatment methods were benefiting qi,followed by tonifying water,invigorating blood,warming yang and nourishing yin.The results of the correlation between the evidence types and treatment methods were that Qi and Yin deficiency was treated by benefiting Qi and nourishing Yin;Yang deficiency and watery flooding,watery Qi overflowing the heart and Yang deficiency of the heart and kidney were all treated by warming Yang and promoting water;Qi deficiency and blood stasis were treated by benefiting Qi and invigorating Blood;Yang deficiency and blood stasis were treated by warming Yang and invigorating Blood;and blood stasis and water interconnection were treated by invigorating Blood and promoting Water.There are seven common types of symptoms,of which the main four symptoms of Qi-Yin deficiency are palpitations,shortness of breath,chest tightness,poor appetite,poor sleep,dull complexion,petechiae on the tongue,thin yellow moss,and sunken thin pulse(or string pulse);the main symptoms of Yang deficiency and water stasis are chest tightness,shortness of breath,breathlessness,cough,sputum,white sputum,poor sleep,white greasy moss(or white slippery moss),and sunken thin pulse;the main symptoms of Qi deficiency and blood stasis are shortness of breath,chest tightness,poor appetite,poor sleep,dull tongue,white moss,and sunken thin pulse.The main four examinations for Qi deficiency and Blood stasis are shortness of breath,chest tightness,poor appetite,poor sleep,pale,dark tongue,white moss,and sunken,weak pulse.In the case of Yang deficiency of the heart and kidney,the four main diagnostic features are palpitation,shortness of breath,chest tightness,breathlessness,dyspnoea(no lying down at night),thin white greasy moss,and sunken weak pulse(or knotted pulse);in the case of water and qi overwhelming the heart,the four main diagnostic features are palpitation,chest tightness,shortness of breath,breathlessness,dyspnoea(no lying down at night),poor sleep,white moss,petechiae on the tongue,and sunken sluggish pulse.The main four diagnostic features of Yang deficiency and blood stasis are palpitations,shortness of breath,chest tightness,dyspnoea(no lying down at night),cough,white sputum,poor appetite,pale purple tongue,thin white moss,weak pulse(or slippery pulse or knotted pulse)under the tongue;the main four diagnostic features of Yang deficiency and blood stasis are palpitations,shortness of breath,dyspnoea(no lying down at night),(dark red tongue),petechiae on the tongue,thin white moss(or white greasy moss),and sunken weak pulse(or knotted pulse).There are five basic types of symptoms,among which the four main symptoms of Qi deficiency are: fatigue,low voice,especially when moving,spontaneous sweating,yellowish face,pale red tongue(or pale white tongue),white moss,thin moist and slow pulse;the four main symptoms of Yin deficiency are:irritability of the five hearts,dry mouth,bitterness of the mouth,night sweating,flushing of the cheeks,dark red tongue,pale yellow moss,counted pulse or knotted pulse;the four main symptoms of Blood stasis are: cyanosis of the face,cyanosis of the lips,cyanosis of the extremities,dull face,purple tongue(or red-purple tongue),thin pulse;the four main symptoms of Yang deficiency are: fear of cold,lack of warmth in the extremities,loose stools,thirst for water.The four main diagnostic features of Blood Stasis are: cyanosis of the face,cyanosis of the lips and mouth,lack of thirst for water,dark face,dark tongue(or red-purple tongue)and thin pulse;the four main diagnostic features of Yang Deficiency are: fear of cold,lack of warmth in the limbs,loose stools,white face,dark tongue and thin pulse;the four main diagnostic features of Water Drinking are: unfavourable urination,oedema of the lower limbs,swelling of the face,abdominal distension,nausea and vomiting,dark tongue(or fat tongue or tongue with teeth marks)and rapid pulse(or weak pulse).Conclusion:Based on the clinical experience of modern famous veteran Chinese medicine practitioners,the basic and common evidence patterns of chronic heart failure and their related four diagnostic information are obtained,among which the basic evidence patterns are easy to identify and collect in digital research,especially in terms of machine recognition artificial intelligence,while the common evidence patterns provide theoretical support for the treatment of chronic heart failure in Chinese medicine and provide the experience of modern famous veteran Chinese medicine practitioners in identifying chronic heart failure.According to the framework theory,the Chinese medical evidence of chronic heart failure can be divided into 5 levels,starting from the disease,the7 most common evidence types of chronic heart failure can be obtained first,in addition to the 5 basic evidence types for digital research,followed by the common four diagnostic information of the 7 common evidence types and the5 basic evidence types,and based on the four diagnostic information of the evidence types,the treatment method can be established,so as to build the framework of "disease-evidence-symptoms" of chronic heart failure.