Analysis Of The Medication Rule Of Cao Zhiqun In The Treatment Of Gastroesophageal Reflux Disease Based On Data Mining Technology

Objective: To explore Professor Cao Zhiqun’s clinical experience in the treatment according to syndrome differentiation of gastroesophageal reflux disease(GERD)by using data mining method based on clinical medical records,so as to form the multidimensional relationship of "symptomsyndrome-treatment-prescription-medicine",as well as provide some reference basis for further discussing Professor Cao Zhiqun’s academic thought and better guiding clinical practice.Methods: To extract the medical records of Professor Cao Zhiqun in the Outpatient Department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2015 to August 2021.Those diagnosed with GERD,reflux esophagitis,non-erosive esophagitis or Barrett’s esophagus,with complete basic information,providing endoscopy reports,and using traditional Chinese medicine treatment were included in the database.Data mining is carried out by using Microsoft Excel2016,Liquorice,IBM SPSS Statistics23.0 and IBM SPSS Modeler14.1 software.The rules of diagnosis and treatment of GERD patients were explored by using frequency analysis,complex network,association rules and factor analysis.And the core prescriptions,core herb pairs and drug common factors for the treatment of GERD were obtained by analyzing the frequency,taste,menstruation,efficacy.Meanwhile,the drug use information of patients of different genders was analyzed,and the core prescriptions of men and women were obtained respectively.Results: A total of 512 patients’ information of GERD were collected,including 272 male patients(53.13%)and 240 female patients(46.88%).The age distribution was mainly in people aged 40 to 59 years old,accounting for 55.66% of the total sample size.In clinical types,there were 295 cases of reflux esophagitis,accounting for 57.62%,43 cases of Barrett esophagus,accounting for 8.40%,and 174 cases of non-erosive reflux disease,accounting for 33.98%.(1)Frequency statistics: This study involved 191 kinds of Traditional Chinese medicine,with a total frequency of 7741.Among them,22 high-frequency Traditional Chinese medicines with frequency > 20% were used for a total of 4818 times,accounting for 62.24%of the total frequency,and the top 10 drugs are: Amomi Fructus,Pinelliae Rhizoma,Atractylodes macrocephala Rhizoma,Astragali Radix,Coptidis Rhizoma,Aurantii Fructus,Fritillariae Thunbergii Bulbus,Salviae Miltiorrhizae Radix et Rhizoma,Codonopsis Radix and Oroxyli Semen;The efficacy of traditional Chinese medicines was mainly tonifying deficiency,regulating qi,reduce phlegm and clearing heat;the syndrome types are mainly liver-stomach disharmony,liver-stomach depression-heat syndrome,spleen deficiency and qi stagnation syndrome.Statistics showed that the four natures of medicines are mainly warm and cold,and the five flavors are mostly bitter,pungent and sweet.Spleen and stomach meridians are the two main channels,followed by lung and liver meridians.(2)Complex network:the core prescriptions of Professor 曹 in treating GERD were Amomi Fructus,Atractylodes macrocephala Rhizoma,Pinelliae Rhizoma,Salviae Miltiorrhizae Radix et Rhizoma,Astragali Radix,Codonopsis Radix,Aurantii Fructus,Pinelliae Rhizoma,Perillae Folium,Fritillariae Thunbergii Bulbus and Oroxyli Semen.(3)Association rules: the analysis of association rules showed that the drug pairs were mainly the combination of Amomi Fructus,Coptidis Rhizoma and other drugs;the drug pairs with the highest compatibility intensity are Fritillariae Thunbergii BulbusSepiae Endoconcha,Coptidis Rhizoma and Euodiae Fructus;the most frequently used pair is Amomi Fructus-Coptidis Rhizoma;the core multiflavor drugs were the combination of Amomi Fructus,Coptidis Rhizoma,Atractylodes macrocephala Rhizoma,Aurantii Fructus,Pinelliae Rhizoma,Fritillariae Thunbergii Bulbus,Astragali Radix,Perillae Folium.(4)Factor analysis: A total of 8 common factors were obtained by factor analysis,reflecting the treatment methods of soothing liver and regulating qi,reducing adverse events and stomach,clearing heat and purging fire,drying dampness and resolving phlegm,tonifying qi and invigorating spleen,suppressing acid and relieving pain,converging sores and promoting healing,etc.(5)Analysis of medication regularity of different genders: Core prescriptions of male patients: Amomi Fructus,Atractylodes macrocephala Rhizoma,Pinelliae Rhizoma,Salviae Miltiorrhizae Radix et Rhizoma,Astragali Radix,Codonopsis Radix,Aurantii Fructus,Coptidis Rhizoma,Euodiae Fructus,Fritillariae Thunbergii Bulbus,Sepiae Endoconcha,Oroxyli Semen,Allii Macrostemonis Bulbus.Among the high-frequency drugs,phlegm-removing drugs is used more frequently than women.The core prescriptions of female patients are: Amomi Fructus,Atractylodes macrocephala Rhizoma,Pinelliae Rhizoma,Salviae Miltiorrhizae Radix et Rhizoma,Astragali Radix,Codonopsis Radix,Aurantii Fructus,Coptidis Rhizoma,Perillae Folium,Fritillariae Thunbergii Bulbus,Bupleuri Radix,Cyperi Rhizoma,Oroxyli Semen,Allii Macrostemonis Bulbus.Among the highfrequency drugs,qi-regulating drugs,wind-heat-dissipating drugs,and blood-tonifying drugs are used more frequently than men.Conclusion: Professor Cao Zhiqun puts forward the syndrome differentiation mode of "ascending and descending of Zang-fu qi-in(qi)-in collaterals(blood)-into strange meridians(kidney)".He believes that GERD takes qi imbalance and stomach loss as the basic pathogenesis,spleen and stomach weakness as the basis of pathogenesis,and the pathogenesis is characterized by deficiency and excess.The real pathological factors are heat depression,dampness,qi stagnation,phlegm,blood stasis,food accumulation and so on.Professor Cao mainly starts from spleen,stomach and liver,attaches importance to regulating Zang-fu qi,and summarizes the treatment principles such as regulating qi,reducing fire,dispelling dampness,removing blood stasis,inhibiting acid,converging sores and promoting healing,replenishing qi and invigorating spleen,tonifying health.