Research On Professor Xie Jingri’s Academic Thought And Medication Regularity Of Treating Gastroesophageal Reflux Disease From Depression Based On Data

Objective:To explore Professor Xie Jingri’s clinical experience in the diagnosis and treatment of Gastroesophageal Reflux Disease(GERD)and analyze its Traditional Chinese Medicine(TCM)Regularity,in order to provide new ideas for the prevention and treatment of GERD and improve the clinical efficacy.Methods:1.The study collected the basic information and the first TCM prescription of 205 GERD patients who met the inclusion criteria in Professor谢晶日outpatient medical record system from January 1,2016 to December31,2020.2.The study had preprocessed and standardized the collected case data,entered it into Microsoft Office Excel 2019 and established a database.3.The study used the software Microsoft Office Excel 2019 to analyze the frequency of general clinical data and TCM,the software IBM SPSS modeler 18.0 was used to analyze the association rules of high-frequency TCM,the software IBM SPSS statistics 20.0 was used for analysing the systematic cluster of high-frequency TCM.Result:1.General data: the age distribution of 205 GERD patients in this study was normality,the high-risk group was 50 ～ 55 years old,and the prevalence rate was more than 40%.There were 128 females and 77 males,the number of female patients was significantly higher than that of males,female patients were about 1.7 times higher than male patients.Qi stagnation and phlegm obstruction syndrome was the most common,accounting for 35%.19.5% of the patients were treated within two weeks,66.83% of the patients were treated within one month.2.Frequency analysis: a total of 143 kinds of traditional Chinese medicine were used in 205 first diagnosis prescriptions of 205 GERD patients,with a total of 4077 times.Among them,the cumulative frequency of 28high-frequency Traditional Chinese Medicines use frequency of more than 50 times was 70.64%,the cumulative frequency of 26 medium frequency traditional Chinese medicines use frequency of 20～50 times was 19.52%,and the frequency of the other 89 low-frequency traditional Chinese medicines was less than 20 times,with a cumulative frequency of 9.84%.The 28high-frequency traditional Chinese medicines were in descending order of frequency: Radix Bupleuri(4.56%),Amomi Fructus Rotundus(4.27%),Calcined Cuttlebone(4.12%),Calcined Clam Shell(3.83%),Dried Tangerine Peel(3.46%),Medicated Leaven(3.41%),Perilla Frutescens Seed(3.41%),Amomum Cardamomum(3.16%),Magnolia officinalis Rehd(2.92%),Citron(2.75%),Fingered Citron(2.67%),Stir-frying Rhizoma Atractylodis Macrocephalae(2.65%),Fritillaria Thunbergii Miq(2.60%),Radix Linderae(2.48%),Fructus Aurantii Immaturus(2.28%),Calcined Abalone Shell(2.21%),Membrane of Chickens Gizzard(2.13%),Rhizoma Atractylodis Macrocephalae(2.04%),Coptis Chinensis(2.04%),Fructus Evodiae(1.86%),Alpinia katsumadai(1.57%),Calcined Oysters(1.55%),Rhizoma Cyperi(1.55%),Coix Seed(1.55%),Calcined Fossil Fragments(1.52%),Areca-nut(1.40%),the Stem of Noble Dendrobium(1.35%),Lysimachia Christinae Hance(1.30%).Among the 28 high-frequency traditional Chinese medicines,TCM with the function of regulating qi accounted for 15.19%,with the function of resolving phlegm accounted for13.96%,with the function of removing dampness accounted for 7.65%.According to the properties,tastes and meridians of 143 kinds of TCM were studied,the proportion of traditional Chinese medicine with hot attribute was45.18%,with cold attribute was 33.84%,with micro cold attribute was the least,accounting for only 0.43%.Meanwhile,31.09% of Chinese herbal medicines were pungent,28.27% were bitter,18.16% were sweet,and 2.11%were not obvious.In addition,there were 17.71% traditional Chinese medicines belonging to stomach meridian,17.44% traditional Chinese medicines belonging to spleen meridian,16.89% traditional Chinese medicines belonging to liver meridian,and 0.54% traditional Chinese medicines belonging to Sanjiao meridian and pericardial meridian.3.Association rule analysis: The association rules of 28 high-frequency traditional Chinese medicines used in the first diagnosis prescriptions of 205 GERD patients included in this study were analyzed of which 129 met the requirements of parameter setting.There were 20 results that two kinds of TCM were interrelated,52 results that three kinds of TCM were interrelated,43 results that four kinds of TCM were interrelated,and 4 results that five kinds of TCM were interrelated.4.Cluster analysis: The 28 high-frequency traditional Chinese medicines used in the first diagnosis prescriptions of 205 GERD patients included in this study were analyzed by systematic cluster analysis,and the following four cluster combinations were obtained,Category I: Calcined Oysters,Calcined Fossil Fragments,Citron,Rhizoma Cyperi,Coptis Chinensis,Fructus Evodiae,Calcined Corrugated,Calcined Clam Shell,Fritillaria Thunbergii Miq,Calcined Cuttlebone,the Stem of Noble Dendrobium.Category II:Fructus Aurantii Immaturus,Areca-nut,Magnolia officinalis Rehd,Rhizoma Atractylodis Macrocephalae,Amomum Cardamomum,Radix Linderae,Alpinia katsumadai.Category III: Lysimachia Christinae Hance.Category IV:Radix Bupleuri,Calcined Abalone Shell,Stir-frying Rhizoma Atractylodis Macrocephalae,Coix Seed,Perilla Frutescens Seed,Fingered Citron,Dried Tangerine Peel,Medicated Leaven,Membrane of Chickens Gizzard.Conclusion:1.Professor Xie Jingri summarized the basic pathogenesis of GERD as"Wu Yu Bu Cheng Suan"(无郁不成酸).Syndrome differentiation was based on"Han(寒)and Re(热)".The most basic treatmentstrategy was"Jie Yu(解郁)Jiang Ni(降逆)and Tong Fu(通腑)".2.Professor Xie Jingri’s treatment of GERD was mainly Qi regulating TCM,supplemented by phlegm resolving TCM,dampness resolving TCM and food eliminating TCM.In terms of TCM properties,warm Medicines and cold Medicines were in the majority,followed by soft Medicines.In terms of TCM taste,most of them were pungent Medicines,followed by bitter Medicines,and sweet Medicines rank third.Most of the TCM belong to the spleen meridian and stomach meridian,followed by the liver meridian.3.Professor Xie Jingri had 28 high-frequency TCM for GERD,respectively: Radix Bupleuri,Amomi Fructus Rotundus,Calcined Cuttlebone,Calcined Clam Shell,Dried Tangerine Peel,Medicated Leaven,Perilla Frutescens Seed,Amomum Cardamomum,Magnolia officinalis Rehd,Citron,Fingered Citron,Stir-frying Rhizoma Atractylodis Macrocephalae,Fritillaria Thunbergii Miq,Radix Linderae,Fructus Aurantii Immaturus,Calcined Abalone Shell,Membrane of Chickens Gizzard,Rhizoma Atractylodis Macrocephalae,Coptis Chinensis,Fructus Evodiae,Alpinia katsumadai,Calcined Oysters,Rhizoma Cyperi,Coix Seed,Calcined Fossil Fragments,Areca-nut,the Stem of Noble Dendrobium,Lysimachia Christinae Hance.4.Professor Xie Jingri’s commonly used TCM combination for the treatment of GERD includes "Calcined four Stones"(calcined corrugated seeds,calcined cuttlebone,calcined clam shells and fritillaria thunbergii);Radix Bupleuri plus Calcined four Stones;Radix Bupleuri and Dried Tangerine Peel;Coptis chinensis and Fructus Evodiae(the dose of coptis chinensis was three times that of fructus evodiae);Amomum Cardamomum and Radix Linderae;Amomum Cardamomum and Alpinia katsumadai;Areca-nut and Fructus Aurantii Immaturus(or Fructus aurantii);Rhizoma Cyperi and Citron;Semen Raphani and Perilla Frutescens Seed;Radix glehniae and Dendrobium.