Based On Data Mining Technology To Explore The Clinical Medication Rule Of Professor Gao Yi In The Treatment Of Bone Arthralgia

Objective: Using cross-sectional study method and data mining technology to analyze and study the high-frequency drugs,core drug pairs,core prescriptions and similar prescriptions of Professor Gao Yi’s clinical syndrome differentiation in the treatment of bone arthralgia,and summarize the characteristics of drug prescription and clinical medication rules,so as to provide ideas for clinical medication,inherit learning and inherit the characteristic diagnosis and treatment experience of the tutor.Method: The medical record information of patients with bone arthralgia treated by Professor Gao Yi in the outpatient department of Osteoporosis Affiliated Hospital of Shandong University of Traditional Chinese Medicine from June 2019 to June 2022 was collected.The medical record prescription information conforming to the included criteria was standardized for symptoms,TCM four diagnosis information,TCM syndrome and prescription drugs,and classified according to different sites of bone arthralgia.To establish Professor Gao Yi’s clinical treatment of bone arthralgia patients medical record database.Microsoft office Excel 2019 was used to analyze the frequency of age,gender,syndromes and drugs in medical records.Apriori algorithm in programming software R language was used to analyze drug-drug,syndrome-drug and drug-drug association rules in different parts of bone arthralgia.SPSS modeler 18.0 was used to construct core TCM complex network diagram and Cytoscape 3.7.2 software was optimized for visualization processing.SPSS Statistics 22.0 was used for systematic cluster analysis of high frequency traditional Chinese medicine(frequency ≥10 times).Results:1.Frequency statistics of general data: A total of 146 patients with bone arthralgia were included in this study,including 23 males and 123 females.The age of 146 patients ranged from 30 to 94 years old,with the youngest age being 30 and the oldest 94 years old.2.Frequency statistics of diagnosis and TCM syndromes:146 patients with bone bi were classified according to the location of bone BI.A total of 60 cases of waist BI,42 cases of knee bi,36 cases of neck bi,5 cases of shoulder BI and3 cases of hip Bi were collected.Western medicine diagnosed 146 cases of bone obstruction as knee osteoarthritis in 39 cases,cervical spondylosis in 36 cases,osteoporosis in 28 cases,lumbar degenerative changes in 18 cases,lumbar disc herniation in 14 cases,rotator cuff injury in 3 cases,femoral head necrosis in 3 cases.Combined with the clinical syndrome differentiation habits of Professor Gao Yi,the TCM syndroms of bone bi can be divided into five basic syndroms: cold dampness obstruction,deficiency of liver and kidney,blood stasis blocking,mutual formation of phlegm and blood stasis,and dampness-heat accumulation.The basic syndroms of the same patient can be combined,accounting for 46.58%,29.45%,26.03%,22.60%,4.79% of all cases,respectively.The frequency analysis of traditional Chinese medicine syndroms of different parts of bone Bi showed that the block syndrome of cold and dampness and blood stasis block syndrome were the main ones.Waist Bi was mainly characterized by deficiency of liver and kidney and obstruction of cold and dampness.The main symptoms of knee obstruction were phlegm-stasis interlocking syndrome,blood stasis blocking syndrome and cold dampness blocking syndrome.3.Statistical results of high-frequency TCM frequency:(1)Statistics on the frequency of high frequency traditional Chinese medicine in total bone arthralgia prescriptions: a total of 146 patients with bone arthralgia were collected.The cumulative frequency of traditional Chinese medicine prescriptions was 2719 times,involving 147 flavors of traditional Chinese medicine and 55 flavors of high frequency Chinese medicine(frequency ≥ 10 times).Utilization rate ≥ 50% of the drugs are:Astragalus,laurel branch,aconite,scorched licorice,white peony,yellow cedar,orange peel,atractylodes,coix seed,pueraria root,angelica,peach kernel.The drug properties of high frequency drugs are warm,cold and flat,and the taste of drugs is sweet,hot and bitter.The main channel is liver,kidney and spleen channel.(2)Statistics of prescription frequency of different bone arthralgia sites:There were 36 prescriptions with a total frequency of 688,involving 100 kinds of Chinese herbs.The frequency of high frequency Chinese herbs in order from high to low were: cassia twig,pueraria root,astragalus membranaceus,tangerine peel,ginger,aconites,etc.There were 60 prescriptions for patients with waist arthralgia,and the total frequency of medication was 1134 times,involving 111 kinds of Chinese herbs.The frequency of high frequency Chinese herbs was as follows: Astragalus,Radix Paeoniae,Radix glycyrrhiza,Radix Phellodendri,Radix angelica,aconite,etc.There were 42 prescriptions for patients with knee arthralgia,the total frequency of medication was 752 times,involving 76 kinds of Chinese herbs.The frequency of high frequency Chinese herbs was: cassia twig,coix seed,atrictylodes,aconite,Astragalus,Radix Astragalus,peach kernel,Radix Phellodendri,licorice and so on.4.Efficacy analysis results of high-frequency traditional Chinese medicine:The efficiency analysis of high-frequency traditional Chinese medicine showed that the utilization rate from high to low was as follows: tonifying deficiency(26.33%),followed by relieving surface(14.27%),promoting blood circulation and removing blood stasis(13.20%),clearing heat(9.23%),and improving water and dampness(6.40%).The most commonly used drug efficacy subclass was diverging wind-cold drug(10.96%),followed by supplementing qi drug(9.27%)and supplementing Yang drug(8.05%).5.Analysis results of high-frequency TCM complex network:The core TCM network consisted of 21 drugs including Radix Astragalus,cassia branch,Aconite,Radix paeoniae alba,Radix Phellodendron,broxiorice,Rhizoma corydalis,Eucommia ulmoides,peach kernel,Moutan bark,ginger,atractylodes atractylodes,poria,pueraria root,coix seed,tetrandrine,tangerine peel,Rhizome and ephedra.6.Analysis results of association rules:(1)The association rule analysis of total Gubi prescription obtained 16 second-order drug combinations(drug pairs)and 23 third-order drug combinations(drug clusters).We found that these core drug combinations mainly came from the combination of Gegen decoction,Guizhi aconiti Decoction,Guizhi poria Wan,etc.(2)Analysis of association rules of different parts of BI prescription obtained 7 groups of second-order drug combination(drug pair),16 groups of third-order drug combination(drug string),20 groups of second-order drug combination(drug pair)of waist BI,34 groups of third-order drug combination(drug string),20 groups of second-order drug combination(drug pair)of knee BI,18 groups of third-order drug combination(drug string).These core drug combinations were mainly derived from Gegen decoction,Yougui Wan,Fangji Huangqi Decoction,Simiao Wan,Guizhi Poria Wan and other prescriptions.(3)The syndrome and drug association analysis of different TCM syndromes showed that cold dampness-obstruction syndrome was strongly associated with 11 drugs,liver and kidney deficiency syndrome was strongly associated with 14 drugs,blood stasis was strongly associated with 7 drugs,phlegm-stasis interjunction was strongly associated with 11 drugs.7.Cluster analysis results:Six combinations of high frequency Chinese herbs were obtained by cluster analysis,which were combination 1: cuscuta seed,amari seed,wolfberry seed,deer horn gum,cooked Rehmannia,Epimedium,codonopsis codonopsis,Rhizoma atractylodes,Rehmannia Rehmannia,bone broken supplement,Eucommia ulmoides,white peony root,Dangica sinensis,sundried licorice;Combination 2: Discontinuity,mulberry parasitism,dog ridge;Combination 3: Psoralea and Veilingxian;Combination 4: Bupleurum bupleurum,Scutellaria scutellaria,Radix aconitum,Oyster,Ligusticum Chuanxiong and Safflower;Combination 5: Scorpion,Xu Changqing,spatholobi,ginger,jujube,piece of turmeric,mulberry branch,Qiang live,pueraria,ephedra,cassia branch,tangerine peel,aconite,rhizoma corydalis;Combination 6: Radix Astragalus,Cypress Phellodendron,alismatis alismatis,alismatis alismatis,Rhubarb,Radix paeoniae,asarum,Poria,peony bark,Radix Paeoniae,peach kernel,atractylodes atractylodes,Coix seed,Radix fanci,Radix Radix Radix.Conclusions: 1.Professor Gao Yi strictly observed the pathogenesis of bone Bi in clinical treatment.He believed that deficiency of liver and kidney,deficiency of qi and blood are the internal factors of bone BI,and weak Wei and external factors are the important external conditions of bone BI,and endogenous pathological products such as qi and blood obstruction in meridian arteries and blood stasis and turbidness are the key factors of bone BI.Clinical treatment of bone arthralgia treatment for this,the use of drugs mainly to Gan warm tonic deficiency,more return to the liver,kidney and spleen meridian,pay attention to dispel evil and promote blood.2.Professor Gao Yi attached great importance to syndrome differentiation,and combined with long-term clinical experience,divided bone sluggishness into five basic syndrome types: deficiency syndrome of liver and kidney,cold and dampness obstruction syndrome,blood stasis syndrome,phlegm-stasis interlocking syndrome,dampness-heat accumulation syndrome.In clinical practice,four methods are commonly used to treat bone sluggishness: tonifying liver and kidney,invigorating spleen and qi,dispelling evil,activating blood circulation and removing blood stasis.For different parts of bone arthralgia,clinical drugs also have their own characteristics.3.Professor Gao Yi is good at clinical use of Jing prescriptions,simple and efficacious,whose core drug pairs and drug clusters are mostly derived from ancient and modern famous prescriptions.In clinical symptoms,he often uses Gegen Decoction,Guizhi Decoction and Guizhi Aconite decoction to relieve surface cold and relieve pain.Fangji Huangqi Decoction and Simiao Pills are the essence of Professor Gao Yi’s academic thoughts on clinical treatment of bone arthralgia as well as his characteristic diagnosis and treatment experience.