Summarize The Rule Of Differentiation And Treatment Of Compensatory Hepatitis B Cirrhosis With Traditional Chinese Medicine Through Digging Clinical Medical Records

Objective: To study the academic experience and academic viewpoints of physicians in the treatment of compensated hepatitis B cirrhosis with traditional Chinese medicine(TCM)in the form of data mining,summarize the clinical treatment experience of physicians,summarize the law of drug use,and provide academic reference for TCM in the treatment of compensated hepatitis B cirrhosis.Methods: The literature on compensated hepatitis B cirrhosis published in CNKI,VIP,Wanfang,CBM,and the books and medical records related to cirrhosis published in the library of Shandong University of Traditional Chinese Medicine,the show search platform and We Chat reading software were used for screening,Enter the medical records that meet the standards into the famous doctor inheritance assistance platform,analyze and summarize the information in the medical records through the platform and excel forms,and summarize the clinical experience of physicians in treating compensatory hepatitis B cirrhosis.Result:(1)In this study,a total of 194 medical records were excavated,and 159 medical records were screened,with a total of 414 visits.Among them,116 were male(73%),39 were female(25%),and 4 were not marked with gender(2%).(2)There are 264 kinds of symptoms in total,and the general symptoms in the top 15 are: fatigue,hypochondria,abdominal distension,dry mouth,yellow urine,poor appetite,poor sleep,bitter mouth,epistaxis,loose stool,fatigue,hypochondria,hypochondria,dizziness,dry stool,epistaxis,no obvious discomfort,pale complexion,nausea,stomach distension,low back pain,belching,fatigue,hypochondria,abdominal distension are the most common symptoms;There are 9 kinds of tongue texture,the most common ones are red tongue and pale tongue;There are 16 kinds of tongue coating,the most common ones are thin white coating,thin yellow coating and white greasy coating;There are 23 kinds of pulse,the most common of which are pulse string,pulse thin string and pulse thin.(3)There are 49 syndrome types in total.The most common syndrome types are liver depression and spleen deficiency,qi stagnation and blood stasis,liver and gallbladder damp-heat syndrome and liver and kidney yin deficiency syndrome.(4)There are 300 kinds of traditional Chinese medicine,with a frequency≥ 50.The first 30 kinds of traditional Chinese medicine are atractylodes macrocephala,paeonia lactiflora,salvia miltiorrhiza,poria cocos,turmeric,bupleurum chinense,turtle shell,angelica sinensis,red peony root,licorice,orange peel,astragalus membranaceus,artemisia,codonopsis pilosula,cauliflower,coptis,fructus aurantii,peony skin,gardenia,hedyotis diffusa,raw ground,oyster,radix pseudostellariae,zedoary rhizome,alisma orientalis,roasted licorice,corydalis,peach kernel,coix seed,and magnolia officinalis.There are 9 kinds of sexual taste,with slight cold,mild and warm being the most common;There are 11 kinds of medicine,mainly bitter,sweet and bitter;There are 12 meridians,mainly liver,spleen and lung.(5)Herb Rank analysis of drug weight: TH values from high to low are:atractylodes macrocephala,white peony,salvia miltiorrhiza,poria cocos,turmeric,bupleurum chinense,turtle shell,angelica sinensis,red peony,orange peel,licorice,radix astragali,wormwood,cauliflower,radix salviae miltiorrhizae,rhizoma peony,hedyotis diffusa,fructus aurantii,radix gardeniae,zedoary rhizome,oyster,radix pseudostellariae,alisma orientalis,peach kernel,rhizoma corydalis,among which,atractylodes macrocephala,radix paeoniae,salvia miltiorrhizae,poria cocos,turmeric Bupleurum chinense,turtle shell and angelica sinensis are the main core drugs,and the other drugs are the secondary core drugs.(6)Herb-herb concurrence and exclusivity analysis of drugs: set the co-occurrence level=4,co-occurrence event ≥ 20,p value less than 0.001,and the top 10 combinations of co-occurrence rate are: broussonetia papyrifera-black beans,atractylodes macrocephala-poria cocos,white peony-bupleurum,white peony-atractylodes macrocephala,bupleurum-atractylodes macrocephala,salvia miltiorrhizae-turtle shell,angelica-poria cocos,bupleurum-poria cocos,red peony-salvia miltiorrhiza,atractylodes macrocephala-tangerine peel.Set the co-occurrence level=-4,the non-co-occurrence event is greater than 200,and the p value is greater than0.001.The top five combinations of mutual exclusion rate are Atractylodes macrocephala-Gentiana,Atractylodes macrocephala-Viola,Paeonia lactiflora-Leech,Paeonia lactiflora-Paris polyphylla,Paeonia lactiflora-Viola.(7)Herb-symptom Associations: Set the event ≥ 10 through the symptom-drug confidence score to analyze the drug with the highest confidence of common symptoms.They are asthenia-atractylodes macrocephala,hypochondriac pain-white peony,epistaxis-peony skin,loose stool-atractylodes macrocephala,abdominal distension-atractylodes macrocephala,dry mouth-white peony,bitter mouth-white peony,urine yellow-white peony,nasia-atractylodes macrocephala,sleeplessness-white peony,and fatigue-atractylodes macrocephala.(8)By cluster analysis of 414 prescriptions of drugs,the co-occurrence rate was set as 0.2,the co-occurrence event was 5,and the number of modules was 10,and 10 groups of drug combinations were obtained: hedyotis diffusa-gardenia-radix pseudostellariae-alisma orientalis-peach kernel;White peony-salvia miltiorrhiza-red peony;Atractylodes macrocephala-Poria cocos-Bupleurum chinense-Angelica sinensis;Turtle shell-chicken inner gold-oyster;Yanhusuo-roasted licorice-Magnolia officinalis-Atractylodes lanceolata;Tangerine peel-wormwood-codonopsis pilosula-coix seed-yam;Rhizoma Cyperi-Fructus Aurantii-Ligusticum chuanxiong;Paeonia suffruticosa-habitat-ground beetle beetle-spargans;Licorice-astragalus;Tulip.Conclusion: Through data mining technology to summarize the experience of famous Chinese doctors in treating compensated hepatitis B cirrhosis,it can be concluded that compensated hepatitis B cirrhosis,as a common disease of the digestive system,is caused by liver dysfunction caused by multiple causes such as damp heat,epidemic toxin,diet fatigue,etc.Liver dysfunction is the source of the disease,spleen deficiency is the basis of the disease,blood stasis is the key to form sclerosis,and the disease location mostly involves the liver and spleen,The pathogenesis of the disease is mixed with deficiency and excess.Spleen deficiency,liver depression and blood stasis are the key pathogenic syndrome elements of the disease.Throughout the disease,damp-heat and yin deficiency are also common pathogenic syndrome elements.The treatment is mainly to soothe the liver,nourish the liver,strengthen the spleen,and promote blood circulation,as well as to clear heat,remove dampness,detoxify,soften and firm.The treatment is reasonably selected according to the degree of sclerosis and the length of the course of disease.In the early stage of the disease,the liver stagnation and spleen deficiency are obvious,so the drugs for dispersing the liver and strengthening the spleen are mainly used,supplemented by the drugs for activating blood circulation,and in the middle stage,the liver stagnation and spleen deficiency and blood stasis are mutually seen.In the clinical practice,both the liver and spleen stasis and blood circulation are emphasized,while in the later stage,the blood stasis is mainly used,the degree of stagnation of blood stasis is heavy,and the range of sclerosis is wide,so the drugs for activating blood circulation and removing stasis,softening hardness and dispersing stasis,and supplementing the drugs for dispersing,The progress of disease is often accompanied by the presence of other pathological products,such as damp-heat,phlegm turbidity,yin deficiency,blood heat,etc.Therefore,the methods of clearing damp-heat,removing dampness and resolving phlegm,nourishing blood and softening the liver,or clearing heat and cooling blood must be added to the basic treatment.As the main core drugs of this excavation,atractylodes macrocephala,poria cocos can strengthen the spleen and replenish qi,white peony,angelica can nourish the blood and soften the liver,bupleurum chinense and turmeric can relieve the depression of the liver,salvia miltiorrhiza and turtle shell can activate the blood and soften the hardness,which can be directly used for the treatment of asymptomatic patients with liver cirrhosis,and can also be used for patients with obvious syndrome types as the basic prescription.Among them,Baizhu and Baishao are the most widely used.The 10 drug pairs summarized and the 10 drug combinations clustered together are the most commonly used combinations by experts and scholars under the corresponding pathogenesis and syndrome types.