Research On The Clinical Usage Rules Of Gastroesophageal Reflux Disease Based On Literature Data Mining

Objective:In this study,gastroesophageal reflux disease(GERD)was the research object,a retrospective study was conducted through the collation of the literature,a database was established,an auxiliary system was passed through traditional Chinese medicine(TCM)with the help of frequency statistics and association rule analysis as the main analysis method,and the rules of syndrome differentiation and drug use in the treatment of gastroesophageal reflux disease by various physicians were analyzed and mined to initiate the ancient day,so as to provide reference and borrowing for the clinical use of TCM in the treatment of greds.Method : Through the collection of the medical and case notes and literature in the Chinese medical classical(Fifth Edition)on the treatment of gastroesophageal reflux disease and the clinical case notes on the use of traditional Chinese medicine for gastroesophageal reflux disease that were publicly published in the China journal full text database(CNKI)from December 2013 to December 2022,the literature was secondarily screened according to the inclusion and exclusion criteria,and after the data were normalized,it was entered into an excel form,The databases of ancient and modern prescriptions for gastroesophageal reflux disease were established respectively,and the data were then imported into an auxiliary system of TCM inheritance(version V3.0)to mine the data using frequency analysis,association rules,and cluster analysis.Summary the analysis of ancient and modern common medicines with core group formula,by contrasting ancient and modern medicines,and mining the rules of medicine,is expected to better guide clinical practice..Result:A total of 2060 articles from relevant ancient literatures were included in the study,and 192 effective prescriptions were screened,involving157 traditional Chinese medicines;With a total of 358 articles in the modern literature,184 effective prescriptions were screened,involving 234 traditional Chinese medicines.1.Drug frequency analysis:The main drugs that were frequently used by ancient doctors for the majority of cases are: Chen PI,Gancao,Banxia,Poria,Atractylodes macrocephala,Panax ginseng,dried ginger,Magnolia officinalis,Rhizoma Atractylodis Macrocephalae,cinnamomi,Coptidis Rhizoma,bupleurum falcatum,habenula hispanica,evodiam,Paeonia lactiflora,etc;The drug resistance is mainly warm,flat,cold and heat;The medicine taste was based on Xin,bitter,Gan and salty;Return is dominated by spleen meridian and stomach meridian,followed by lung meridian,heart meridian and liver meridian;The drug efficacy has the advantages of warming medium and eliminating deficiency,invigorating spleen qi,eliminating dampness and eliminating phlegm,reducing reverse and stopping vomiting,draining liver and excreting heat,and preparing acid and relieving pain,and is based on toning deficiency,clearing heat,regulating qi,and eliminating dampness.2.Group association rules / clustering analysis:(1)Ancient prescribing rules / cluster analysis results: 32 common drug pair combinations were derived by association analysis,containing combinations involving the core traditional Chinese medicine 13 herbs,and the top ranked combinations were: Chenpi Gancao;Chenpi Poria;Chen PI Banxia;Licorice Poria et al;The drug pairs with confidence levels ranging from high to low were: Glycyrrhiza pallidum Chen PI;Gancao Fuling Chen PI;Pallidum Chen PI et al;Cluster analysis extracted a total of 4 core classes square,the first class: pallium Atractylodis macrocephala cortex-Magnolia cortex-Glycyrrhizae Radix Praeparata-Poria cocos;Class II: liquorice-dried ginger-Baizhu-Ginseng-cinnamon-Chenpi;Class III: Woody--Chenpi--sandren--Gancao--Qingpi--Curcumae Rhizoma;Class IV: Chenpi Banxia Huanglian Fuling Gancao Huangqin.(2)Results of modern prescribing rules / cluster analysis: 108 combinations of commonly used drug pairs were derived by association analysis,containing 20 herbs involved in the core traditional Chinese medicine;The top ranked combinations were: Huanglian Banxia;Coptidis Fructus;Gancao Huanglian et al;The pairs with confidence from high to low were: Chenpi-evodiam-Huanglian;Hyoscis evodiam Coptidis;Chaihu evodiam Huanglian et al;Cluster analysis extracted four core classes formula,the first class: Pinellia Radix Glycyrrhizae-Poria cocos-Bupleurum Radix-Coptidis-Paeonia lactiflora;Class II: Gancao Baizhu Huanglian Banxia Fuling Dai ochre;Class III: liquorice Chaihu Shaoyao Huanglian guar Banxia;Class IV: habenula--Chenpi--Huanglian--Banxia--evodiam--Gancao.3.Basic information of modern prescriptionAmong 184 modern clinician cases,there were 105 females and 79 males,and the age group was dominated by those aged 50-59 years;A total of 48 tongue images,which were reddish and greasy,light red and thin yellow in color,were observed;Eight common tongue image combinations were analyzed based on the FP Tree Optimization Algorithm association rule;The top three levels of confidence were: thick tongue with thin whitish coat and dentate marks;The tongue was pale with dental marks on its sides;Tongue red,lichen yellow thick;The vasculature is predominantly choroidal synostosis,fine chords,and sinusoids.4.Modern prescription symptom / syndrome analysis:In total,152 symptoms were observed,and the most frequent ones were antacid(163 times),eructation(95 times),heartburn(94 times),nalyze(92times),and mouth pain(89 times);Association analysis resulted in 29 symptom combinations comprising 9 symptoms;Cluster analysis was performed using the k-means algorithm to extract 3 categories of core symptom combinations,the first category: antacid-dry mouth-dizziness-retrosternal pain-dry stool junction;Class II: acid aversion eructation nadir burning stool erosions;Class III: antacid mouth soreness poor sleep-dry mouth eructation;A total of 46 syndromes occur frequently,with liver and stomach depression syndrome,liver and stomach discord syndrome,liver and spleen deficiency syndrome,and Qi Yu phlegm and obstruction syndrome being the most common.Conclusions:1.The core medicines used by ancient doctors in the treatment of gastroesophageal reflux disease are: Chen PI,Gancao,Banxia,Poria,Atractylodes macrocephala,Panax ginseng,Coptidis Rhizoma,Bupleurum chinense,and habonella hispanica..2.The drug efficacy is based on toning deficiency medicine,Wenli medicine,clearing heat medicine,Qi medicine and moistening medicine the most,and the disease mechanism of visible GERD is mainly spleen and stomach weakness,dampness heat block and Qi machine reverse.3.The analysis resulted in eight cluster core formula combinations,and the formula consistently revolved around classic formulas such as di Chen decoction,Si Jun Zi decoction,Banxia Lianxin decoction,and Xiao Chaihu Decoction;The medicines used were based on warmth,flat and cold,while the medicinal taste was dominated by Xin,bitter and Gan,which established the direction of medicines in warming deficiency supplementation,hard work dampness and Gan palliation.4.Ancient and modern physicians in the treatment of gastroesophageal reflux disease advocated taking the weakness of the spleen and stomach as the foundation,being good at using sweet and warm products to warm up the middle energizer,and hard products to regulate the Qi machine.The characteristics of the medication were the combination of cold and heat,pungent opening and bitter reducing,supplemented with heat clearing and inverse reducing,Qi regulating and stomach,acid making and pain relieving methods,closely adhering to the basic pathogenesis of "spleen deficiency as the foundation,Qi inverse as the standard",and being good at using drug pairs in the clinic,and treating according to syndrome differentiation..