To Explore The Clinical Medication Rule Of Professor Hu Yueqiang In Treating Dementia Based On The Real World

Objective: Based on data mining technology in the real world,this study sorted out,counted and analyzed the previous cases of Professor Hu Yueqiang’s treatment of dementia,and summarized the experience of Professor Hu Yueqiang’s treatment of dementia in the real world.Methods: Clinical data of dementia patients who met the inclusion criteria and were treated in the Department of Encephalopathy,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from June 2020 to June 2022 were selected.After data cleaning,the data were imported into the web version of the cloud platform of ancient and modern medical records(website :https://www.yiankb.com/).Through the statistical analysis,cluster analysis and association rule analysis sections of the platform,gender,age,TCM syndrome type,tongue and pulse pattern,clinical symptoms,high-frequency Chinese medicine,aconite dosage,four Qi and five flavor channels were analyzed,and the clinical medication rules of Professor Hu Yueqiang in the treatment of dementia were summarized and condensed.Results: A total of 140 dementia cases and 291 TCM prescriptions were included in this study.Data were analyzed through the platform,and the main results were as follows:1.General information: A total of 140 cases and 291 prescriptions were included in this study.Among them,61 were males and 79 were females,with composition ratios of 43.57% and 56.43%,respectively.The age of onset is mostly between 70 and 89 years old,and the incidence of female is relatively higher than that of male.2.TCM syndromes and clinical symptoms: The main syndromes of dementia were spleen and kidney deficiency syndromes(120 times).The second was syndrome of phlegm turbidity and Mongolian orifice and syndrome of blood stasis blocking collaterals(93,63 times);The rare syndrome was Qi and blood deficiency(15 times).A total of 58 clinical symptoms were involved,among which the first 15 were warm limbs,sore waist and knees,dry teeth and burnt hair,difficult walking,dizziness and tinnitus,clear and long urine,dark complexion,epigastric tightness and nausea,forgetfulness,pain and pleasure,stuffy epigastric swelling,indifferent expression,abnormal thinking,cold shape and cold limbs,and heavy head.3.Tongue pulse: A total of 8 types of tongue were involved,and the first5 types were pale tongue(57.04%),fat tongue(16.15%),dark tongue(15.12%),dark tongue with ecchymoid(9.28%)and red tongue(8.59%).There were 6 kinds of tongue coating involved in total,which were thin white coating(31.96%),little coating(19.93%),white and greasy coating(19.24%),white coating(15.46%),greasy coating(12.71%)and no coating(0.69%).A total of 13 types of pulse were involved,and the top 5 types were smooth pulse(30.93%),dull pulse(28.53),thin and astringent pulse(17.53%),thin and weak pulse(11.68%),and weak pulse(2.41%).4.Traditional Chinese medicine with high frequency: A total of 121 traditional Chinese medicines were involved in the statistical analysis of 291 prescriptions,with a frequency of 3084.Frequency is higher the first 30 taste of traditional Chinese medicine is main licorice respectively,aconite,stone calamus,rhizoma ligustici wallichii,astragalus root,safflower,notoginseng,pinellia,ginger,dried ginger,dried tangerine or orange peel,cassia twig,epimedium,hawthorn,codonopsis,radix curcumae,poria cocos,radix bupleuri,angelica,keel,oysters,amomum fruit,peach seed,atractylodes,twotooth achyranthes root,radix paeoniae rubra,rhizoma atractylodis,bitter orange,platycodon grandiflorum and god eight.5.Aconite dosage: Aconite was used in 144 of 291 prescriptions,49.48%(144/291)of which contained aconite.The minimum dose was 6g,the maximum was 70 g,and the most used dose was 15g(45.14%).The common dosage of aconite fluctuates between 15-45 g.6.The four Qi and five flavors of traditional Chinese medicine(TCM):A total of 121 TCM were involved.According to the statistics of the four qi,the frequency of warm medicine was the most,1239 times(40.18%),followed by that of peaceful medicine,611 times(19.81%).According to the statistics of the five flavors of traditional Chinese medicine,the frequency of use of occinative medicine was the most,1717 times(55.67%),followed by the frequency of use of sweet medicine,1497 times(48.54%),and the frequency of use of bitter medicine,1017 times(32.98%).According to the statistics,the five viscera channels were the main channels: liver channel(42.83%),spleen channel(41.67%),heart channel(37.61%),stomach channel(35.67%),lung channel(34.53%)and kidney channel(23.44%).7.Association rules and cluster analysis: Association rule analysis(confidence level ≥0.8,support level ≥0.2)and cluster analysis were performed on 121 Chinese medicines in the study.A total of 27 pairs of drugs were obtained,of which 8 were confidence level ≥0.9 and 10 were cooccurrence level ≥85.Among them,the higher co-occurrence rate is safflower-Ligusticum Chuanxiong,ginger-Pinellia pinellia,pinellia pinellia-calamus,pinellia pinellia-cassia twig,ginger-calamus stonecuta,dried ginger-aconite.The first 30 Chinese herbs with high frequency were selected for clustering,and a total of 5 clusters were obtained.The first category was:Gladiolus calamus,turniflora,atractylodes,tangerine peel,poria cocos,cassia twig,hawthorn,pinellia pinellia and ginger.The second category: processed licorice,aconite,panax notoginseng,Epimedium,astragalus,dried ginger;The third category: Safflower,Ligusticum Chuanxiong,Bupleurum Radix,Angelica sinensis,peach kernel,Radix Paeoniae,platycodon grandiflorum,Radix rhizoma urantii,Fructus aurantii;The fourth category: codonopsis,white art,Fu God,sand kernel,keel,oyster.These four kinds of prescriptions are Guizhi method,Sini method,Xuefu Zhuyu decoction and soil cultivation method based on regulating medium coke,which are common basic prescriptions for treating dementia.Conclusion(s): Professor Hu Yueqiang,my supervisor,has rich experience in the clinical treatment of dementia.Through analyzing the medical records of my supervisor in the clinical treatment of dementia,the following conclusions are drawn:1.The main syndromes of dementia are the deficiency of spleen and kidney,and the deficiency of kidney Yang is the main symptom,and the symptoms are more Yang deficiency,followed by the syndrome of phlegm turbidity and Mongolian body circulation and blood stasis.Professor Hu Yueqiang,the tutor,believed that the fundamental pathogenesis of dementia was the deficiency of Yuan Yang,which resulted in the deficiency of five viscera organs and the loss of divine machinery.Deficiency of five viscera organs,imbalance of qi,blood and body fluid,endogenous phlegm stasis turbidities poison are important signs of dementia.In the treatment of syndrome differentiation of the six channels,in the early stage of the disease mostly belong to the three Yang channels,the first use of cassia Zhi method,Xuefu Zhuyu decoction to reduce phlegm stasis to make Yang qi unblocked;With the development of the disease to the three Yin meridian,with the four reverse method to reduce temperature and supplement Yuan Yang,with the conditioning of the spleen soil,and finally restore the balance of Yin and Yang.2.There are 30 commonly used medicines,which are processed licorice,aconitum,calamus,Ligusticum Chuanxiong,Radix astragalus,safflower,panax notoginseng,pinellia pinellia,ginger,dried ginger,Tangerine peel,cassia twigs,Epimedium,hawthorn,codonopsis,turpentine,poria,bupleurum,Angelica,keel,oyster,sand kernel,peach kernel,white art,rhizome,red peony,atractylodes,Fructus aurantii,Rhizoma grandiflori,and Fu Shen.The choice of drugs mainly to Xin,temperature,belong to the five Zang.It can be seen that the tutor attaches importance to Yang qi and the five Zang organs in the treatment of dementia.