Study On The Medication Rule Of Professor Wei Wei’s Experience In The Treatment Of Functional Diarrhea Based On Data Mining

Objective: To summarize Professor Wei Wei’s medication experience and compatible characteristics in the treatment of functional diarrhea(FDr),better understand and apply his clinical thinking and medication skills of treatment based on disease differentiation,and provide reference for the clinical treatment of FDr.Methods: The case records of Professor Wei’s treatment of FDr in the outpatient clinic of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine from September 2018 to September 2022 were collected.The cases were screened according to the inclusion and exclusion criteria.Sex,age,symptom,pattern type,treatment method-formula-medicine,as well as name,category,property,flavor,and meridian affinity of Chinese medicines were analyzed by frequency,clustering,and association rules using the“Computing Platform of Traditional Chinese Medicine Inheritance(V3.0)”to obtain high-frequency core medicines,commonly used medicinal combinations and medication association rules,etc.Combined with Professor Wei’s clinical practice and experience,the principle-method-formula-medicinal relations of the FDr treatment based on pattern differentiation and the potential enlightenment of new formulas to clinical thinking were evaluated.Professor Wei’s medication rules for the treatment of FDr were studied.Results:1.92 cases were included in this study,with high incidence rates concentrated in the age group of 27 to 38 years old,affecting mainly young and middle-aged adults,which accounted for 48.91% of the total.Men were more affected than women,but the ratio of males to females(48 men,44women)was not significantly different.2.The most frequent symptoms were loose stools,increased frequency of bowel movements,dry mouth,and a bitter taste successively.Typically,the tongue was pale red with yellow,greasy coating,and the pulse was thin,wiry and slippery.Eight pattern types were found as follows(according to the frequency in order from highest to lowest): internal retention of damp-heat pattern(43),spleen deficiency with phlegm dampness pattern(35),spleen and stomach weakness pattern(21),liver stagnation with spleen deficiency pattern(9),qi and yin deficiency pattern(4),combined cold and heat pattern(2),yang deficiency of the spleen and kidney pattern(1),and internal exuberance of cold dampness(1).The top 10 most-used treatment principles and methods included circulating qi and harmonizing blood(55),drying dampness and strengthening the spleen(31),clearing heat and drying dampness(31),ascending the nutrients and descending the turbid(19),drying dampness and circulating qi(15),strengthening the spleen and tonifying qi(11),clearing heat and transforming dampness(10),suppressing the liver and strengthening the spleen(7),strengthening the spleen and transforming dampness(5),and tonifying the kidney and stopping diarrhea(3).3.Among the 116 formulas,Professor Wei employed 113 kinds of Chinese medicines,with the cumulative total frequency of 1706 for single medicine.Warm-property medicines were most frequently applied,followed by cold and cool-property ones.Mainly “bitter,pungent,sweet and sour” in flavor,these medicines are mostly attributive to the spleen,stomach,lung and liver meridians.The top 18 most-used medicines were Fuling(Poria),Gancao(Radix Glycyrrhizae),Wuzhuyu(Fructus Evodiae,Huanglian),Huanglian(Rhizoma Coptidis),Binglang(Semen Arecae),Baishao(Radix Paeoniae Alba),Muxiang(Radix Aucklandiae),Zhiqiao(Fructus Aurantii),Dangshen(Radix Codonopsis),Baizhu(Rhizoma Atractylodis Macrocephalae),Zexie(Rhizoma Alismatis),Shengma(Rhizoma Cimicifugae),Roudoukou(Semen Myristicae),Yiyiren(Semen Coicis),Fangfeng(Radix Saposhnikoviae),Banxia(Rhizoma Pinelliae),Houpo(Cortex Magnoliae Officinalis),and Guanghuoxiang(Herba Pogostemonis).The drug frequency analysis showed that the top 10 most-used categories of medicines contained tonic medicines,urination-promoting and dampness-draining medicines,qi-regulating medicines,interior heat-clearing medicines,exterior-releasing medicines,dampness-transforming medicines,interior-warming medicines,parasite-expelling medicines,astringing medicines,as well as phlegm-transforming cough-stopping and panting-alleviating medicines.The core combination frequency analysis revealed that the most frequent medicinal pair,triangular combination,and quadrangular combination were“Fuling(Poria)and Gancao(Radix Glycyrrhizae)”,“Fuling(Poria),Gancao(Radix Glycyrrhizae)and Wuzhuyu(Fructus Evodiae,Huanglian)”,and“Fuling(Poria),Gancao(Radix Glycyrrhizae),Wuzhuyu(Fructus Evodiae,Huanglian)and Binglang(Semen Arecae)” respectively.The best association rule for medicinal pairs indicated “Binglang(Semen Arecae)and Fuling(Poria)”(S=55%,C=100%).The core medicines of the formulas include Fuling(Poria),Gancao(Radix Glycyrrhizae),Wuzhuyu(Fructus Evodiae,Huanglian),Huanglian(Rhizoma Coptidis),Binglang(Semen Arecae),Baishao(Radix Paeoniae Alba),Muxiang(Radix Aucklandiae),and Zhiqiao(Fructus Aurantii),which may be combined according to differentiated patterns.According to statistics of high-frequency medicines for common pattern types,internal retention of damp-heat pattern requires a greater focus of attention on Fuling(Poria)and Huanglian(Rhizoma Coptidis);spleen deficiency with phlegm dampness pattern,on Wuzhuyu(Fructus Evodiae,Huanglian)and Binglang(Semen Arecae);spleen and stomach weakness pattern,on Dangshen(Radix Codonopsis)and Baizhu(Rhizoma Atractylodis Macrocephalae);liver stagnation with spleen deficiency pattern,on Baishao(Radix Paeoniae Alba)and Baizhu(Rhizoma Atractylodis Macrocephalae);qi and yin deficiency pattern,on Baishao(Radix Paeoniae Alba)and Dangshen(Radix Codonopsis).Five potential new formulas were obtained from the cluster analysis as below:(1)Fuling(Poria),Gancao(Radix Glycyrrhizae),Baishao(Radix Paeoniae Alba),Baizhu(Rhizoma Atractylodis Macrocephalae),Huanglian(Rhizoma Coptidis),and Dangshen(Radix Codonopsis),(2)Fuling(Poria),Gancao(Radix Glycyrrhizae),Wuzhuyu(Fructus Evodiae,Huanglian),Guizhi(Ramulus Cinnamomi),Dangshen(Radix Codonopsis),and Huanglian(Rhizoma Coptidis),(3)Fuling(Poria),Gancao(Radix Glycyrrhizae),Binglang(Semen Arecae),Wuzhuyu(Fructus Evodiae,Huanglian),Huanglian(Rhizoma Coptidis),and Zhiqiao(Fructus Aurantii),(4)Huanglian(Rhizoma Coptidis),Fuling(Poria),Wuzhuyu(Fructus Evodiae,Huanglian),Gancao(Radix Glycyrrhizae),Binglang(Semen Arecae),and Chaihu(Radix Bupleuri),and(5)Fuling(Poria),Gancao(Radix Glycyrrhizae),Wuzhuyu(Fructus Evodiae,Huanglian),Huanglian(Rhizoma Coptidis),Binglang(Semen Arecae),Baizhu(Rhizoma Atractylodis Macrocephalae)”.Conclusion(s): According to Professor Wei Wei,with the main pathogenesis of spleen deficiency and dampness retention,FD typically manifests as combined deficiency and excess patterns.However,as exogenous pathogenic factors,diet,emotions,constitution,habits and other factors intertwine with one another in the pathological process,various pattern types including cold dampness,damp heat,phlegm dampness,combined cold and heat,liver qi stagnation,as well as qi,blood,yin and yang deficiency patterns may occur concurrently.In dealing with the evil of dampness,drying,draining and transforming methods should be emphasized,and qi movement of ascending and descending should be properly regulated.Only when dampness is removed,can the spleen maintain its function of transportation.