| BACKGROUND:Chronic obstructive pulmonary disease(COPD)is a common,preventable and treatable chronic airway disease,and the newly published GOLD 2023 defines chronic obstructive pulmonary disease(COPD)as a heterogeneous lung disease characterized by airway abnormalities(bronchiectasis,capillary bronchitis)and/or chronic respiratory symptoms(including dyspnea,cough,and sputum)caused by alveoli(emphysema),resulting in persistent,repeatedly worsening airflow obstruction.By 2020,COPD will become the world’s third leading cause of death.In treating chronic obstructive pulmonary disease,the conventional treatment in modern medicine includes oxygen therapy,mechanical ventilation,bronchodilators,glucocorticoids,and anti-infectives,etc.Currently,there are also treatment deficiencies and discrepancies between patient benefits and expectations,therefore,in this current situation,it is important to study the experience of Chinese medicine in the treatment of chronic obstructive pulmonary disease.The multi-targeted and multi-pathway approach of TCM has shown great advantages in treatment,especially in improving the health status and long-term prognosis of patients,which can effectively compensate for the shortcomings of modern medicine.Data mining technology is to analyze a large amount of data through various algorithms,search for hidden information,refine and classify it,and reflect the regular information in an orderly manner.With the help of data mining technology,we can analyze the pattern of medicine dispensing of Prof.Zhang Yongsheng,so that we can analyze the implicit experience and pattern,and realize the effective summary and inheritance of the experience of medicine dispensing in the stable stage of Chinese medicine for the treatment of chronic obstructive pulmonary disease.The content of this study is divided into two parts:1.Literature reviewThe review of literature is divided into two parts,review 1 is the progress of modern medical research on COPD,focusing on the epidemiology,risk factors,pathogenesis and pathological changes of COPD,management and treatment of COPD in the stable phase.The second review is on the research progress of Chinese medicine in the treatment of COPD in the stable stage,which compares the understanding of the etiology and pathogenesis of COPD by medical practitioners from ancient times to the present,and introduces the Chinese medicine treatment in the stable stage of COPD.2.Data mining on the treatment of stable stage of chronic obstructive pulmonary disease by Prof.Zhang Yongsheng.OBJECTIVE:Using data mining techniques,we summarized the medication and experience of Professor Zhang Yongsheng in the treatment of qi deficiency and phlegm stasis evidence in the stable stage of chronic obstructive pulmonary in recent years in his outpatient clinic,and discussed the types of medication,attribution and formula pattern,with a view to providing new ideas for the treatment of chronic obstructive pulmonary in Chinese medicine.METHODS:We collected case and prescription data of patients with stable chronic obstructive pulmonary disease from January 2018 to May 2022 from the Department of Respiratory Heat Diseases of Dongfang Hospital of Beijing University of Chinese Medicine and the outpatient clinic of Famous Doctor’s Hall,screened them according to the inclusion and exclusion criteria,organized and standardized the data of medical cases,and entered them into the "Ancient and Modern Medical Case Cloud Platform v2.3.5" software.The software was used for statistical analysis,correlation analysis,hierarchical clustering,and complex networks to explore the patterns of prescriptions and medications.Results:(1)A total of 32 patients with 234 cases were included,of which the ratio of male patients to female patients was about 3.57.The age distribution of patients ranged from 55 to 92 years old,with an average age of 69.53 years.(2)A total of 118 clinical symptoms with 910 frequencies were counted,among which the symptoms with frequencies≥30 were mainly shortness of breath,white sputum,cough,breathholding,chest tightness,and dry mouth.(3)The tongue quality and tongue coating of 234 cases were counted separately,among which those with frequency≥50 were mainly:pale tongue,fat tongue,tortuous veins under the tongue,dark tongue,and tongue with teeth marks;those with frequency≥50 were mainly:thin white coating,yellow coating,and greasy coating.(4)The pulse signs of 234 cases were counted,and those with frequency≥50 were mainly:thin pulse,slippery pulse,and sunken pulse.(5)A total of 177 Chinese herbal medicines were used,and the top 10 drugs in terms of frequency of use were:licorice,semen,astragalus,ephedra,thick park,almond,white fruit,yam,dong hua,and dogwood;in the analysis of the properties of Chinese herbal medicines,the four gases were mostly warm and flat,and very few drugs with great heat and cold were used;the five flavors were mainly sweet drugs,followed by pungent and bitter;the normalizing meridians mainly belonged to the lung,spleen,stomach,heart,and kidney meridians;the efficacy was mainly beneficial to The main effects are to promote water retention,reduce swelling,moisten the bowels,and dry dampness and resolve phlegm.(6)Using the association rule,the results of symptom-drug association showed that the support and confidence of asthma with licorice,ephedra,semen,astragalus,and phlegm color white with semen,were generally high,with good elevation,suggesting an extremely strong association between them;the results of drug-drug association showed that the support and confidence between two drugs,such as ephedra,semen,licorice,astragalus,thick park,and white fruit,were generally high.(7)Cluster analysis was performed for the top 30 drugs,and the grouping distance>11 was used as the boundary,from which six categories of commonly used combinations were obtained:the first category:yam,dogwood,white fruit,thick park,almond,astragalus,ephedra,licorice,and semen;the second category:gua hua,stiff silkworm,and coix seed;the third category:suzi,zhebeizi,and scutellaria;the fourth category:dong hua,orris,and heliotrope;the fifth category:poria,atractylodes,rhodiola The sixth category:Salvia miltiorrhiza,Radix Angelicae Sinensis,Radix et Rhizoma prunus,Radix et Rhizoma Macrocephala,Fructus Schisandrae,Rhizoma Polygonati,Radix et Rhizoma Dioscoreae.(8)The complex network diagram was taken out with side weights>30,and the core prescriptions were obtained:ephedra,semen,licorice,astragalus,houpo,yam,almond,white fruit,cornelian,angelica,salvia,dang shen,dong hua,and atractylodes.Conclusion:(1)Using the "ancient and modern medical case cloud platform" to analyze Professor Zhang Yongsheng’s outpatient cases for the treatment of stable stage of chronic obstructive pulmonary disease,and the location of the disease was mainly in the lung and kidney,involving the spleen and stomach,heart and liver in the stable stage of qi deficiency and phlegm stasis.The nature of the disease is deficiency at the origin and the symptoms are real.The deficiency at the origin involves the failure of qi in many organs,and the symptoms are phlegm and phlegm stasis blocking the ligaments.(2)Professor Zhang Yongsheng’s treatment of chronic obstructive pulmonary disease is based on the rule of warmth,the use of cold and warmth,and the use of sweet medicine to supplement and benefit,together with the use of pungent,bitter,and descending medicines to open and vent the lung qi.The treatment method is established around opening and promoting lung qi,lowering qi and calming asthma,stopping cough and resolving phlegm,benefiting qi and invigorating blood,resolving phlegm and clearing ligaments,nourishing kidney and moistening lung,and nourishing yin and generating fluid.(3)The refined core prescriptions reflect that Professor Zhang Yongsheng often treats both the symptoms and the root cause of chronic obstructive pulmonary disease,taking into account multiple organs,nourishing the deficient and dipping the actual,and adjusting the functions of the internal organs. |
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