Development And Research Of Clinical Decision-making Support Scheme For Stroke Based On Data Mining Of Ancient Chinese Medical Book

Background:Stroke,also known as cerebral apoplexy in modern medicine,is a neurological deficit syndrome caused by local blood circulation disorders in the brain.Epidemiology shows that stroke is the main cause of disability and death in adults worldwide,with high disability and mortality rates,posing a great burden on patients and society.At present,there are efficacy bottlenecks in the clinical diagnosis and treatment of stroke in both traditional Chinese and Western medicine.How to break the bottleneck and improve the efficacy is the focus of attention in the field of traditional Chinese medicine.The rich and reliable information in ancient Chinese medicine books is the source of the inheritance and development of traditional Chinese medicine.Currently,there is a phenomenon of insufficient application of knowledge in ancient Chinese medicine books in traditional Chinese medicine clinical practice,which affects the improvement of clinical diagnosis and treatment efficacy of stroke.Objective:To sort out and explore the relevant content of stroke in 600 ancient Chinese medicine books,and analyze the law of " disease pulse syndrome combined treatment" of stroke in ancient Chinese medicine books.Based on literature research and data mining results,a clinical decision-making assistance plan for stroke based on traditional Chinese medicine ancient books is constructed to demonstrate the overall diagnosis and treatment approach of ancient physicians towards stroke,in order to provide reference for contemporary stroke clinical diagnosis,treatment,and scientific research with ancient book data.Methods:In this study,the terms of "stroke" related ancient books were used as the key words.Through searching the knowledge sharing service platform of traditional Chinese medicine ancient books,we screened out the causes,pathogenesis,symptoms,prescriptions,acupuncture and moxibustion and other contents that were consistent with the stroke,and then put them into Microsoft Excel 2019 to build the knowledge database of stroke ancient books.Use Python 3.8 combined with manual inspection to standardize and proofread data,use Python third-party database Pandas for frequency statistics and Delphi method method for suvey index calculation,Apriori module for association rule analysis,and Networkx database for visual display of relevant charts;Using Lantern 5.0 software to achieve modeling and analysis of hidden structure models.According to the results of data analysis,combined with the supplementary opinions of the subject expert group,the first draft of the TCM Clinical Assistant Decision making Scheme for Stroke Based on Ancient Chinese Medicine Books was constructed,and the final draft was revised after the Delphi method method was used to carry out expert argumentation in many places across the country.Result:Study 1:A total of 1410 original texts of traditional Chinese medicine knowledge were included.○ 1 Frequency analysis results:There are 6 types of causes involved in the original text of all knowledge subjects,including overwork,emotional disorders,internal injury accumulation and damage,invasion of external pathogens,improper diet,and aging and physical decline;There are 135 types of pathogenesis involved,with 32 high-frequency pathogenesis(frequency>10 times),including wind phlegm obstruction,qi and blood deficiency,wind meridians,deficiency of vital energy,internal movement of liver wind,disorder of qi and blood,qi deficiency,wind organs in the wind,excessive fire heat,deficiency of kidney essence,stroke due to positive deficiency,excessive phlegm fire,yin deficiency and yang hyperactivity,phlegm dampness obstruction,phlegm obstructing the mind,phlegm fire closure,disturbance of wind and fire,deficiency of essence and blood,excessive yin deficiency and fire,blood deficiency,phlegm heat movement of wind,yin deficiency and wind movement Qi and blood stasis,wind cold closure of the body,loss of vital energy,internal movement of deficiency wind,deficiency of kidney yin,yang deficiency,liver and kidney deficiency,liver wind entrapment of phlegm,hyperactivity of liver yang,and internal obstruction of blood stasis;There are 424 types of symptoms involved,including 42 high-frequency symptoms(frequency>20 times),including dizziness,hemiplegia,sudden fall,language difficulty,mouth eye deviation,limb weakness,limb numbness,strong tongue,phlegm and saliva obstruction,silence,dizziness,mouth silence,excessive sweating,constipation,closed jaw,facial redness,paralysis,enuresis,salivation in the corners of the mouth,limb twitching,limb pain,mouth opening,eye closure,hand movement,limb tightness,wheezing Muscle and pulse cramps,lack of appetite,poor urination,headache,partial numbness,deafness,cold limbs,nasal snoring,mouth deviation,loss of voice,muscle and flesh sensation,phlegm in the throat,blurred vision,chest tightness,excessive saliva in the mouth,and trance;There are 34 types of tongue images involved,among which 6 are high-frequency tongue images(frequency>2 times),including red tongue,yellow fur,greasy fur,rolled tongue,black fur,and white greasy fur;There are 27 types of pulse signals involved,including 8 high-frequency pulse signals(frequency>50 times),namely pulse string,pulse large,pulse number,pulse smooth,pulse floating,pulse sinking,pulse thin,and pulse flood;There are 430 types of traditional Chinese medicines involved,including 54 high-frequency drugs(frequency>50 times),including licorice,ginseng,Poria cocos,Pinellia ternata,Angelica sinensis,Fangfeng,Atractylodes macrocephala,Aconite,Gastrodia elata,White peony,Ginger,Chuanxiong,tangerine peel,cinnamon,ephedra,cooked rehmannia,Qianghuo,Tiannanxing,Acorus tatarinowii,Zhuli,Ophiopogon japonicus,Astragalus membranaceus,Scutellaria baicalensis,Achyranthus bidentata,Antelope horn,Angelica sinensis,Rehmannia glutinosa,Silkworm,Chuanwu,Gentiana macrophylla,Polygala,Fushen,tangerine,musk,chrysanthemum,etc Bitter almonds,asarum,jujube,dried ginger,dendrobium,cinnabar,scorpion,gypsum,angelica dahurica,woody incense,cornus officinalis,Fructus aurantii,Cistanche deserticola,Fangji,borneol,Bupleurum chinense,Schisandra chinensis,bezoar;The medicinal properties are mainly warm,mild,and cold(frequency>1000 times);The medicinal taste is mainly sweet,spicy,and bitter(frequency>3000 times);The main meridians are the spleen,lungs,liver,heart,stomach,and kidney meridians(frequency>2300 times);Medicines are divided into 25 categories,with the first 5 being dispersing wind and cold medicines,calming wind and antispasmodic medicines,tonifying qi medicines,regulating qi medicines,and warming the internal organs;Acupuncture and moxibustion involves 36 kinds of acupoints.○ 2 Association rule analysis results:Symptom association analysis set support≥4%and confidence≥ 40%,resulting in 12 groups of strong association rules,4 groups of binomial association rules,and 8 groups of three association rules.The correlation analysis of symptoms and pulses was set with a support level of≥ 7%and a confidence level of≥ 40%,resulting in 27 groups of strong association rules,including 17 groups of two associations and 10 groups of three associations;The support level and confidence level of symptom drug association analysis were≥ 2%and≥ 30%,resulting in 75 groups of strong association rules,including 34 groups of two associations and 41 groups of three associations;The drug association analysis was set with a support level of≥ 10%and a confidence level of ≥70%,resulting in 48 groups of strong association rules,including 8 groups of 2 association rules,32 groups of 3 association rules,and 8 groups of 4 association rules.○ 3 Hidden structure model analysis,incorporating 77 symptoms(i.e.explicit variables)to construct a hidden structure model for stroke symptoms,obtaining 14 hidden variables.Through model interpretation and comprehensive clustering,8 traditional Chinese medicine syndrome types were identified,including yang closure(phlegm heat closure of the orifices),yin closure(phlegm dampness and obstruction of the orifices),de syndrome(loss of vital energy),wind yang internal movement,yin deficiency wind movement,heat pole wind generation,true stroke(wind meridians in the wind),and true stroke(wind organs in the wind);Incorporating 83 Chinese herbal medicines to construct a hidden structure model for stroke,33 hidden variables were output.Through model interpretation and comprehensive clustering,17 formulas were summarized,and the syndrome was measured by formulas.Then,13 syndrome types were derived,including Yin Yang deficiency,liver kidney deficiency,kidney yin deficiency,wind phlegm obstruction,phlegm dampness obstruction,spleen stomach qi deficiency,qi deficiency phlegm obstruction,wind heat stagnation,qi deficiency stroke,phlegm fire obstruction,phlegm heat obstruction,qi deficiency obstruction,phlegm stasis obstruction.Study 2:Delphi method investigation.Develop the first draft of the "Clinical Assistance Decision Plan for Stroke Based on Traditional Chinese Medicine Classics" and the first round of expert questionnaire survey.Revise the questionnaire based on the results of the first round of expert questionnaire survey and distribute the second round of expert questionnaire survey.The positive coefficients of experts in both rounds of questionnaire surveys were 100%.On this basis,based on the results of two rounds of questionnaire surveys and the supplementary opinions of the project expert group,the preliminary draft of the plan was revised to form the final draft of the "Traditional Chinese Medicine Clinical Assistance Decision Plan for Stroke Based on Ancient Chinese Medicine Books".Conclusion:This study uses the combination of documentary research and data mining technology to comprehensively sort out and mine the law of "treatment of disease pulse and syndrome" of stroke in 600 kinds of ancient Chinese medical books,build the first draft of"TCM clinical auxiliary decision-making scheme for stroke based on ancient Chinese medical books",and later incorporate the opinions of dozens of clinical experts nationwide through the Delphi method method,and synthesize the supplementary opinions of the subject expert group,Revise the initial draft of the plan and explore the formation of the final draft of the "Stroke Clinical Assistance Decision Plan Based on Traditional Chinese Medicine Ancient Books",making the formulation of the stroke clinical assistance decision plan more objective,scientific,and practical,promoting the transformation of ancient book research results into auxiliary clinical practice,expanding the application scope of traditional Chinese medicine ancient book knowledge in stroke clinical diagnosis and treatment,and providing ancient book data reference for the revision of traditional Chinese medicine diagnosis and treatment guidelines,Realized two-way interaction between ancient Chinese medicine books and clinical practice.