Study On TCM Syndrome And Treatment Regular Rule Of Chronic Hepatitis B Based On Clinical Scientific Research Information Sharing System

Background and0bjectiveOur country is a high incidence of chronic hepatitis B, whichis widely epidemic and difficult to completely cure, it is estimatedthat more than93,000,000hepatitis B virus carrier in our country,and over20,000,000people has chronic hepatitis B.In which10-20%may develop into hepatic cirrhosis,1-5%can evolve intohepatocellular carcinoma, it is caused huge economic losses and theconsumption of resources, but also posed a serious threat topeople’s health and social productivity, it is one of the mostserious public health problems faced by our country. Chinesemedicine is the precious wealth of Chinese people, is thecrystallization of the wisdom of the ancient, is Chinnese mostoriginal field. Strengthen the research on traditional Chinesemedicine in the treatment of chronic hepatitis B, is of greatsignificance to improve our ability of prevention and treatment ofchronic hepatitis B. Chinese medicine treatment in hepatic diseasehas its Chinese medicine theory, and a system with long history,accumulated a large amount of clinical experience. Since60yearsof the last century clinical treatment of Chinese medicine is widely used in the related diseases of hepatitis B virus, and get a lotof the clinical and experimental study with it. The world today isthe age of big data, that is as a great resource, innovation modelto solve the problem by data has been paid attention to more andmore. The large data theory and research method is applied to theclinical and scientific research of TCM, will bring revolutionarychange to traditional Chinese Medicine. In this study, through theconstruction of hepatic disease clinical research informationsharing system,to form the basic information platform ofintegration of clinical research, based on the massive clinicalinformation, to carry out scientific research and clinicalpractice on the data of the real world, then we can find TCMclinical experience, rules and problems, verify the clinical effectof traditional Chinese medicine, find the clinical curative effectof TCM related rules.In this study, chronic hepatitis B as the research object,analysis of chronic hepatitis B distribution characteristics of TCMsyndromes and syndrome differentiation and treatment of drug rules,to provide reference for the establishment of standardization ofTCM diagnosis and treatment mode, also to provide the basis theoryfor regulating the differentiation of chronic hepatitis B treatment,improving the level of diagnosis and treatment.Methods: Our study is divided into three partes.Part one:the study on construction of hepatic disease clinicalresearch information sharing systemFirst, we collect the clinical term from the three basic aspectsof teaching materials, standard, literature, then establish TCMhepatic disease clinical basic term set, formulat structured electronic medical record based on the clinical basic terminologyand hepatic disease in TCM diagnosis and treatment scheme, formatof liver structured electronic medical record template set, fullyintegrated hospital information resources, we use the moderninformation and network technology, to construct the system ofsharing digital, information, network of Chinese medicine clinicaldata supporting platform and management services, called clinicalresearch information sharing system,which has the ability ofwhole clinical information collection, collation and analysis,achieve clinical research based on the real data.Part two: Study on chronic hepatitis B syndrome rule based onsharing systemBased on clinical research information sharing system, wecollect the information of inpatients with chronic hepatitis B byapplicating of structured electronic medical records. The data iscollecting from patients with diagnosis of chronic hepatitis B whoinpatient in the year of2002to2013,a total of1200cases.Analysising, conversing, cleaning, processing the collecting data,and import data that we need into Data warehous. Using theintegration of clinical research technology platform and complexnetwork technology. Analysising the basic information, tongue,pulse and symptoms, TCM syndrome, and the correlation between TCMsyndromes and symptoms, tongue, pulse. SPSS17software is used forstatistical analysis, investigating the regularity of TCMSyndromes of chronic hepatitis B.Part three: Study on chronic hepatitis B syndrome treatment rulebased on sharing systemBased on the information in part two, we analysis the traditional Chinese medicine data, use the clinical researchtechnology integration platform and complex network technology, tostatistical analysis Chinese medicine usage frequency, flavor andmeridian tropism, and analysis the correlation between traditionalChinese medicine and TCM Syndrome. SPSS17software is used forstatistical analysis, investigating the regularity of traditionalChinese medicine of chronic hepatitis B.ResultsPart one:the study on construction of hepatic disease clinicalresearch information sharing system1.We format criterion standard of TCM hepatic disease clinicalbasic terminology, including26main clinical terms,10propertyterms, in which the common symptoms of hepatic disease terms are69.2. Base on the hepatic disease in TCM diagnosis and treatmentscheme and TCM hepatic disease clinical basic terminology,we makehepatic structured electronic medical record template set,including107structured electronic medical record template, andformating hepatic template system table.3. Make structured electronic medical record as the core, wefully integrated hospital information resources, including HIS、LIS、PACS, to construct the digital, information, network ofhepatic disease clinical research information sharing system.Part two: Study on chronic hepatitis B syndrome rule based onsharing system1.Statistically analysis the basic situation of patients withchronic hepatitis B, in the1200cases from clinical collecting,there is922of male patients, accounted for76.8%;there is278 cases of female patients, accounted for23.3%, male to female ratiois3.32:1, this shows that the rate of male patients of chronichepatitis B was higher than that of female.The age distributionis that aged under40years old patients has714cases, accountedfor59.5%, aged40-60years old patients has362cases, accountedfor30.2%, over60years old patients were124cases, accounted for10.3%, this shows that the age of40years is main.2.The distribution of TCM symptoms in patients with Chronichepatitis B, in the1200cases from clinical collecting, There were5278symptoms. After statistical analysis, the main symptoms ofpatients with chronic hepatitis B are weakness, irritability, chestpain, flank pain, thirstiness, bitterness, poor appetite, loosestools, jaundice, abdominal distention, yellow urine, et. Theweakness is in the highest proportion of all symptoms, accountedfor65.50%.3. The distribution of tongue and pulse in patients with Chronichepatitis B, the common tongue of tongue distribution is redtongue, pale tongue, dark red tongue, and red tongue, pale tongueas the main, the total proportion is90%; the common coat of thetongue is thin white fur, white fur, thin yellow fur, white andgreasy fur, yellow greasy fur, yellow fur, and thin white fur, whitefur as the main, the total proportion is49.83%,21.08%; the commonpulse is taut pulse, slow pulse, slippery pulse, wiry pulse, threadypulse, taut and slippery pulse, rapid pulse, slippery and rapidpulse, moisten pulse,and taut pulse as the main.4. The distribution of TCM syndrome in patients with Chronichepatitis B, we totally extract64TCM Syndrome of chronichepatitis B,1200rates, with standard processing, get the main TCM Syndrome of chronic hepatitis B: syndrome of liver depressionand spleen deficiency, endoretention of damp heat, qi stagnation,spleen deficiency and dampness, blood stasis, liver kidney yindeficiency, spleen kidney yang deficiency syndrome. Among that thebiggest proportion is syndrome of liver depression and spleendeficiency, endoretention of damp heat,each accountedfor53.41%,28.33%.It is show that he main TCM Syndrome is syndromeof liver depression and spleen deficiency, endoretention of dampheat.Through analysising, there is no significant correlationbetween TCM Syndrome patterns of chronic hepatitis B and gender,there is no significant correlation between age and syndrome ofliver depression and spleen deficiency, endoretention of damp heat,qi stagnation, spleen deficiency and dampness,but blood stasis,liver kidney yin deficiency, spleen kidney yang deficiency syndromehas a certain significant correlation with age.5. We make TCM syndrome differentiation standardization studyon chronic hepatitis B in syndrome of liver depression and spleendeficiency, endoretention of damp heat, do correlated analysis onsyndrome and symptoms, tongue and pulse, combined with syndromedifferentiation standardization,to analysis the standard andaccuracy of TCM syndrome differentiation, comparing the resultswith the standardization, it is basicly specification.Part three: Study on chronic hepatitis B syndrome treatment rulebased on sharing system1. Analysis of drug rule in chronic hepatitis B, the five mostcommonly used chinese herb for chronic hepatitis B are poria, yinchen, white atractylodes rhizome, radix salviae miltiorrhizae,radix curcumae, and the usage rate of poria is678, accounted for57.25%; yin chen is585, accounted for48.75%, whiteatractylodes rhizome is547, accounted for45.58%, radix salviaemiltiorrhizae is488,accounted for40.67%, radix curcumae is407,accounted for33.92%. The first20using chinese medicinal herbs areporia, yin chen, white atractylodes rhizome, radix salviaemiltiorrhizae, radix curcumae, hedyotis diffusa, forsythia, malt,licorice root, pinellia, dried orange peel, gu ya, bupleurum,scutellaria, plantain, citrus fruit, coix seed, magnolia bark,radix paeoniae rubra, Radix pseudostellariae.We can find thatmedication idea of chronic hepatitis b is the centralizerdetoxification, remove blood stasis phlegm.2. Study on the tropism and flavour of chinese herb using forchronic hepatitis B, we discover that the common used chinese herbis bitter and sweet, the second is pungent. The property of Chineseherb is cold, slightly cold, warm, flat, but no colder, hot,ferocious medicine, which show the differential treatment thoughtof traditional Chinese medicine "flat to flat-yin and Yang,".Channel tropism in traditional herb is mainly in liver and spleen,it shows the treatment ideas from the liver and spleen in chronichepatitis B.3. By analyzing the evolution of chronic hepatitis B treatment,shows that the dialectical thought of chronic hepatitis B is fromthe "toxic" to "toxic phlegm and blood stasis" even to "toxic phlegmstasis virtual". Reflecting that the treatment ideas of " thecentralizer detoxification, remove blood stasis phlegm" isformatted.ConclusionsThe construction of hepatic disease clinical research information sharing system in this study,using in clinic, can meetthe demand of clinical research, and can improve the work efficiencyand quality of clinicians. Through structured standardized storagefor clinical data,we can meet the demand of data mining, can makethe massive clinical information as basic, to carry out scientificresearch and clinical practice based on the data of the real world.It is initial manifestation of the "people-centered, clinicaldata-oriented, from clinic to clinic" clinic researchintegration paradigm in clinical research. Sharing system isstructured to collect the clinical data of patients with chronichepatitis B,the distribution regularity of TCM syndromes,differentiation treatment characteristics and drug research inchronic hepatitis B, providing reference for the establishment ofstandardization of TCM diagnosis and treatment mode of chronichepatitis B,providing the basis theory standardization for TCMsyndrome differentiation treatment.