| Objective: Based on the ancient literature of pregnant abdominalgia of Traditional Chinese Medicine(TCM),taking “disease-symptom-pathogenesis-treatment methodsprescription” as the main subject,this study is to explore the theoretical understanding,syndrome differentiation and treatment,the law of prescription in ancient literature from Qin dynasty to Qing dynasty so as to provide literature reference for the clinical diagnosis and treatment of pregnant abdominalgia and related diseases in modern TCM.Methods: This study combines the literature research methods with the data mining methods of ontology.The research method consists of five steps.First step,using “?”,“?”,“?”,“?” as keywords to rearch all the books about pregnant disease in Encyclopaodia of TCM and then sort out the books about pregnancy abdominalgia by manually reading.Then,by reading the e-books of “Chinese Medicine Clinical Required Books” and “Top Ten Famous Works of Women's Medicine”,the books about pregnant abdominalgia were screened out which was not included in the Encyclopaodia of TCM.After above procedures,the ancient books to be studied were determined.According to the title,the contents of ancient books related to pregnant abdominalgia was extracted from the existing electronic documents.At the same time,all the literature data of pregnant abdominalgia were named as the unit of books,and the ancient literature database of pregnancy abdominalgia is established.Second step,determine the semantic types and data preprocessing.The semantic types were determined by reading and analyzing the characteristics of ancient literature.At the same time,the ancient documents were divided into data units to avoid the incomplete and incoherent context caused by the confusion of computer typesetting.Third step,Build the structured knowledge base.The pre-processed data was imported into the tagging system,the annotators carry on the anntation work of 50% data,which was used to train and test the Conditional Random Field(CRF)model to automaticly annotate the remaining 50% data.With this step,the structured knowledge base of ancient Chinese literature of pregnant abdominalgia was constructed.Fourth step,standardization of part of the structured data.The standardized processing of concept “Chinese medicine” with the largest amount of data was completed with the assistance of machine learning method of using the fully connected feedforward neural network to train the sound code model.The rest of the semantic concepts were standardized manually.Fifth step,data analysis and data mining.According to the age of the included books,the included literatures were divided into four periods: the Qin and Han dynasties,the Wei and Jin dynasties to the Sui and Tang dynasties,the Song,Jin and Yuan dynasties,the Ming and Qing dynasties.Based on the above four historical periods,the literature analysis and data mining were conducted with the help of frequency analysis,association rule analysis.Moreover,this study used python software to draw the scattered plot to help analysising the distribution of the entities and events in the history.At the same time,the antient literatures of TCM about pregnant abdominalgia were analyzed and excavated horizontally and vertically form five aspects: disease name,symptoms,syndrome elements,treatment methods and prescriptions.ResultsA total of 179 ancient books are selected from more than 1200 ancient books of TCM,involving a total of 156 authors,124900 words which are divided into 1330 records manually.In the process of constructing structured and standardized knowledge base,a total of 19 semantic concepts are established and annotated,involving “desease name”,“symptom”,“etiology and pathgenesis”,“desease location of syndrome element”,“desease nature of syndrome element”,“treatment principle”,“treatment method”,“prescription”,“ chinese medicine”,“processing method”,“decoction medium”,“liquid for drug delivery”,“chinese medicine dosage”,“intaken dosage”,“cited books”,“cited authors”,“month of pregnancy”,“cautions or contraindications”,“pulse condition”,and 7 of the above concepts are standardized processing,they are “symptom”,“desease location of syndrome element”,“desease nature of syndrome element”,“treatment method”,“prescription”,“chinese medicine”,and “month of pregnancy”.The final F1-Measure of automatic machine anntoation is 0.87 on average,indicating that the machine learning model can be competent for the entity extraction task of ancient Chinese medicine literature.By comparison,the accuracy rate of machine standardization task is 33.6%,suggesting that the machine learning method to standardize traditional Chinese medicinal materials is not ideal,which needs further research in the future.The results of literature analysis and data mining are as follows.1.Literature analysis of pregnant abdominalgia.(1)Name of pregnant abdominalgia:Pregnant abdominalgia gradually developed from symptoms name to independent disease name.There are 47 kinds of disease names related to pregnant abdominalgia in ancient literature of TCM,and the most commonly used are“????”,“??”,“??”,“????”and so on.Meanwhile,it also includes the variant name of pregnant abdominalgia,and other disease names closely related to pregnant abdominalgia.The meaning of“??”in ancient books has three different meanings:abdominal pain during pregnancy,colporrhagia during pregnancy,abdominal pain and colporrhagia during pregnancy.Among them,the first viewpoint is part of the doctors'standpoint during Qing Dynasty.(2)Symptom: A total of 912 records described the symptom of abdominal pain,containing 16 pain properties,37 pain sites,3 types of pain frequency,2 types of pain degree,and 2 types of the urgency of pain.The highest frequency of pain properties are “distending pain” and “cold pain”.As for the pain sites,the pregnant abdominalgia often occurs in the lower abdomen,umbilical abdomen.Meanwhile,the pain also spread to the entire trunk of the ventral side and waist,including the rib,chest,waist,heart,hip,epigastric,waist and other positions.The frequency of pain included “occasional pain”,“pain from time to time”,“constant pain”.The degree of pain is mainly divided into light and severity.The urgency of pain include relieving pain and acute pain.Mastering the clinical significance of five aspects of pain symptoms is helpful for syndrome differentiation,treatment and judging the trend of disease.(3)Syndrome elements: There are 22 types,2437 frequency of syndrome elements of disease attribute,including “deficiency”,“wind”,“cold”,“toxin”,“blood stasis”,“qi”,“fire” and “dampness”.There are 20 types,504 frequency of syndrome elements of disease location,involving viscera,meridians,blood and water system,and fetus.Among vercera,liver,spleen and kidney are mostly related to abdominal pain.Among meridians and collaterals,Chong Channel,Ren Channel,collaterals of the uterus,liver maridian and kidney maridian are mostly related to it.In addition,the fetus is the specific disease location of pregnancy disease,and the concept of disease location of water and blood system needs further study.(4)Treatment methods: There are 14 methods for treating pregnant abdominalgia in ancient literatures of TCM.During Qin and Han Dynasties,the methods of warming and tonifying the Chong and Ren meridians,and regulating the function of liver and spleen were mainly used.From Wei and Jin to Sui and Tang Dynasties,doctors mainly used the methods of nourishing blood and clearing heat,the method of tonifying the kidney appeared.In the Song Dynasty,doctors thought highly of regulating qi and nourishing blood,while in the Jin and Yuan Dynasty,doctors attached importance to regulating the function of liver,spleen and kidney.And the method of invigorating spleen and removing dampness,nourishing blood and clearing heat were considered significant.During Ming and Qing Dynasties,all schools of thoughts contend for attention,activating blood circulation methods were in good use and the method of tonifying the kidney was used seriously.In a word,the treatment of pregnant abdominalgia in the past dynasties paid most attention to strengthening the body resistance,especially tonifying blood and regulating the spleen and stomach,followed by regulating qi,warming interior,clearing heat etc.The combination of different treatment methods could be used to treat various types of pregnant abdominalgia.(5)Prescription and medication: There are a total of 1095 prescriptions to be used to treat the pregnant abdominalgia,containing a total of 857 prescriptions with 293 names.There are 217 types of Chinese medicine with 7258 frequency,in which 165 typs of them are commonly used in modern clinical Chinese medicine.In ancient times,the pregnant abdominalgia was usually treated by the the prescriptions with the function of replenishing deficiency and regulating qi.The most frequently used tonic medicine are in the function of tonifying qi,blood and yang.The nature of the medications are mainly warm and flat,the drug tastes are mostly acrid,sweetish taste,bitter taste,and the channels tropism are mainly spleen meridian,liver meridian,kidney meridian and stomach meridian.The contraindications for Chinese medicine during pregnancy are used to inducing abortion and fetal protection.If using in fetal protection,the dosage of medications and the compatibility of chinese medicine should be paid needs to be treated with emphasis.2.Analysis of the correlation rules between prescriptions and syndrome elements,prescription and treatment methods of pregnant abdominalgia.(1)There are correlations between prescriptions and chinese medicine with 15 types of syndrome elements of disease attrbute and 7 types of syndrome elements of disease location.Among them,angelica,ginseng,atractylodes macrocephala,glycyrrhiza uralensis are strongly related to several syndrome elements of disease attribute as well as liver,spleen and liver-spleen.It can be seen that tonifying qi and blood,and protecting spleen and stomach are important ways to treat pregnant abdominalgia.If the pregnant abdominalgia is closely related to kidney deficiency,tonifying kidney yang will be the most common used.If it is caused by the uterine or fetal problems,the teatment method should focus on replenishing healthy qi.(2)Prescriptions and chinese medicine are associated with 8 types of treatment methods.The tonifying methods mainly focus on tonifying qi and blood,combining activating blood and regulating qi.The method of regulating qi always combined invigorating qi and blood with tonifying methods.The methods of promoting blood circulation mainly aim at regulating qi and promoting blood circulation,in which Dang Gui(Angelica sinensis)and Chuan Xiong(Ligusticum wallichii)are highly frequent used.The method of reconciliation takes the composition of Danggui Shaoyao Powder as the core.The relieving superficies method is usually added medicine with function of strengthening healthy qi.The method of eliminating phlegm always used the Chinese medicinal materials with the function of invigorating the spleen,drying dampness and resolving phlegm.This method is highly related to the Sijunzi decoction and Erchen decoction.Conclusions1.It is highly efficient and feasible of source and association analysis based on the data mining methods of ontology.In this study,the semi-automated method of combining manual annotation with computer annotatation is used to construct structured knowledge base of ontology and standardize part of the data,which reduces the input of manpower,and improves the efficiency of knowledge base construction.Based on this knowledge base,it is feasible and convenient to carry out literature research on origin,development and association of principle,method,recipe,medicines.2.There is abundant knowledge about pregnant abdominalgia in theoretics,diagnosis and treatment in ancient literature of TCM,which has certain clinical value for modern TCM.The history of pregnant abdominalgia have experienced four periods: the theoretical origin in Qin and Han dynasties,the accumulation of experience from Wei and Jin to Sui and Tang dynasties,the summary and development in Song,Jin and Yuan dynasties,and the contention of a hundred schools of thought in Ming and Qing dynasties.It has been found that the pregnant abdominalgia developed from symptoms to independent disease with the progress of history.The literature of pregnant abdominalgia mainly described the pain symptoms.Mastering the clinical significance of pain properties,pain sites,pain frequency,pain degree,and the urgency of pain will contribute to syndrome differentiation,treatment and judging the trend of disease.The syndrome elements mainly include qi deficiency,blood deficiency,qi stagnation,internal and external cold.Syndrome differentiation focuses on whether qi and blood are sufficient and in harmonious way,whether spleen and stomach are in healthy state,whether kidney yin and kedney yang are sufficient as well as in harmonious proportion.As for treatment method,it focuses on tonifying and regulating liver,spleen and kidney,tonification and purgation in combination,tonifying and regulating qi in combination.In this way,the therapeutic methods will not consume the qi and blood and will not cause qi stagnation.The prescriptions are mainly placid and less fierce on the whole.In some special circumstances,eliminating pathogenic qi is also a method of pretecting fetus,or even using aborticide to save pregnant patient.In summary,there is abundant knowledge about pregnant abdominalgia in theoretics,diagnosis and treatment in ancient literature of TCM,which has certain clinical value for the symdrome differentiation and treatment of pregnant abdominalgia and related diseases in modern TCM. |
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