| Objective:To collect,screen and sort out the studies of vascular dementia(VaD)treated with traditional Chinese medicine(TCM)by using association rules based on data mining technology,analyze the characteristics of drug use and summarize the drug use rules of different syndrome types.In addition,to design a clinical control trial to study the clinical efficacy of warming kidney,helping yang,resolving phlegm and removing blood stasis in the treatment of VaD,so as to enrich the TCM treatment of VaD.Methods:1.Medication regularity study: Computer was used to search the literature of traditional Chinese medicine in the treatment of VaD collected in China National Knowledge Infrastructure(CNKI),Wanfang academic Journal full-text Database,VIP full-text Journal Database(VIP)and China Biomedical Medicine Database(CBM)from January 1,1990 to December 31,2020,screened and sorted out the corresponding clinical research literature,inputted the data into the Microsoft Excel table,established the database of TCM in treatmenting VaD,and adopted the descriptive statistical methods of counting data to describe the frequency of high-frequency drugs,classification of TCM,four qi,five flavors,meridian tropism and TCM syndrome.Each syndrome type of TCM was extracted and the Apriori algorithm was used in SPSS Modeler18.0 to analyze the association rules of different syndrome-medicine,and the results of association analysis were shown in the form of table and web visualization map.2.Clinical study: Patients with VaD were often accompanied with clinical manifestations such as fear of cold limbs,sore waist and knees,mental malaise,cough with phlegm,purple tongue and so on.The pathogenesis of kidney yang deficiency and phlegm stasis was common.We selected 100 patients diagnosed as kidney yang deficiency and phlegm stasis syndrome for clinical study.The patients were randomly divided into treatment group(n = 50)and control group(n = 50).The treatment group was treated with Wenyang Huatan Quyu decoction combined with Donepezil Hydrochloride tablets while the control group was treated with Donepezil Hydrochloride tablets,and both groups were treated with 4 weeks as a course of treatment for a total of 4 courses.After treatment,the cognitive ability,the ability of daily living and the curative effect of TCM syndrome were determined.Results:1.High-frequency drugs:(1)High frequency drugs: A total of 8822 articles were retrieved and screened according to inclusion criteria and exclusion criteria after weight removal.Finally,239 articles were selected,including 273 prescriptions,involving a total of 174.The total frequency of application was 2768,and there were 38 traditional Chinese medicines with a frequency of more than 20.From high to low were Acorus calamus,Polygala,Ligusticum chuanxiong,Radix Astragali,Salvia miltiorrhiza,Radix Rehmanniae,Poria cocos,Polygonum multiflorum.(2)There are 19 categories of traditional Chinese medicine,and the frequency from high to low is deficiency medicine,promoting blood circulation and removing blood stasis medicine,resuscitation medicine,antipyretic medicine,heat-clearing medicine,phlegm-relieving and wind-relieving medicine,expectorant and asthma medicine,etc.In the classification of deficiency-tonifying drugs,kidney-tonifying drugs are the main drugs,and qi-tonifying drugs are the most important in the classification of deficiency-tonifying drugs.(3)Four qi,five flavors and meridian tropism: the four qi are mainly warm,flat and cold,the five flavors are sweet,bitter and pungent,and the meridians are mainly liver meridian,kidney meridian,spleen meridian,lung meridian and heart meridian.(4)TCM syndrome types: a total of 14 syndrome types were collected,and the frequency from high to low was marrow sea deficiency syndrome,blood stasis syndrome,phlegm stagnation syndrome,qi deficiency and blood stasis syndrome,spleen and kidney deficiency syndrome,liver and kidney deficiency syndrome,heart and spleen deficiency syndrome and so on.(5)Analysis of syndrome-drug association rules: in order to avoid the deviation of results,only the syndrome types with a sample size of more than 30,namely,deficiency of marrow sea,internal resistance of blood stasis,phlegm-turbid block and qi deficiency and blood stasis,were analyzed.The commonly used combinations of Suihai deficiency syndrome were Cinnamon,Cooked Rehmannia,Polygonum multiflorum,Aconite,Pilose Antler,Wolfberry,etc.;the combination of blood stasis syndrome was Safflower,Musk,Peach Kernel,Red Peony,Chuanxiong and so on;the common combination of phlegm turbid block was Poria Cocos,Acorus Calamus,Pinellia Ternata,Tangerine Peel,Arisaema Cum Bile,etc.;the common combination of qi deficiency and blood stasis syndrome was Radix Astragali,Red Peony,Peach Kernel,Safflower,Earth Dragon and so on.2.Clinical study: A total of 5 cases were lost,and the final number of patients was included in the treatment group(n = 48)and the control group(n = 47).Before treatment,the sex,age,course of disease,education level,complications,MMSE score,MoCA score,ADL score and TCM syndrome score of the two groups were comparable(P > 0.05).The statistical results showed that after treatment with Wenyang Huatan Quyu decoction,the curative effect index of MMSE,MoCA,ADL and TCM syndrome in the treatment group was higher than that in the control group(P < 0.05).MMSE score and MoCA score in both groups were significantly higher than those before treatment(P < 0.01).ADL score and TCM syndrome score were significantly lower than those before treatment(P < 0.01).The scores of MMSE and MoCA in the treatment group were significantly higher than those in the control group(P < 0.01),ADL score in the treatment group was significantly lower than that in the control group(P < 0.01),and the scores of TCM syndromes in the treatment group were significantly lower than those in the control group(P < 0.05).Conclusions:1.The incidence of VaD is closely related to kidney,spleen and liver,especially to kidney.Tonifying deficiency is the basic method for the treatment of VaD,and resolving phlegm and removing blood stasis is an effective way for the treatment of VaD.Among the common syndrome types,the commonly used combinations of Suihai deficiency syndrome were Cinnamon,Cooked Rehmannia,Polygonum multiflorum,Aconite,Pilose Antler,Wolfberry,etc.;the combination of blood stasis syndrome was Safflower,Musk,Peach Kernel,Red Peony,Chuanxiong and so on;the common combination of phlegm turbid block was Poria Cocos,Acorus Calamus,Pinellia Ternata,Tangerine Peel,Arisaema Cum Bile,etc.;the common combination of qi deficiency and blood stasis syndrome was Radix Astragali,Red Peony,Peach Kernel,Safflower,Earth Dragon and so on.2.Clinical study: Warming kidney-yang,resolving phlegm and removing blood stasis can improve the cognitive ability and ability of daily life of patients with VaD,and improve the symptoms of patients with kidney-yang deficiency and phlegm and blood stasis in VaD. |
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