Tutor's Experience Summary Based On Data Mining And The Efficacy Evaluation Of Traditional Chinese Medicine By Syndrome Differention In Treating Chronic Arophy Gastritis

The research contains two parts:the first one is about a clinical research using herbal medicine based on syndrome differentiation in treating precancerous lesion of gastric cancer (PLGC),and the second one is about academic experience summary of professor Tang Xudong in treating chronic atrophy gastritis(CAG).1.Clinical research using herbal medicine by syndrome differentiation in treating PLGC comparing with folic acid: a randomized, positive drug control studyObjective To evaluate the effectiveness and safety of herbal medicine in treating CAG, exploring an effective treatment protocols and establishing perfect therapeutic evaluation system.Methods A randomized, positive drug folic acid controlled clinical trial design was adopted in the trial. The experiment group was given herbal medicine (No.Ⅰ,No.Ⅱ, No.Ⅲ,No.Ⅳ) based on syndrome differentiation,150ml twice a day, and the control group was given folic acid three times a day,5mg each time. The treatment courses of both groups were 6 months. After the treatment, we could evaluate therapeutic effect through the following four aspects:histopathology, gastroscopic manifestations, patient reported outcome (PRO) evaluation scale and clinical symptoms.Results Among 55 included patients,37were treated with herbal medicine, while the other were given folic acid.53 patient were screened for full analysis set (FAS), and 45 were screened per-protocol set (PPS). The results were as follows:(1) Assessment of therapeutic effects (FAS) Histopathological changes:both groups were effective in treating dysplasia, the cure rate of dysplasia in TCM group was 46.9%, while the other was 53.3%, the therapeutic effect had no statistically significant differences between the two groups (χ2=0.170,ρ=0.460>0.05). The experiment group manifested a better tendency in atrophy and total pathological score improvement. Endoscopic findings:The experiment group was better in improving vascular see-through, intestinal metaplasia nodules, the color and luster of mucosa and mucosa texture, there were no statistically significant difference between the two groups in improving mucosa rugae. (ρ=0.765>0.05)PRO score:The experiment group had a better effect in improving dyspepsia, psycho-logical and social functions, and the total PRO score.Scores of main symptoms:The experiment group was better than the controlled group in treating stomach plugging (ρ=0.033<0.05.ρ=0.018<0.05) and in improving the total symptom score at the 6th month after treatment. (p=0.034<0.05).The controlled group had a better effect in alleviating heartburn at the3th month after treatment (p =0.0290.05)(2) Adverse event reportsThe total 35 cases in the experiment group reported 7 adverse events making up the incidence of 20.0%, while the other total 18 cases reported 3 adverse events making up the incidence of 16.7%. No specific adverse reaction was confirmed to be related to the research drugs.Conclusions The TCM group had a better effect in improving the clinical symptoms (stomach plugging, the total symptom score), PRO scores (dyspepsia dimension, psychological and social functions dimension, and the total PRO score), endoscopic findings (vascular see-through, intestinal metaplasia nodules, the color and luster of mucosa and mucosa texture) with different degree compared with the folic acid group. Both groups had no significant difference in improving histopathological changes. The folic acid had a better effect in alleviating heartburn than herbal medicine through the experiment. No specific adverse reaction was confirmed to be related to the research drugs, which proved the effectiveness and safety of herbal medicine in treating CAG. Though the TCM group was effective in improving the clinical symptoms (stomachache, gastric distension.etc.), no statistically significant differences was shown, considering it's relevant to the small sample size in the research.2. Academic experience summary of professor Tang Xudong in treating CAG based on data miningObjective To mine and summarize professor Tang'academic experience in treating CAG based on data mining system.Methods By using the structural clinical data collection system designed by Xiyuan Hospital of China Academy of Chinese Medical Sciences, we established a data collection framework according to tutor's diagnostic method. Especially focusing on the correlation between clinical symptoms and traditional Chinese medicine (TCM) syndrome types of CAG to analyze and summarize professor Tang's academic experience.Results 86 diagnosed CAG patients treated by professor Tang, including 128 complete medical records. Through the data mining system we could get the corresponding relations of TCM syndrome types vs herbs, herbs vs herbs and clinical symptoms vs TCM syndrome types, which could be combined with my gaining as an assistant doctor under professor Tang's guidance. In terms of analysis of the correlation between clinical symptoms and TCM syndrome types, I associated his diagnostic method with related theories in Western medicine (gastrointestinal rhythmic motion, gastric acid secretion, etc) to explore and form a unique way of treating digestive diseases through the integration of Traditional Chinese Medicine with Western Medicine.Conclusion Professor Tang combined gastrointestinal rhythmic movement with the etiology and pathogenesis of TCM in the therapeutic process of CAG, and then used it as the guidance of prescription, which obtained good clinical curative effect. His unique thinking method could be helpful in exploring a new mode to cure the digestive diseases in the integration of TCM with Western Medicine.