Research On The Medication Rule Of Professor Fu Si In The Treatment Of Chronic Atrophic Gastritis Based On Data Mining

Chronic Atrophic Gastritis(CAG)is a common disease of digestive system,with no specific symptoms.At present,the diagnosis of CAG mainly relies on gastroscopy and pathological biopsy.The main features of CAG are atrophy,reduction of gastric mucosal epithelium and intrinsic glands,with or without Intestinal Metaplasia(IM)and Dysplasia(Dys).In 1978,the World Health Organization Cancer Research Association listed CAG as a pre-cancerous state.CAG's complications,IM and Dys,are considered as Precancerous Lesion of Gastric Cancer(PLGC).The progression from normal gastric mucosa to gastric cancer(GC)is a long-term evolutionary process,which has a widely accepted mode(Correa mode):normal gastric mucosa ? superficial gastritis ? atrophic gastritis ? intestinal metaplasia?dysplasia?GC.GC is one of the most common malignant cancers in the world with a low survival rate and poor prognosis.China has a high incidence of GC.Therefore,the key of preventing the occurrence of GC is to intervene in the precancerous lesions,to block or even reverse the disease progression and reduce its incidence.Because the pathogenesis of CAG is undefined,western medicine does not have effective therapy for PLGC,but mainly uses symptomatic treatment.The Traditional Chinese Medicine(TCM)has unique advantages in treating CAG,which can not only effectively alleviate the symptoms of dyspepsia,but also improve the gastroscopy and pathological manifestations of patients.Therefore,the treatment of PLGC by TCM has become a popular research topic in both domestic and international areas.Professor Fu Si is a chief physician of the Digestive Department of China-Japan Friendship Hospital,and a master supervisor in Beijing University of Chinese Medicine,who has been engaged in clinical work of TCM digestive treatment for more than 30 years.In line with this,Professor Fu gained much experience and his treatment had a remarkable curative effect on digestive diseases such as CAG.He has absorbed the theories of Ye Tianshi and professor Yin Huihe,and then formed his own unique academic thoughts which models the ancients while also makes great progress.Research ObjectiveThe research objective of this paper is to explore Prof.Fu's diagnosis method and the composition of prescriptions for the treatment of CAG,summarize his academic thoughts,and finally,provide new perspectives on clinical treatment of CAG and prevention of PLGC using TCM.Research Methods1.Collecting basic information and the first-time prescriptions of patients who meet the inclusion criteria for CAG and visited Prof.Fu at the TCM Department of Digestive in China-Japan Friendship Hospital from April 2017 to October 2018.2.Preprocessing and standardizing the collected data into Excel to form a database.3.Analyzing the data with research methods including frequency analysis,cluster analysis,and analysis of association rules using IBM SPSS Statistics 20.0 and SPSS clementine 12.0.4.Combing above research methods with the method of expert interviews to summarize Prof.Fu's diagnosis method and the composition of prescriptions for the treatment of CAG.Results1.General information:There were 39 males and 73 females separately in all 112 CAG patients.And the ratio of male to female was 0.53:1.The patients' age ranged from 29 to 85 years old,with the highest number of cases between the ages from 51 to 70 years old,with an average age of 58.75±11.71 years old.2.The frequency analysis:147 different Traditional Chinese Medicines were used in the 112 prescriptions,with a total frequency of 1889 times.The most frequently used medicine was Magnolia,which was used for 76 times(accounts for 4.02%in all medicine used times),followed by Codonopsis Pilosula,with a frequency of 73 times(accounts for 3.86%in all times).There were 34 medicines were used more than 1%of all medicine used times,and the cumulative frequency of using them was 76.39%.Other 113 medicines were used less than 1%,and the cumulative frequency was merely 23.61%.As mentioned above,34 frequently used Chinese medicines(with a frequency of more than 1%)was identified as high-frequency medicines.With the analysis of high-frequency medicines,it shows that there are 10 kinds of medicines as following(sorting by proportion):Tonic medicine(19.38%),Digestive medicine(12.39%),Dampness medicine(12.07%),Qi medicine(11.12%),Heat-clearing medicine(5.82%),Huatan Zhike anti-asthmatic medicine(4.87%),Wenli medicine(4.39%),Receiving medicine(2.54%),Lishui osmotic drugs(1.96%),Anshen(1.85%).3.Cluster analysis:The result of cluster analysis of 34 high-frequency medicines demonstrates that there are five cluster combinations.The first category includes Rhizoma cyperi,Musk,Woody,Radish seed,Charred semen arecae,Amomum cardamomum,Magnolia,Codonopsis,and Medlar.The second category includes Jcharred fructus crataegi,Melanoidin malt,Jiaoshenqu.The third category includes Dendrobium,Ophiopogon root,Rglehnia root,Gentiana,Rhizoma coptidis,Squid bone,and Valeriana.The fourth category includes Dried ginger,Rhizoma pinellinae praeparata,Cinnamon,Licorice,Paeonia lactiflora pallas,Yam,Medlar,Amomum,Amomum cardamomum,Dried tangerine peel,Rhizoma atractylodis macrocephalae.The fifth category includes Fried buds,Coloured malt,Ganoderma lucidum,Astragalus root.4.Association rule analysis:When the parameters were set to support degree>50%,confidence level ?90%,the results of association rule analysis for high frequency medicines shows that there are 57 rules in total.Among them,there were 16 rules associating with two medicines,27 rules with three medicines,and 14 rules with four medicines.5.Expert interviews:The position of CAG is in stomach,relating to spleen,liver and gallbladder.CAG is mainly based on weak performance with symptoms including Qi stagnation,moisture resistance,food accumulation,heat depression,yin deficiency,etc.Soothing Qi,strengthening the spleen and regulating the Qi and phlegm is the main rule for CAG's treatment.ConclusionBased on the basic pathogenesis of CAG which include spleen deficiency,liver stagnation,Qi stagnation and damp retention,Prof.Fu Si mainly uses the methods of soothing the liver,strengthening the spleen and regulating the Qi and phlegm.Commonly-used medicine recipes are Modified Sanxiang Decoction and Shenling Baizhu Powder,which can be adjusted according to specific symptoms.Invigorating the healthy Qi,regulating Yin and Yang,harmonizing liver-spleen,and paying attention to nurseing back to health are the academic thoughts of Prof.Fu in treating CAG,which also reflects the unique advantages of TCM in preventing and treating PLGC.