Professor Jin Shi’s Experience In The Treatment Of Autoimmune Hepatitis

Objective:Taking the medical records of traditional Chinese medicine treatment of autoimmune hepatitis in CNKI and Professor Jin Shi’s clinical treatment of autoimmune hepatitis as the research objects,this paper reveals the medication characteristics of each doctor in the treatment of autoimmune hepatitis in recent 20 years and summarizes Professor Jin Shi’s experience in treating autoimmune hepatitis by using data mining technology to sort out,summarize and compare the two parts of data.Methods:(1)The medical records of autoimmune hepatitis treated with traditional Chinese medicine from 2000 to 2020 in CNKI were collected,and the names,gender,age,clinical manifestations,tongue,pulse,pathogenesis,treatment and medication of 43 patients with 111 times of diagnosis were entered into Medcase V5.0 data record mining system,this paper summarized the medication characteristics of traditional Chinese medicine doctors in the treatment of autoimmune hepatitis in recent 20 years by using the methods of frequency method,association rules and cluster analysis.(2)The clinical records of autoimmune hepatitis treated by Professor Jin Shi from January 2000 to February 2021 in Bai Cao Tang of Nanjing University of Chinese Medicine,Ming Yi Tang of Jiangsu Province Hospital of Chinese Medicine and Guo Yi Tang of Nanjing University of Chinese Medicine were collected,and the names,gender,age,clinical manifestations,tongue,pulse and medication of 18 patients with 288 times of diagnosis were entered into Medcase V5.0 data record mining system,Professor Jin Shi’s experience in treating autoimmune hepatitis had been summarized by using the methods of frequency method,association rules,cluster analysis.Results:1.Literature research results:(1)In the medical records database,43 patients with 111 times of diagnosis are included,including 4 males with 15 times of diagnosis and 39 females with 96 times of diagnosis.Most of them are 40-59 years old,and most of them are middle-aged and old women.(2)The most common clinical manifestations are fatigue,anorexia and hypochondriac pain.The most common tongue is red and dark red;the most common tongue coating is thin white coating and thin yellow coating.The most common pulse condition is veinlet and chordal veins.(3)The pathogenesis is mainly damp heat accumulation,liver and spleen disorder and blood stasis block.The treatment methods are clearing heat and dampness,soothing liver and spleen,promoting blood circulation and removing stasis,supplementing Qi and nourishing blood.(4)Drugs include tonifying deficiency drugs,clearing heat drugs,diuretic and dampness drugs,promoting blood circulation and removing blood stasis drugs,etc.Drugs mainly belong to hepatic meridians,followed by spleen,heart,stomach and gallbladder meridians.Three core prescriptions were obtained by cluster analysis:San Wu Huang Qin decoction,Ba Zhen Decoction and Tao Hong Si Wu Decoction.On this basis,they add and subtract with the evidence.2.Retrospective study results:(1)In the clinical medical records database,18 patients with 288 times of diagnosis are included,including 4 males with 72 times of diagnosis and 14 females with 216 times of diagnosis.The age concentrates in 40-59 years old,and the high incidence group was middle-aged and elderly women.(2)Sjogren’s syndrome is the most common secondary diagnosis in western medicine.The most common clinical manifestations were dry mouth,dry eyes and epigastric fullness.The tongue is mostly red and dark red.The most common tongue coating is thin yellow coating,thin white coating,thin yellow greasy coating.The pulse condition is mainly composed of veinlet and chordal veins,and the sum of them is more than 100%.(3)Drugs include heat clearing drugs,tonifying drugs,diuretic and dampness infiltrating drugs,blood activating and stasis removing drugs,qi activating drugs,etc.Drugs mainly belong to hepatic meridians,followed by spleen,gallbladder,stomach,heart and kidney meridians.Four core prescriptions are obtained by cluster analysis:Xiao Chai Hu Decoction,Yin Shao Er Jin Decoction,Yang Gan Jiang Mei Decoction and Xin Jia Lian Su Decoction.On this basis,they add and subtract with the evidence.Conclusion:(1)In terms of pathological factors,literature research shows that most traditional Chinese medicine doctors think that it mainly includes heat,dampness and blood stasis.Professor Jin Shi thinks that pathological factors include dampness,heat,depression and blood stasis,and emphasizes the influence of depression in the pathogenesis of the disease.(2)In terms of location,most traditional Chinese medicine doctors believe that the location of the disease is in the liver,involving the spleen,heart,stomach and gall bladder.Professor Jin Shi believes that the location of the disease is in the liver,involving the spleen,gall bladder,stomach,heart and kidney.(3)In the aspect of pathological nature,most traditional Chinese medicine doctors believe that the pathological nature of the disease is deficiency of the origin and excess of the spleen,which includes dampness,heat and blood stasis;Professor Jin Shi thinks that the pathological nature is deficiency of origin and excess of standard.Deficiency of origin includes spleen deficiency and yin deficiency of liver and kidney.Excess of standard includes dampness,heat,depression and blood stasis.(4)In terms of treatment,most traditional Chinese medicine doctors take tonifying deficiency and reducing excess as the treatment principle.Tonifying deficiency is reflected in soothing the liver and strengthening the spleen,supplementing qi and nourishing blood.Reducing excess is reflected in clearing heat and dampness,promoting blood circulation and removing blood stasis;Drug use involves tonifying deficiency,clearing heat,diuresis and dampness,promoting blood circulation and removing blood stasis;Representative prescriptions include Sanwu Huangqin decoction,Bazhen decoction,Taohong Siwu Decoction,etc;Professor Jin Shi takes "flowing Qi and harmonizing collaterals" as the principle of treatment,and uses six methods of dredging,clearing,transforming,transporting,nourishing and benefiting to smooth Qi and harmonize liver collaterals;Drug use involves heat clearing,tonifying deficiency,diuresis and dampness,promoting blood circulation and removing blood stasis,and promoting qi.Xiaochaihu decoction,Yinshao Erjin decoction,Yanggan Jiangmei decoction,and Xinjia Liansu decoction are commonly used.