| Background:Neoplastic fever is a non-infectious fever caused by the tumor itself,which is a common complication in the development of malignant tumors.If neoplastic fever cannot be effectively controlled in clinical,it is difficult for patients to continue anti-tumor treatment,and the quality of life is seriously declining and the survival time is shortened.However,as the pathogenesis of the disease is still unclear,symptomatic treatment is still the main method of western medical therapy.But the choice of drugs is limited and the risk-benefit ratio can not be confirmed which has become a difficult problem in the process of clinical diagnosis and treatment.In recent years,many doctors have used traditional Chinese medicine to treat neoplastic fever,which has achieved good results,so that clinicians have a new choice in treatment.By searching databases such as CNKI,Wanfang and Weipu,it is found that a large number of doctors' experiences in the treatment of neoplatic fever in traditional Chinese medicine is scattered in the databases,and the methods about diagnosis and treatment of syndrome differentiation are different within these experience.Without regular analysis and extensive clinical verification,it is difficult to apply these experiences into clinical practice directly.The medical records is the record of doctors in the process of clinical diagnosis and treatment,which can fully reflects the academic thoughts of doctors in clinical.To summarize the clinical experience of these doctors,analyzing their medical history is undoubtedly the most effective way.Objective:The purpose of this study is to explore the commonness of academic thoughts on the treatment of neoplastic fever by TCM through data mining of cases,so as to provide clear and accurate clinical thoughts for the treatment of neoplastic fever by TCM,alleviate the pain of cancer patients,improve the quality of life,and lay a solid foundation for anti-tumor therapy.In the analysis process,the clinical characteristics of patients with neoplastic fever will be summarized,the disease characteristics and syndrome characteristics of neoplastic fever treated by Chinese medicine will be summarized,the medication rules of neoplastic fever treated by Chinese medicine will be searched,and the Chinese medicine database of neoplastic fever will be established,so as to provide the basis for the safe,effective and standardized treatment of neoplastic fever by Chinese medicine.Methods:The information was retrieved from January 1995 to December 2020 in CNKI Database,VIP Database and Wanfang Database.According to the inclusion and exclusion criteria,the medical cases with complete information of the four diagnoses and the treatment with TCM prescriptions were screened out,the information of the four diagnoses and herb prescriptions were extracted,and the TCM medical record database of neoplastic fever was established by Excel.The clinical characteristics and medication rules were analyzed respectively.1.Clinical characteristics analysisThe basic information of TCM medical cases was statistically analyzed,such as gender,age,diagnosis of western medicine,diagnosis of traditional Chinese medicine,body temperature,duration of fever,tongue image,pulse image and number of agents,etc.The correlation and difference among the variables were analyzed by statistical methods.Analyze and summarize the clinical features of the cases treated by traditional Chinese medicine.2.Analysis of medication ruleThe using frequency,efficacy,property,herbal taste,attribution meridians of herb were counted,and cluster analysis and association analysis were conducted on high-frequency TCM.Results:1.A total of 1382 relevant literatures were retrieved,from which 82 qualified literatures were included after excluding randomized controlled studies,reviews and various duplicated literatures.Finally,129 cases of TCM medical cases were extracted.2.Clinical characteristics analysis:Male accounts for 63%,and middle-aged people aged 45-70 account for the highest proportion,68.99%,with an average age of 57.4 years;the patient whose fever duration? 1 month accounted for 49.61%,the shortest fever duration was 2 days,and the longest fever duration was more than 7 months;83.72%of patients were cured within 14 doses of traditional Chinese medicine,the minimum was 1 dose,the maximum was 90 doses,the median was 10 doses,and the average was 11 doses.In terms of cancer types,lung cancer and liver cancer accounted for 50.39%of the total.According to the proportion analysis of neoplastic fever related factors,non-treatment-related neoplastic fever accounted for 67%,and chemotherapy-related neoplastic fever accounted for 22%.Tongue image analysis showed that the tongue color of patients with neoplastic fever was mainly light(32.88%)and red(32.56%).Pulse analysis showed that the total frequency of thready pulse,rapid pulse and stringy pulse was 164 times(65.34%),which was the main pulse pattern in patients with neoplastic fever.The TCM types of neoplastic fever can be divided into four categories:deficiency syndrome type(33%),excess syndrome type(22%),mixed type of deficiency and excess syndrome(23%),and accompanied syndrome type(22%).There was a significant negative correlation between maximum body temperature and age in patients with neoplastic fever(P<0.0001).There was a significant positive correlation between the duration of fever and the number of agents in patients with neoplastic fever(P<0.05).Difference analysis showed that there was a significant difference between lung occupying group and liver occupying group in syndrome type classification(P<0.05).The result showed that lung tumor group are more likely belonged to deficiency syndrome type,liver tumor group are more likely belonged to deficiency and excess syndrome type,accompanied syndrome type,excess syndrome type.3.Drug use analysis:221 traditional Chinese herbs were included in the statistics.The traditional Chinese herbs most frequently used were Licorice,Bupleurum,Astragalus and Rehmannia rehmanniae.The proportion of heat-clearing herbs in Chinese medicines was the largest(23.98%).The most common property of the herbs is cold property,accounting for 51.13%.The higher frequencies of flavors of the Chinese medicines are bitter,sweet and acrid,the sum of which is 84.66%.The most common meridian of Chinese medicines is liver meridian,accounting for 19.82%.The cluster analysis and association analysis of high frequency Chinese medicines showed that high frequency Chinese medicines could form three clustering formulas,and could get 18 pairs of high frequency drug combinations.Conclusion:According to the cases of neoplastic fever recorded by different doctors,the key pathogenesis of neoplastic fever may be the deficiency of Qi,blood,Yin and Yang,or the accumulation of pathological factors such as phlegm and blood stasis.It is also possible that the stagnation of qi produces heat,owing to Shaoyang pivot congestion.The TCM types of neoplastic fever can be divided into four categories:deficiency syndrome type,excess syndrome type,mixed type of deficiency and excess syndrome,and accompanied syndrome type.In terms of treatment,because many patients with neoplastic fever are deficient syndrome,it is necessary to attach importance to replenishing vital qi,especially the qi of spleen and stomach,and carefully apply offensive herbs;it is effective to clear damp and phlegm,promote blood circulation to remove blood stasis,remove food retention with herbal medicine,so that Qi and blood flow smoothly,the stagnation of heat will clear out;also,herbs with anti-tumor activity can be used at the same time.Patients with accompanied Exterior syndrome type should use the prescription as Xiaochaihu decoction. |
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