| Objective:The study combs the theoretical understanding of the etiology,pathogenesis and treatment of recurrent abortion in ancient literature,and carries out data mining on the syndromes and prescriptions of modern literature on the treatment of recurrent abortion with traditional Chinese medicine.and compare the prescriptions used in pre-pregnancy and pregnancy treatment,and analyze their treatment similarities and differences,in order to explore the syndrome and treatment rules of traditional Chinese medicine in the treatment of this disease,in order to provide theoretical reference for clinical practice.Methods:By using the method of literature research,this paper collates the contents related to recurrent abortion in the ancient books of traditional Chinese medicine,and combs the ancient doctors’ theoretical understanding of the etiology,pathogenesis and treatment of the disease.Data mining methods,such as frequency statistics,association rule analysis,cluster analysis,complex network analysis and so on,are used to mine the syndrome and prescription information in the modern literature of traditional Chinese medicine in the treatment of recurrent abortion.the syndrome characteristics and prescription usage rules of traditional Chinese medicine in the treatment of recurrent abortion were analyzed.Results:1.Based on the study of ancient books of traditional Chinese medicine,it is found that recurrent abortion is affected by maternal,fetal and paternal factors.Due to congenital deficiency,emotional disorders,room fatigue and other factors,lead to kidney deficiency,spleen and kidney deficiency,qi and blood weakness and other pathological changes,and then lead to maternal injury,fetal instability,and finally lead to recurrent abortion.Most of the syndromes of this disease are deficiency syndrome or deficiency-excess mixed syndrome.The treatment follows the principle of precultivation of its damage,reason without malaise,and treatment by stages.The treatment is mainly to tonify deficiency and strengthen vital energy,and pay attention to tonifying the kidney and consolidating the foundation before and after pregnancy,supplemented by regulating qi and activating blood circulation and so on.Before pregnancy,pay attention to both strengthening and removing blood stasis;treatment based on syndrome differentiation during pregnancy,tonifying the kidney and calming the fetus,medication should be careful.2.The modern literature data mining research of traditional Chinese medicine in the treatment of recurrent abortion includes 501 modern literatures,including 60 kinds of syndromes,including spleen and kidney deficiency syndrome,kidney deficiency and blood stasis syndrome,kidney deficiency syndrome and so on.There are 7 syndrome elements in disease position,the higher frequency is kidney,spleen and liver,There are 13 disease syndrome elements,and the higher frequency is qi deficiency,yang deficiency,blood stasis and so on.3.A total of 218 prescriptions are used in the treatment of recurrent abortion,including 36 prescriptions,163 self-made prescriptions and 18 combined prescriptions.Shoutai pills,Zishen Yutai pills,Bushen Huoxue recipe and Taishan Panshi Powder are frequently used prescriptions.Tonics are the most common types of prescriptions.A total of 80 prescriptions were used before pregnancy and 174 prescriptions were used during pregnancy.Before pregnancy,Bushen Huoxue recipe,Bushen Jianpi recipe,Tiaochong decoction,Bushen Guchong Pill,Taishan Panshi Powder,etc.,and Shoutai Pill,Zishen Yutai Pill,Taishan Panshi Powder,Bushen Huoxue recipe,Antai decoction are often used in the treatment of pregnancy.Seventeen prescriptions were used before pregnancy,and the more commonly used are Shoutai pills,Zishen Yutai pills,Taishan Panshi Powder,Bushen Guchong pills and so on.32 prescriptions were used during pregnancy,and the most frequently used are:Shoutai Pill,Zishen Yutai Pill,Taishan Panshi Powder,Buzhong Yiqi decoction and so on.4.There are 227 kinds of drugs used in the treatment of recurrent abortion,including dodder,Dipsacus,Mulberry parasite,Atractylodes macrocephala,Ejiao,Radix Paeoniae Alba,Codonopsis pilosula,Eucommia ulmoides,Angelica sinensis and Radix Rehmanniae.The medicinal properties are mainly flat and warm,and the taste of medicine is mainly sweet,and the meridians are mostly liver and spleen meridians.The efficacy categories are as follows:deficiency medicine,wind-dampness medicine,blood-activating medicine and heat-clearing medicine.There are 146 kinds of traditional Chinese medicine before pregnancy,such as dodder,angelica,Dipsacus,Atractylodes macrocephala,mulberry parasite,etc.,and 165 kinds of traditional Chinese medicine during pregnancy,such as dodder,Dipsacus,mulberry parasite,Atracty lodes macrocephala,Ejiao and so on.The efficacy categories of drugs used before pregnancy are:deficiency drugs,promoting blood circulation and removing blood stasis drugs,heat-clearing drugs,wind-dampness-dispelling drugs,qi-activating drugs and so on.5.According to the association rule analysis of the drugs used,66 associated drug pairs were obtained,and the support and confidence of Dipsacus,dodder,mulberry parasite,Atracty lodes macrocephala,Ejiao,Codonopsis pilosula,Eucommia ulmoides and other drugs are higher.A total of 59 related drug pairs were obtained before pregnancy.Dipsacus,dodder,mulberry parasite,Angelica sinensis,Atractylodes macrocephala and other drugs had high support and confidence.71 pairs of related drugs were obtained in the treatment of pregnancy.Dipsacus,dodder,mulberry parasite,Atractylodes macrocephala,Ejiao and other drugs had high support and confidence.6.Twenty-nine high frequency drugs were analyzed by cluster analysis.the results were divided into six categories:1 Eucommia ulmoides,Atractylodes macrocephala,Codonopsis pilosula;2 Ejiao,dodder,Dipsacus,Mulberry parasitism;3 Radix Paeoniae Alba,Glycyrrhiza uralensis,4 Angelica,Radix Astragali;5 Radix Rehmanniae,Amomum,wolfberry,Morinda officinalis,ginseng,Polygonum multiflorum,deer horn cream,moxa leaf;6 yam,Cornus officinalis,Scutellaria baicalensis,Ligusticum chuanxiong,Salvia miltiorrhiza,Radix Rehmanniae,Poria cocos,tangerine peel,Ramie root,Radix Pseudostellariae.Cluster analysis of 27 high frequency drugs in prepregnancy treatment was conducted,the results were divided into seven categories:1 dodder,Dipsacus,Mulberry parasitism;2 Ejiao,Eucommia ulmoides,Atractylodes macrocephala,Codonopsis pilosula;3 Angelica,Astragalus;4 Chinese yam,Cornus officinalis,Radix Rehmanniae,Fructus Lycii,Morinda officinalis,Amomum villosum;5 Radix Paeoniae Alba,Radix Glycyrrhizae;6 Salvia miltiorrhiza;7 Ligusticum chuanxiong,Scutellaria baicalensis,Radix Rehmanniae,Poria,tangerine peel,red peony,Xiangfu,Epimedium,raspberry.The results of cluster analysis of 27 highfrequency drugs used in pregnancy are similar to those of all drugs,except that the order is different.7.The core drugs for the treatment of spleen and kidney deficiency syndrome of recurrent abortion are:Atractylodes macrocephala,dodder,Dipsacus,mulberry parasite,Codonopsis pilosula,ginseng,yam,Poria,etc.;the core drugs for the treatment of kidney qi deficiency syndrome are:Atractylodes macrocephala,dodder,Dipsacus,mulberry parasite,Eucommia ulmoides,wolfberry,etc.;the core drugs for the treatment of kidney deficiency syndrome are:Atractylodes macrocephala,dodder,Dipsacus,mulberry parasite,Radix Rehmanniae,Chinese wolfberry and so on.The core drugs for the treatment of kidney deficiency and blood stasis syndrome are:Atractylodes macrocephala,dodder,Dipsacus,mulberry parasite,Chuanxiong,Salvia miltiorrhiza,motherwort,etc.;the core drugs for the treatment of qi and blood deficiency syndrome are:Atractylodes macrocephala,dodder,Dipan,mulberry parasite,Ejiao,cooked Rehmannia,ginseng,tangerine peel,etc.;the core drugs for the treatment of kidney deficiency and blood deficiency syndrome are:Angelica sinensis.The results of complex network analysis of traditional Chinese medicine showed that the core drugs for the treatment of spleen and kidney deficiency syndrome before pregnancy are dodder,Dipsacus,Codonopsis pilosula,mulberry parasite,yam,Poria,Salvia miltiorrhiza,etc.The core drugs for the treatment of kidney deficiency and blood stasis syndrome are:dodder,Dipsacus,mulberry parasite,Angelica sinensis,Radix Paeoniae Alba,Salvia miltiorrhiza,Ligusticum chuanxiong,etc.The core drugs of deficiency of qi and blood are Angelica sinensis and Radix Astragali.The result of treatment during pregnancy is basically the same as the result of complex network analysis of all syndromes-traditional Chinese medicine.Conclusions:1.Recurrent abortion is affected by maternal,fetal and paternal factors,due to congenital deficiency,emotional disorder,room fatigue and other factors,resulting in kidney deficiency,spleen and kidney deficiency,qi and blood weakness,blood heat,blood stasis and other pathological changes,resulting in maternal Chong Ren injury,fetal yuan is not solid,and finally lead to recurrent abortion.Recurrent abortion involves kidney,spleen,liver and other internal organs.Qi deficiency,blood deficiency,blood stasis,spleen and kidney deficiency,kidney deficiency and blood stasis are common syndromes.Compared with the theoretical understanding of ancient doctors,modern physicians pay more attention to the study of kidney deficiency and blood stasis syndrome.2.Prevention should be given priority to recurrent abortion,and tonifying the kidney is the key point of treatment.Tonifying kidney and tonifying qi,tonifying kidney and spleen,replenishing qi and nourishing blood are common treatments for recurrent abortion.Shoutai Pill is the most commonly used prescription for the treatment of recurrent abortion,followed by Zishen Yutai Pill.Modern research pays more attention to the use of Bushen Huoxue recipe,taking into account Fuzheng and removing blood stasis,which is in line with the pathological characteristics of deficiency and blood stasis in women today.3.The drugs for the treatment of recurrent abortion are mainly tonifying drugs,especially qi-tonifying drugs,and are compatible with heat-clearing,qi-regulating and blood-activating drugs,giving consideration to both specimen and deficiency,so as to achieve the ideal effect of dispelling pathogens without harming vital energy,strengthening vital energy and not retaining pathogens.The taste of the medicine is mainly sweet and warm,which mostly enters the meridians of liver,spleen and kidney,and has the effect of tonifying kidney and spleen,tonifying qi and nourishing blood.Such as:dodder,Dipsacus,Mulberry parasite,Atractylodes macrocephala,Ejiao,Radix Paeoniae Alba,Codonopsis pilosula,Eucommia ulmoides,Angelica sinensis,Radix Rehmanniae and so on.4.Both ancient and modern doctors follow Zhang Jingyue’s principle of "precultivation of its damage" and advocate the treatment of recurrent abortion by stages.In this study,the prescriptions used in the treatment of pre-pregnancy and pregnancy were compared,and it was found that the treatment before and after pregnancy paid attention to tonifying the kidney,but most of the treatment during pregnancy paid attention to both symptomatic treatment and calming the fetus,with particular attention to tonifying the kidney and calming the fetus.The method of promoting blood circulation and removing blood stasis and its related drugs are extremely cautious.On the other hand,the treatment based on syndrome differentiation before pregnancy is more flexible in the use of drugs for promoting blood circulation and removing blood stasis,paying equal attention to strengthening and removing blood stasis,tonifying and reducing,and maintaining the uterus,in order to improve the success rate of pregnancy again. |
