A Study On The Medication Law Of Traditional Chinese Medicine In The Treatment Of Gastro-esophageal Reflux Disease Based On Data Mining

Objective: Based on the data mining technology,by sorting out the clinical research and experimental literature of traditional Chinese medicine in treating gastroesophageal reflux disease(GERD),and relying on the traditional Chinese medicine inheritance computing platform V3.0(TCMICS V3.0),to analyze and discuss the medication rules and characteristics of traditional Chinese medicine in treating GERD,in order to provide reference for clinical treatment.Methods: The clinical research and experimental literature on the treatment of GERD with traditional Chinese medicine published in CNKI,VIP,Wanfang data,Chinese Biomedical and other databases were collected and retrieved from January 2007 to December 2022.According to the established inclusion criteria,189 documents meeting the inclusion criteria were established into Excel tables,and 189 prescription data were standardized.TCMICS V3.0 software was used to excavate the frequency,four qi,five flavors,meridian tropism,and efficacy of drugs from frequency analysis,association rule analysis,and cluster analysis,to analyze and summarize the medication rules of traditional Chinese medicine in treating GERD.Result:1.Syndrome type: This study included a total of 189 relevant literature on the treatment of GERD with traditional Chinese medicine,including 90 literature on single syndrome type research,involving 26 types of syndrome types.The liver stomach stagnation heat syndrome is the most frequently used,followed by the liver stomach disharmony syndrome,followed by the mixed cold and heat syndrome and the middle deficiency qi inversion syndrome.2.Syndromic elements: through the classification of syndrome types,the disease sites with frequency ≥ 10 times were counted as stomach,liver and spleen.Pathogenic factors include heat,depression,deficiency,cold,phlegm,stagnation,dampness and blood stasis.3.Prescriptions: In this study,a total of 103 prescriptions were obtained after splitting the combined formula,There are 31 prescriptions with a frequency of ≥ 2 times;The most frequently used one is Banxia Xiexin Tang,accounting for 10.55%;Other drugs with a frequency exceeding 10 times include Zuojin Wan(accounting for 5.50%),Xuanfu Daizhe Tang(accounting for 5.05%),and Sini San(accounting for 4.59%).It has been indirectly confirmed that Banxia Xiexin Tang,Zuojin Wan,Xuanfu Daizhe Tang,and Sini San do have therapeutic effects on GERD.4.Medication:(1)The frequency analysis shows that 161 traditional Chinese medicines are involved and the total frequency of use is 2074 times.The frequency of drug use ≥ 60 times are pinellia ternata,licorice,coptis chinensis,bupleurum chinense,white peony,evodia rutaecarpa,tangerine peel,poria cocos,cuttlebone,codonopsis pilosula and fructus aurantii.(2)The use frequency of cold drugs in the four qi is the highest(frequency 806,frequency 39.39%),followed by warm drugs(frequency 723)and mild drugs(frequency 404);There are relatively few hot drugs and cold drugs.The top three are bitter drugs(frequency 1202,accounting for 38.20%),bitter drugs(frequency 923,accounting for 29.34%),and sweet drugs(frequency 641,accounting for 20.37%).Secondly,sour drugs(frequency 206,accounting for 6.55%)and salty drugs(frequency 175,accounting for 5.56%)are relatively less.(3)In the aspect of meridian tropism: the spleen meridian is the most frequently used medicine with a frequency of 23.22%,followed by the stomach meridian(18.24%),the lung meridian(18.05%)and the liver meridian(11.95%)with a frequency of ≥ 10%.(4)In terms of efficacy: 17 kinds of traditional Chinese medicine have been counted,and the most commonly used are the drugs for tonifying deficiency,with a total of 428 times,accounting for 20.92%;In addition,the top ten categories also include expectorant,cough relieving and asthma relieving(309 times),heat clearing(300 times),regulating qi(281 times),relieving exterior symptoms(165 times),warming the interior(107 times),activating blood circulation and removing stasis(91 times),diuretic and dampness-inhibiting(73 times),astringent(71 times),dampness-inhibiting(66 times).(5)Association rule analysis: 161 traditional Chinese medicines(excluding licorice)involved in this study were analyzed by association rules,with a support of 0.2 and a confidence of 0.7.A total of 22 rules were mined.Most commonly used drug combinations are based on pinellia ternata.The top 10 combinations are pinellia ternata,coptis chinensis(85 times),pinellia ternata,radix bupleuri(71 times),coptis chinensis,fructus evodiae(67 times),radix bupleuri,radix paeoniae alba(64 times),pinellia ternata,tangerine peel(60 times),pinellia ternata,radix paeoniae alba(59 times),coptis chinensis,radix bupleuri(56 times),pinellia ternata,radix scutellariae(55 times),pinellia ternata,radix codonopsis pilosula(52 times),pinellia ternata,poria cocos(51 times).The drug pair with the highest confidence is Bupleurum chinense,Evodia rutaecarpa-Coptis chinensis.(6)Cluster analysis: there are five core components of the copolymer,which are in turn: A1 group: Pinellia ternata,Coptis chinensis,Scutellaria baicalensis,Bupleurum chinense,Chinese date,Evodia rutaecarpa;Group A2:Pinellia ternate,Poria cocos,Codonopsis pilosula,Coptis chinensis,cuttlebone,orange peel;Group A3: bupleurum,trifoliate orange,white peony,orange peel,coptis chinensis,pinellia ternata;Group A4: Pinellia ternata,Bupleurum chinense,Coptis chinensis,Curcuma,Scutellaria baicalensis,Atractylodes lanceolata;Group A5: pinellia ternate,ochre,coptis chinensis,convolvulus,bupleurum chinense,cassia twig.Conclusion:1.Pinellia ternate is the most commonly used traditional Chinese medicine for treating GERD.2.GERD is characterized by deficiency,excess,cold and heat,with "stagnation,depression,phlegm,dampness" as the main pathological factors;The syndrome types are mainly liver stomach stagnation heat syndrome and liver stomach disharmony syndrome,followed by mixed cold and heat syndrome and middle deficiency qi inversion syndrome;The treatment mainly focuses on soothing the liver and regulating qi,clearing heat and phlegm,dispelling external pathogens,tonifying deficiency and strengthening the body,supplemented by treatment methods such as promoting diuresis and dampness,promoting blood circulation and resolving blood stasis.Banxia Xiexin Tang,Xuanfu Daizhe Tang,and Zuojin Wan are commonly used formulas for treating GERD.3.The commonly used drugs for the treatment of GERD in traditional Chinese medicine are characterized by cold,warm,and calm properties,and the main flavors are bitter,spicy,and sweet.They mainly belong to the spleen,stomach,lung,and liver meridians,which indirectly reflect that the location of GERD is mainly in the stomach and is closely related to the liver and spleen.Gastric disharmony and downregulation,as well as the inversion of stomach qi,are the fundamental pathogenesis of GERD,and the abnormal rise and fall of visceral qi mechanisms run through the occurrence and development of this disease.4.In this study,the commonly used drugs are mostly tonifying deficiency,while the syndrome type is mainly liver and stomach heat stagnation;The author believes that it can be understood from two aspects:(1)"When evil gathers,its qi must be deficient." GERD is often characterized by a combination of deficiency and excess,and the syndrome of liver and stomach heat stagnation is often characterized by changes in soil deficiency and wood multiplication.Therefore,clinical dialectical prescriptions can be appropriately added to tonify the spleen and qi;(2)Doctors often use licorice as a tonic,which has a certain impact on the study of its efficacy.5.In the correlation analysis,the combination of drugs for soothing the liver and stomach,reducing adverse reactions and resolving phlegm,and clearing stomach fire is the most common.6.In cluster analysis,it can be confirmed that Banxia Xiexin Decoction,Xuanfu Daizhe Decoction,Zuojin Pill and other prescriptions are commonly used in the treatment of GERD.