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Association Study on Diseases, Syndromes, Formulas and Herbs of Qing Court Original Medical Records

Author: XieYuanHua
Tutor: ChenKeJi;ZhangJingChun
School: Beijing University of Traditional Chinese Medicine
Course: Traditional Chinese Medicine
Keywords: Qing Court Original Medical Records Formula and Herb Corresponding to Disease and Syndrome Multidimensional Data Analysis Association Rule
CLC: R-092
Type: PhD thesis
Year: 2008
Downloads: 300
Quote: 1
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Abstract


1. ObjectivesFor multidimensional data analysis (MDA), it is necessary to create Qing Court Original Medical Records Database (QCMD) and Data Warehouse (DW). This is one of the objectives about study. The second objective is to explore the methodologies that could ascertain associations between diseases, syndromes, formulas and herbs of medical records. Based on ACMD, DW and the methodologies, thus the study could process intelligent data analysis (IDA) of Qing Court Original Medical Records and mine some regular clinical rules that have not been summarized before.2. MethodsThe Methodologies about the study of medical records are regarded as the repeatability principle and the strong association rule. The repeatability principle considers that an efficacious remedy would be repeated continuously. The repeatability of remedy could be calculated by frequency statistics and MDA, and the main means of frequency statistics are SQL query and Access query. For MDA with online analytical processing (OLAP), it is necessary to create data cube including six dimensions of‘disease name’,‘syndrome’,‘symptom’,‘principle of treatment’,‘formula’and‘herb’. The strong association rule considers that the more probability of any specific dimensions presenting to the same medical record, the more clinical value they have. The intensity of association could be measured by association rule of Data Mining (DM). Association rule generates frequent itemsets firstly, and then generates the subset and its complimentary set for each frequent itemset. The evaluation indexes of association rule are Support (Sup) and Confidence (Con).3. Results3.1General conditionsThe QCMD has collected 894 medical records, including 19,853 rows in total. And there are 213,355 rows in the assemble table of DW. Diseases caused by exogenous pathogenic factor are the most common while internal diseases are mainly about thoracic obstruction, hypochondriac pain, vertigo, arthralgia disease, bellyache, cough, etc. The most common syndromes are affection by exogenous wind cool and stagnation of qi, and then disharmony between the liver and stomach, heat syndrome of the lung and stomach, damp turbidity and excessive fluid of the stomach, heat syndrome of the liver and stomach, excessive fluid and heat syndrome of the lung and stomach, etc. The most common principles of treatment are resolving heat and clearing away excessive fluid, and then reconciling the liver and regulating qi. Formulas are named by principles of treatment mostly, and the most common formulas are Shujie Zhengqi Tang and Hegan Huayin Tang. There are 299 kinds of herbs in the QCMD; the most common herbs used in QCMD are Fructus Aurantii Submaturus, Poria, Radix Scutellariae Baicalensis, Cortex Magnoliae Officinalis, Pericarpium Citri Reticulatae, Rhizoma Cyperi, etc. 3.2Association between diseases and syndromesThe most common syndromes of cold are affection by exogenous wind cool, affection by exogenous wind cold, heat syndrome of the lung and stomach, fluid retention and heat syndrome, excessive fluid and heat syndrome of the lung and stomach, etc. The syndrome of affection by exogenous wind cool is often cured by Shujie Zhengqi Tang, and the heat syndrome of the lung and stomach is often cured by Qingre Huazhi Tang. Colds with cough could use Radix Platycodi and Radix Peucedani, with pharyngalgia could use Radix Platycodi and Radix Scrophulariae, with headache could use Rhizoma Chuanxiong and Radix Angelicae Formosanae, etc.The main syndromes of thoracic obstruction are stagnation of qi, heat syndrome of the Liver meridian, damp turbidity and excessive fluid of the stomach, and the most common principles of treatment are regulating qi, removing heat from the liver, clearing away excessive fluid, resolving heat, etc. Pericarpium Citri Reticulatae Viride, Fructus Aurantii Submaturus, Rhizoma Cyperi are in common used to regulate qi; Herba Gentianae to remove heat from the liver; Radix Paeoniae Alba to nourish the liver; Fructus Aurantii Submaturus to clear away excessive fluid; Fructus Gardeniae, Rhizoma Coptidis, Radix Scutellariae Baicalensis and Radix et Rhizoma Rhei Palmati to resolve heat; Fructus et Semen Trichosanthis Kirilowii to relieve chest stuffiness; Lignum Aquilariae Resinatum and Rhizoma Corydalis Yanhusuo to alleviate pain; Rhizoma Atractylodis Macrocephalae and Cortex Magnoliae Officinalis to normalize function of the stomach and spleen. The common binomial compatibilities of thoracic obstruction treatment are Fructus Aurantii Submaturus and Pericarpium Citri Reticulatae Viride, Rhizoma Pinelliae and Fructus et Semen Trichosanthis Kirilowii, Radix Angelicae Sinensis and Rhizoma Cyperi, etc. The common trinomial compatibilities are Cortex Magnoliae Officinalis, Fructus Aurantii Submaturus and Radix et Rhizoma Rhei Palmati; Rhizoma Pinelliae, Fructus et Semen Trichosanthis Kirilowii and Rhizoma Coptidis; Radix et Rhizoma Rhei Palmati, Fructus Gardeniae and Herba Gentianae.Vertigo has a great relationship with the liver, and heat syndrome of the liver is the most common. The main principles of treatment are resolving heat, clearing away excessive fluid, reconciling the liver, removing heat from the liver, eliminating dampness, normalizing function of the stomach and spleen, nourishing yin, etc. Flos Dendranthematis, Folium Mori, Cornu Saigae Tataricae, Radix Scutellariae Baicalensis are in common used to resolve heat; Pericarpium Citri Reticulatae, Poria, Fructus Aurantii Submaturus, Cortex Magnoliae Officinalis to clear away excessive fluid; Pericarpium Citri Reticulatae Viride, Herba Menthae Haplocalycis, Rhizoma Cyperi to reconcile the liver; Radix Paeoniae Alba, Flos Dendranthematis, Cornu Saigae Tataricae to remove heat from the liver; Radix Bupleuri Chinensis, Radix Paeoniae Rubra to soothe the liver; Rhizoma Chuanxiong, Pericarpium Citri Reticulatae, Rhizoma Atractylodis Lanceae to eliminate dampness; Poria, Rhizoma Atractylodis Macrocephalae to normalize function of the stomach and spleen; Radix Scrophulariae, Radix Rehmanniae, Cortex Moutan Radicis, Radix Paeoniae Alba to nourish yin. The most common herb used for vertigo is Flos Dendranthematis. The common compatibilities are Folium Mori and Flos Dendranthematis, Cortex Magnoliae Officinalis and Pericarpium Citri Reticulatae, Radix Rehmanniae and Radix Paeoniae Alba.3.3 Association between formulas and syndromesHegan Huayin Tang is composed of Poria, Rhizoma Cyperi, Rhizoma Pinelliae, Cortex Magnoliae Officinalis, Radix Bupleuri Chinensis, Pericarpium Citri Reticulatae Viride, Fructus Aurantii Submaturus, Radix Angelicae Sinensis, Pericarpium Arecae, etc. It is a formula indicated for pleural effusion, abdominal mass, hypochondriac pain, heart palpitation due to disharmony between the liver and stomach or excessive fluid retention, in common with the symptom of painful distension over hypochondrium. Pericarpium Arecae, Fructus Amomi are in common used in pleural effusion while Radix Paeoniae Rubra, Rhizoma Chuanxiong, Radix Angelicae Sinensis, Rhizoma Corydalis Yanhusuo in abdominal mass; Radix Curcumae Wenyujin in hypochondriac pain; Radix Paeoniae Alba, Poria Cum Radix Pini, Radix Curcumae Wenyujin in heart palpitation.Chushi Niantong Tang is composed of Radix Angelicae Sinensis, Rhizoma et Radix Notopterygii, Rhizoma Atractylodis Lanceae, Poria, Rhizoma Alismatis, Herba Artemisiae Capillaris, Radix Saposhnikoviae, Radix Sophorae Flavescentis, Polyporus, Radix Angelicae Biserratae, Radix Scutellariae Baicalensis, Radix Puerariae Lobatae, etc.. It is a formula indicated for arthralgia disease due to downward flow of damp-heat or damp-heat obstruction of the meridian.The liver-stomach syndrome contains many syndromes; disharmony between the liver and stomach can result in hypochondriac pain, arthralgia disease, thoracic obstruction, abnormal menstruation, etc; heat syndrome of the liver and stomach can result in odontalgia, epistaxis, etc; excessive fluid and heat syndrome of the liver and stomach can result in vertigo, cephalalgia, etc; damp-heat syndrome of the liver and stomache can result in inflammation of the throat, vertigo, etc. Pericarpium Citri Reticulatae Viride, Rhizoma Cyperi, Radix Bupleuri Chinensis, Radix Curcumae Wenyujin are in common used to reconcile the liver; Herba Gentianae, Gypsum Fibrosum, Fructus Gardeniae, Radix et Rhizoma Rhei Palmati, Flos Dendranthematis to resolve heat; Poria, Pericarpium Citri Reticulatae, Fructus Crataegi Pinnatifidae, Massa Medicata Fermentata, Rhizoma Atractylodis Macrocephalae, Rhizoma Pinelliae, Cortex Magnoliae Officinalis to normalize function of the stomach and spleen.The lung-stomach syndrome is most common in the diseases caused by exogenous pathogenic factor. Heat syndrome of the lung and stomach could be also in arthralgia disease, vertigo, alvine flux, etc; excessive fluid and heat syndrome of the lung and stomach could be also in vertigo, convulsive disease. Radix Scutellariae Baicalensis, Fructus Gardeniae, Rhizoma Coptidis, Caulis Bambusae in Taeniam, Rhizoma Anemarrhenae, Bulbus Fritillariae Cirrhosae, Radix Trichosanthis, Radix et Rhizoma Rhei Palmati are in common used to clear heat of lung and stomach. Rhizoma Atractylodis Lanceae, Rhizoma Pinelliae, Pericarpium Citri Reticulatae, Poria, Cortex Magnoliae Officinalis are in common used to eliminate dampness and clear away excessive fluid.3.4 Association between symptoms and herbsRhizoma Cyperi is used to regulate qi, soothe the liver, regulate and tonify the blood, alleviate pain. It is often with Poria, Cortex Magnoliae Officinalis, Fructus Aurantii Submaturus and is a herb indicated for thoracic obstruction, cold, hypochondriac pain, bellyache, arthralgia disease, vertigo, convulsive disease, abnormal menstruation, emesis due to stagnation of qi, excessive fluid retention, etc. Rhizoma Cyperi is the common compatibility with Pericarpium Citri Reticulatae Viride, Rhizoma Corydalis Yanhusuo, Radix Curcumae Wenyujin, Fructus Amomi, Radix Aucklandiae, Radix Angelicae Sinensis, Radix Paeoniae Rubra, etc.Rhizoma Chuanxiong is mainly used to eliminate dampness, dispel pathogenic wind in QCMD. It is a herb indicated for cold, cephalalgia, vertigo, arthralgia disease, hypochondriac pain, thoracic obstruction, bellyache, wind-warm disease, dysmenorrheal, in common with the symptom of headache. Rhizoma Chuanxiong is the common compatibility with Radix Angelicae Sinensis, Fructus Viticis Simplicifoliae, Radix Angelicae Formosanae, etc. Fructus Viticis Simplicifoliae, Rhizoma Chuanxiong, Flos Dendranthematis are the common herbs to the symptom of headache, while Radix Scrophulariae, Radix Platycodi to pharyngalgia; Fructus Aurantii Submaturus, Semen Armeniacae Amarum, Radix Peucedani to cough; Poria, Rhizoma Atractylodis Macrocephalae, Cortex Magnoliae Officinalis, Polyporus, Rhizoma Alismatis to alvine flux; Radix Scutellariae Baicalensis, Radix Trichosanthis, Fructus Gardeniae to thirst; Pericarpium Citri Reticulatae, Cortex Magnoliae Officinalis, Poria to emesis; Rhizoma Cyperi, Rhizoma Corydalis Yanhusuo to bellyache; Pericarpium Citri Reticulatae Viride, Rhizoma Cyperi, Radix Paeoniae Alba to hypochondriac pain; Radix Angelicae Biserratae, Radix Stephaniae Tetrandrae, Cortex Phellodendri Amurensis, Radix Achyranthis Bidentatae to lumbago; Radix Aucklandiae, Semen Arecae, Rhizoma Coptidis to dysentery; Semen Ziziphi Spinosae, Radix Paeoniae Alba, Poria Cum Radix Pini to ahypnosis.3.5 Specific formulas and herbsIn QCMD, Shenghua Tang is the specific formula for bellyache caused by lochia. Fructus Cannabis and Semen Pruni Japonicae are the specific herbs for constipation, always used with Radix Angelicae Sinensis, sometimes with Xiao Chenqi Tang.4. ConclusionsThe theory of formula and herb corresponding to disease and syndrome develops the proposition of correlation between formula and syndrome. Repeatability principle and strong association rule give more meaning of medical record data analysis. Multidimensional Database of QCMD reflects accurately complex relationship between diseases, syndromes and formulas, herbs. So we could process multidimensional query and analysis. Some regular clinical rules of Qing Court medical records never summarized before have been mined and discussed in the study.

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