Research on the rules of Professor Dai Xiaohua's medication for coronary heart disease and chronic heart failure based on data mining

Jun-Feng Shi, Ke-Xin Lu, Pan Liu, Xiao-Hua Dai

1. Anhui University of Chinese Medicine,Anhui Hefei,230038

2. The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei,230031

Keywords:Data mining Dai Xiaohua Professor Frequency analysis Cluster analysis

ABSTRAC T Objective: To analyze and discuss the rules and thoughts of Professor Dai Xiaohua's treatment of coronary heart disease and chronic heart failure using data mining technology. Methods: The medical records of outpatients from Professor Dai Xiaohua, who were treated in the Department of Cardiology, First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from June 2019 to October 2019 and standardize it. With the help of Microsoft Excel 2016, SPSS 23.0, and SPSS Modeler 18.0 computer software, a database was established and the frequency of medication, association rules, and cluster analysis were performed. Results: Of the 109 prescriptions included in the study, 87 Chinese medicines were involved. The top 10 drugs are Chenpi, Atractylodes, Dandelion, Zhuru, Muxiang, Fructus aurantii, Ophiopogon, Poria, Sour Jujube, semen coicis. A total of 10 associations such as “Bamboo Ru → Dandelion, Dandelion → Cinnamon”; Cluster analysis yields 5 clustering square groups. Conclusion: Professor Dai Xiaohua's treatment of coronary heart disease and chronic heart failure focuses on regulating qi and strengthening spleen, resolving phlegm and dampness.

1. Introduction

Coronary heart disease is an abbreviation of coronary atherosclerotic heart disease. It refers to ischemia and hypoxia, cardiac dysfunction, and / or organic disease caused by coronary artery stenosis due to various reasons. It is also called ischemic Cardiomyopathy[1]. Coronary heart disease ranks first in the basic causes of heart failure. Long-term treatment leads to structural changes in the heart and eventually heart failure. The efficacy of traditional Chinese medicines such as single-flavor drugs and compound preparations in treating coronary heart disease has been confirmed[2]. Professor Dai Xiaohua believes that coronary heart disease heart failure belongs to Ben Deficiency and Biao Shi. Spleen deficiency is main part of Ben Deficiency, Phlegm,Wet and Stasis are main part of Biao Shi. To Study medication characteristics and summarize clinical treatment experience, the study collected patient medical records from the outpatient department of Professor Dai Xiaohua in the Department of Cardiology of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from June 2019 to October 2019.

2. Materials and Methods

2.1 Data sources and selection

The selected cases were from June 2019 to October 2019.They were diagnosed in the outpatient department of Department of Cardiology, the First Affiliated Hospital of Anhui University of Chinese Medicine, and received 109 eligible cases.

2.2 Inclusion criteria

(1)First diagnosis is coronary heart disease heart failure; (2)The basic information is complete, including name, gender, age, date of visit, and medication.

2.3 Exclusion criteria

Professor Dai Xiaohua's Outpatient Prescriptions; Contains prescriptions for outpatient records other than coronary heart disease; Unrecognizable clinic records; Only one medical record with the same medical record symptoms, tongue pulse and prescription is retained.

2.4 TCM Information Specification and Entry

Standardized according to the "Pharmacopoeia of the People's Republic of China" [3] and "Traditional Chinese Medicine" [4]. Unified naming of drug names due to processing methods or origin, etc. For example, the specification of "fried Atractylodes macrocephala" is "Atractylodes macrocephala" and "Chuan Achyranthes bidentata" is "Achyranthes bidentata". Computer software was used to convert the counted cases into computerrecognizable languages, that is, no = 0, yes = 1.

The "Chinese Medicine Information Collection Form for Coronary Heart Disease Heart Failure" was compiled, with detailed information covering name, gender, age, date of consultation, medication, etc. The database was established using Microsoft Office Excel 2016. To ensure the accuracy and reliability of the data, the data was independently entered and verified by 2 people.

2.5 data analysis

Cluster analysis was performed using SPSS 23.0 software, and Microsoft Office Excel 2016 was used for statistics such as frequency of use, "four" gas, "five" flavor, and meridian meridian. IBM SPSS Modeler18.0 was used for association analysis. The results of two association rules were extracted with the minimum support of 60% and the minimum confidence of 90%. The summary of Professor Dai Xiaohua's commonly used drug pairs and groups for the treatment of coronary heart disease and heart failure was summarized.

3. Results

3.1 High frequency medication

A total of 109 cases were included in this study, contains 87 Chinese medicines. Medication frequency 1494 times, A total of 28 flavors of high-frequency drugs with a frequency greater than 10%,Total usage frequency is 1346 times, accounting for 90.1%. Among the top 10 drugs are Chenpi, Atractylodes, Dandelion, Zhuru, Muxiang, Coriander Shell, Ophiopogon, Poria, Sour Jujube, Coix Seed. Chenpi, atractylodes, woody incense, and clam shells are good for your heart and your Spleen. Poria, Coix Seed, Zhuru can expel phlegm. Dandelion, Ophiopogon japonicum, Sour Jujube solidify Yin and Yang and calm you.

Tab1 Professor Dai Xiaohua Prescribes High Frequency Drugs for Coronary Heart Disease Heart Failure (Frequency＞ 10%)

3.2 "four" gas, "five" flavor, and meridian meridian

The 87 flavors of drugs prescribed by Professor Dai Xiaohua contain 7 kinds of medicinal properties and 7 kinds of medicinal tastes, which belong to the twelve canons. The medicine is warm and flat, and the medicine tastes sweet, bitter, and bitter. It mainly supplements the spleen and stomach and nourishes the heart and lungs. See Tables 2 to 4 for details.

Tab2 Medication properties of Professor Dai Xiaohua for coronary heart disease heart failure

Tab3 Professor Dai Xiaohua's medication for coronary heart disease and heart failure

Tab4 Flavors of Professor Dai Xiaohua on Coronary Heart Disease and Heart Failure

3.3 Efficacy classification

According to the analysis of the data in the table, it can be known that Professor Dai Xiaohua's treatment of coronary heart disease heart failure is mainly based on qi, tonifying qi, clearing heat, soothe the nerves; drugs such as water and dampness, digestion, and phlegm are also commonly used Chinese medicine for treatment.

3.4 Correlation Analysis

Correlation analysis was performed on 28 drugs with a frequency of 10% in the prescription (total frequency of 1201 times, accounting for 80.4%) (minimum support was 60% and minimum confidence was 90%). A total of 10 associations such as “Bamboo Ru → Dandelion, Dandelion → Chen Pei” were generated, as shown in Table 6; the links between variables (stronger links are thicker) are displayed on the network, see Fig1 for details.

Fig 1 Association diagram of high-frequency drugs prescribed by Professor Dai Xiaohua for coronary heart disease

3.5 Cluster analysis

Cluster analysis was performed on 28 drugs using software, and five clustering square groups were obtained, as shown in Fig2 and Tab7.

Tab5 The efficacy of Professor Dai Xiaohua in treating coronary heart disease and heart failure

Tab6 Two-flavor association analysis of high-frequency drugs prescribed by Professor Dai Xiaohua for coronary heart disease and heart failure

Fig2 Tree diagram of cluster analysis of high-frequency drugs prescribed by Professor Dai Xiaohua for coronary heart disease

Tab7 Results of cluster analysis of high-frequency drugs prescribed by Professor Dai Xiaohua for coronary heart disease and heart failure

4. Discussion

In the traditional medicine of the motherland, there is no such name as “coronary heart disease” and there is no related discussion about “heart failure”. According to the typical symptoms of chest tightness, chest pain, asthma, palpitations, and fatigue, it can be classified as "chest palsy" [5]. "Su Wen Bi Bi" said: "Heart disease patients, the pulse is not connected", and put forward blood stasis as the core factor of chest paralysis. Medical doctor Zhang Zhongjing put forward "yang micro-yin string" as its basic pathogenesis, and created the rule of "Xuanbi Tongyang" based on this. Most contemporary medical practitioners use Yiqi Yangyin [6], Qi and blood circulation [7], Huatan Qushi method [8]. Modern research has found that traditional Chinese medicine methods such as qi and blood circulation can improve heart function, increase activity endurance, and reduce blood adhesion [9]. This coincides with Professor Dai Xiaohua's thought of treating coronary heart disease and heart failure.

Data mining shows that Professor Dai Xiaohua's treatment of coronary heart disease and heart failure is most commonly used in the treatment of Qi, sedatives, antipyretics, and diuretics. According to the core prescription, the top 10 flavors that are good at using drugs are Chenpi, Atractylodes, Dandelion, Zhuru, Muxiang, Fructus Aurantii, Ophiopogon, Poria, Sour Jujube, Coix Seed. It can be seen that the thinking of Professor Dai Xiaohua in the treatment of coronary heart disease heart failure is based on strengthening the spleen, expectorant, qi, and soothe. The "four" qi is mainly warm and flat, the "five" is more sweet, bitter, bitter, and belongs to the spleen and stomach. Warm medicine, calm medicine can warm the middle, Tongyang disperse cold, warm the spleen and yang, invigorate the heart yang; Ganneng, middle and tonic, Xin Qi, bitter and more dry, dampness, venting, and various flavors can be used to achieve the benefit of the spleen and stomach , Xuantong chest-yang, dry and dampness of the good effects.

According to the two association rules, Professor Dai Xiaohua's most commonly used medicine pairs (confidence＞ 90%) are dandelion, bamboo rut, woody scent, tanned peel, snail shell, and atractylodes. Its main effects are to clear heat and reduce phlegm, and regulate qi and spleen. "The spleen is the source of sputum", the spleen is dehydrated and debilitated, the water gathers into wetness, wet coagulates into sputum, and the phlegm is endogenous. It is yin, which blocks the sun in the chest and the hair is paralyzed[10]. "If there is more than Qi, there is fire, and if there is more than Liquid, it is sputum." Those who are good at treating phlegm must lower their fire first. Muxiang, Chenpi, Zhihu and Atractylodes manage their temper. Today, the spleen and stomach are healthy, the spleen is ascending and descending, and the sputum is passive.

According to cluster analysis, the drugs commonly used by Professor Dai Xiaohua can be divided into five categories. They are one category: grain germ, malt, astragalus, and salvia. Professor Dai Xiaohua believes that the spleen and stomach are the basis of Cangjie. Weakness of the spleen and stomach means child disease and mother, heart trauma, weakness in blood flow, stasis in the chest, and chest paralysis. Guya and malt are warm and sweet, and belong to the two classics of the spleen and stomach. The combination of the two can enhance their spleen and appetizing power. Astragalus is the “strength of Qi”, salvia promotes blood circulation, refreshes the heart, and calms the nerves. "Gongtong Siwu Decoction" said that the four drugs combined played a role in strengthening the spleen and stomach, and nourishing the spleen. If it is smooth, the blood flow is smooth and the gods are at ease. Three categories: Ophiopogon japonicus, Rehmannia glutinosa, Polygala chinensis, Melon yam, nourishing yin and clearing heat. Four categories: Coix Seed, Pinellia ternata, Poria, Divine Comedy, Bitter Almond, Chicken Inner Gold. Pinellia has dryness, dehumidification and phlegm removal, coix seed and Poria cocoa water soaking. Its mild nature can achieve the effect of nourishing the water without harming the positive effects; Divine Comedy, chicken internal gold and medium digestion, spleen appetizer. Combined with various medicines, it has the effects of strengthening the spleen, soaking wetness and improving water flow. Five categories: dandelion, bamboo rut, tangerine peel, woody incense, coriander shell, atractylodes. Chest palsy is evidence of the fact that this is true, and those who experience it are more common with Qi stagnation, phlegm dampness, and blood stasis. "Compendium of Materia Medica" said: "Wooden incense, the general medicine for qi, and stomach qi, Tongxin qi,… quick temper,… control the internal and external qi of the body, for its own merits". The clam shell is wide in the middle of the air; the combination of Chenpi and Atractylodes can strengthen the spleen and dampness, and is suitable for the syndrome of spleen deficiency and dampness; dandelion is cold, with heat-clearing and diuretic effects[11]; Water, wetness, and phlegm resolve.

This article analyzes the rules of clinical medication of Professor Dai Xiaohua in treating coronary heart disease through the contents of Chinese medicine frequency, association rules, and cluster analysis. Based on the characteristics of the disease, its healthy treatment of "cangjie" and solidification of "monarch" provide a new direction for traditional Chinese medicine to treat coronary heart disease and heart failure, with a view to inheriting Professor Dai Xiaohua's clinical dialectical experience.