Analysis of Chinese Medical Syndrome Features of Ischemic Stroke Based on Similarity of Symptoms Subgroup / 中国结合医学杂志

OBJECTIVE@#To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients.@*METHODS@#By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup.@*RESULTS@#Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens.@*CONCLUSIONS@#There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.

Identification of Hypertension Subgroups through Topological Analysis of Symptom-Based Patient Similarity / 中国结合医学杂志

OBJECTIVE@#To obtain the subtypes of the clinical hypertension population based on symptoms and to explore the relationship between hypertension and comorbidities.@*METHODS@#The data set was collected from the Chinese medicine (CM) electronic medical records of 33,458 hypertension inpatients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between July 2014 and May 2017. Then, a hypertension disease comorbidity network (HDCN) was built to investigate the complicated associations between hypertension and their comorbidities. Moreover, a hypertension patient similarity network (HPSN) was constructed with patients' shared symptoms, and 7 main hypertension patient subgroups were identified from HPSN with a community detection method to exhibit the characteristics of clinical phenotypes and molecular mechanisms. In addition, the significant symptoms, diseases, CM syndromes and pathways of each main patient subgroup were obtained by enrichment analysis.@*RESULTS@#The significant symptoms and diseases of these patient subgroups were associated with different damaged target organs of hypertension. Additionally, the specific phenotypic features (symptoms, diseases, and CM syndromes) were consistent with specific molecular features (pathways) in the same patient subgroup.@*CONCLUSION@#The utility and comprehensiveness of disease classification based on community detection of patient networks using shared CM symptom phenotypes showed the importance of hypertension patient subgroups.

Combination rules of Chinese herbal prescriptions for treating unstable angina based on complex network / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore combination rules of Chinese herbal prescriptions from effective cases for treatment of unstable angina (UA).</p><p><b>METHODS</b>Prescription data from 156 UA patients effectively treated at Cardiovascular Diseases Centre of Xiyuan Hospital were analyzed using complex network method.</p><p><b>RESULTS</b>According to multi-scale analysis of backbone network and pointwise mutual information analysis, core prescriptions from the 156 UA patients were presented as follows: Rhizoma Ligustici wallichii, Radix Paeoniae rubra, Radix Codonopsis, Rhizoma Pinelliae, poria, and Angelica sinensis. Meanwhile, core couplet medicines for these patients covered Rhizoma Ligustici wallichii and Radix paeoniaerubra, Angelica sinensis and Rhizoma Ligustici wallichii, Radix Codonopsis and Rhizoma Ligustici wallichii, Rhizoma Ligustici wallichii and Rhizoma Pinelliae, Rhizoma Atractylodis Macrocephalae and poriacocos, Bulbus Alli Macrostemi and Rhizoma Pinelliae. Among different primary symptoms, there was slightly difference in core prescriptions.</p><p><b>CONCLUSION</b>The core prescriptions for the treatment of UA include blood-activating drug, phlem-resolving drugs. As an exploration of combination rules of Chinese herbal prescriptions in treating UA based on complex network, it can be used as a reference for further researches.</p>

Optimized treatment program for unstable angina by integrative medicine based on partially observable Markov decision process / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To initially optimize comprehensive treatment program for treating and preventing unstable angina (UA) by integrative medicine (IM).</p><p><b>METHODS</b>Based on partially observable Markov decision process model (POMDP), we chose 3 syndrome elements, i.e., qi deficiency, blood stasis, and phlegm turbidity from UA inpatients. The efficacy of treating UA by IM was objectively assessed by in-depth data mining and analyses.</p><p><b>RESULTS</b>The treatment programs for UA patients of qi deficiency syndrome, blood stasis syndrome, and phlegm turbidity syndrome were recommended as follows: nitrates +statins +clopidogrel +angiotensin II receptor blockers +heparins +Astragalus membranaceus +Condonopsis + poria and large-head atractylodes rhizome (ADR = 0.85077869); nitrates + aspirin + clopidogrel + statins + heparins + Astragalus membranaceus + safflower + peach seed + red peony root (ADR = 0.70773000); nitrates + aspirin + statins + angiotensin-converting inhibitors + snakegourd fruit + onion bulb + ternate pinellia + tangerine peel (ADR = 0.72509600).</p><p><b>CONCLUSION</b>As a POMDP based optimized treatment programs for UA, it can be used as a reference for further standardization and formulation of UA program by integrative medicine.</p>

Discussion on solutions to ethical issues of clinical researches in a real world / 中国中西医结合杂志

The paradigm of a real world study has become the frontiers of clinical researches, especially in the field of Chinese medicine, all over the world in recent years. In this paper, ethical issues which probably exist in real-world studies are raised and reviewed. Moreover, some preliminary solutions to these issues such as protecting subjects during the process of real-world studies and performing ethical review are raised based on recent years' practices to enhance the scientificity and ethical level of real-world studies.

Discovery of regularities in the use of herbs in Chinese medicine prescriptions / 中国结合医学杂志

Chinese medicine (CM) is a discipline with its own distinct methodologies and philosophical principles. The main method of treatment in CM is to use herbal prescriptions. Typically, a number of herbs are combined to form a formula and different formulae are prescribed for different patients. Regularities in the mixture of herbs in the prescriptions are important for both clinical treatment and novel patent medicine development. In this study, we analyze CM formula data using latent tree (LT) models. Interesting regularities are discovered. Those regularities are of interest to students of CM as well as pharmaceutical companies that manufacture medicine using Chinese herbs.

Topic model for Chinese medicine diagnosis and prescription regularities analysis: case on diabetes / 中国结合医学杂志

Induction of common knowledge or regularities from large-scale clinical data is a vital task for Chinese medicine (CM). In this paper, we propose a data mining method, called the Symptom-Herb-Diagnosis topic (SHDT) model, to automatically extract the common relationships among symptoms, herb combinations and diagnoses from large-scale CM clinical data. The SHDT model is one of the multi-relational extensions of the latent topic model, which can acquire topic structure from discrete corpora (such as document collection) by capturing the semantic relations among words. We applied the SHDT model to discover the common CM diagnosis and treatment knowledge for type 2 diabetes mellitus (T2DM) using 3 238 inpatient cases. We obtained meaningful diagnosis and treatment topics (clusters) from the data, which clinically indicated some important medical groups corresponding to comorbidity diseases (e.g., heart disease and diabetic kidney diseases in T2DM inpatients). The results show that manifestation sub-categories actually exist in T2DM patients that need specific, individualised CM therapies. Furthermore, the results demonstrate that this method is helpful for generating CM clinical guidelines for T2DM based on structured collected clinical data.

Patterns of herbal combination for the treatment of insomnia commonly employed by highly experienced Chinese medicine physicians / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the most effective herbal combinations commonly used by highly experienced Chinese medicine (CM) physicians for the treatment of insomnia.</p><p><b>METHODS</b>We collected and analyzed data related to insomnia treatment from the clinics of 7 highly experienced CM physicians in Beijing. The sample included 162 patients and 460 consultations in total. Patient outcomes, such as sleep quality and sleep time per day, were manually collected from the medical records by trained CM clinicians. Three data mining methods, support vector machine (SVM), logistic regression and decision tree, and multifactor dimensionality reduction (MDR), were used to determine and confirm the herbal combinations that resulted in positive outcomes in patients suffering from insomnia.</p><p><b>RESULTS</b>Results show that MDR is the most efficient method to predict the effective herbal combinations. Using the MDR model, we identified several combinations of herbs with 100% positive outcomes, such as stir-fried spine date seed, Szechwan lovage rhizome, and prepared thinleaf milkwort root; white peony root, golden thread, and stir-fried spine date seed; and Asiatic cornelian cherry fruit with fresh rehmannia.</p><p><b>CONCLUSIONS</b>Results indicate that herbal combinations are effective treatments for patients with insomnia compared with individual herbs. It is also shown that MDR is a potent data mining method to identify the herbal combination with high rates of positive outcome.</p>

Summary of professor Tian Cong-huo's commonly-used acupoint prescriptions / 中国针灸

Clinically, professor TIAN Cong-huo pays attention to treatment based on syndrome differentiation, with acupoint selection based on syndrome differentiation. In this present paper, clinically commonly-used 19 acupoint prescriptions, and relatively fixed indication ranges, manipulation methods, modified acupoint prescriptions, and professor TIAN's experience in application of these acupoints are summarized and introduced.

Study on law using Chinese drug of famous old docter of traditional Chinese medicine to coronary heart disease based on association rules / 中国中药杂志

<p><b>OBJECTIVE</b>To analyze the law that famous old doctor of traditional Chinese medicine (TCM) treat angina pectoris using Chinese drugs, explore the method that well-known doctor's experience was arranged.</p><p><b>METHOD</b>Typical medicine case 115 of angina pectoris were collected and well-known doctor coronary heart disease database making a diagnosis was set up, then used association rules to analyze well-known doctor's prescription compatibility law curing coronary heart disease.</p><p><b>RESULT</b>In 175 kinds of traditional Chinese medicinal used, the compatibility among blood-activating drug, phlegm-resolving drug and tonic was the most frequently used medicinal groups, Gualou Xiebai decoction, Huoxue decoction and Shengmai powder were the basic formula that well-known doctor treat coronary heart disease, matching and employing between the three form the universal law that the well-known doctor used medicine.</p><p><b>CONCLUSION</b>Drug groups drew with association rules that well-known doctor treat coronary heart disease reacted well-known doctor's therapeutic thought of curing, would provide the method reference to research in the hereafter.</p>