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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.
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Humanos , Síndrome , Accidente Cerebrovascular Isquémico , Medicina Tradicional China , Hígado , FenotipoRESUMEN
OBJECTIVES@#To construct a clinical prediction model for the impact of acupuncture on pregnancy outcomes in poor ovarian response (POR) patients, providing insights and methods for predicting pregnancy outcomes in POR patients undergoing acupuncture treatment.@*METHODS@#Clinical data of 268 POR patients (2 cases were eliminated) primarily treated with "thirteen needle acupuncture for Tiaojing Cuyun (regulating menstruation and promoting pregnancy)" was collected from the international patient registry platform of acupuncture moxibustion (IPRPAM) from September 19, 2017 to April 30, 2023, involving 24 clinical centers including Acupuncture-Moxibustion Hospital of China Academy of Chinese Medical Sciences. LASSO and univariate Cox regression were used to screen factors influencing pregnancy outcomes, and a multivariate Cox regression model was established based on the screening results. The best model was selected using the Akaike information criterion (AIC), and a nomogram for clinical pregnancy prediction was constructed. The prediction model was evaluated using receiver operating characteristic (ROC) curves and calibration curves, and internal validation was performed using the Bootstrap method.@*RESULTS@#(1) Age, level of anti-Müllerian hormone (AMH), and total treatment numbers of acupuncture were independent predictors of pregnancy outcomes in POR patients receiving acupuncture (P<0.05). (2) The AIC value of the best subset-Cox multivariate model (560.6) was the smallest, indicating it as the optimal model. (3) The areas under curve (AUCs) of the clinical prediction model after 6, 12, 24, and 36 months treatment were 0.627, 0.719, 0.770, and 0.766, respectively, and in the validation group, they were 0.620, 0.704, 0.759, and 0.765, indicating good discrimination and repeatability of the prediction model. (4) The calibration curve showed that the prediction curve of the clinical prediction model was close to the ideal model's prediction curve, indicating good calibration of the prediction model.@*CONCLUSIONS@#The clinical prediction model for the impact of acupuncture on pregnancy outcomes in POR patients based on the IPRPAM platform has good clinical application value and provides insights into predicting pregnancy outcomes in POR patients undergoing acupuncture treatment.
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Embarazo , Femenino , Humanos , Resultado del Embarazo , Modelos Estadísticos , Pronóstico , Terapia por Acupuntura , Sistema de RegistrosRESUMEN
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.
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<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>
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Humanos , Angelica sinensis , Angina Inestable , Quimioterapia , Medicamentos Herbarios Chinos , Estándares de Referencia , Usos Terapéuticos , Pinellia , Raíces de Plantas , Guías de Práctica Clínica como Asunto , Prescripciones , Estándares de ReferenciaRESUMEN
<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>
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Humanos , Angina Inestable , Terapéutica , Toma de Decisiones , Sistemas de Apoyo a Decisiones Clínicas , Medicina Integrativa , Cadenas de MarkovRESUMEN
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.
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Humanos , Investigación Biomédica , Ética , MétodosRESUMEN
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.
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Humanos , Química Farmacéutica , Estándares de Referencia , Composición de Medicamentos , Estándares de Referencia , Medicamentos Herbarios Chinos , Usos Terapéuticos , Medicina Tradicional China , Modelos Biológicos , Medicamentos bajo Prescripción , Usos TerapéuticosRESUMEN
<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>
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Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Competencia Clínica , Minería de Datos , Quimioterapia Combinada , Medicamentos Herbarios Chinos , Usos Terapéuticos , Medicina Tradicional China , Pacientes Ambulatorios , Médicos , Trastornos del Inicio y del Mantenimiento del Sueño , Quimioterapia , Resultado del TratamientoRESUMEN
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.
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Humanos , Diabetes Mellitus Tipo 2 , Diagnóstico , Terapéutica , Diagnóstico Diferencial , Medicina Tradicional China , Modelos TeóricosRESUMEN
<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>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Angina de Pecho , Quimioterapia , Enfermedad Coronaria , Quimioterapia , Bases de Datos Factuales , Combinación de Medicamentos , Medicamentos Herbarios Chinos , Usos Terapéuticos , Medicina Tradicional China , Métodos , Fitoterapia , Plantas Medicinales , QuímicaRESUMEN
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.