Utilizing data mining techniques to analyze traditional Chinese medicine patterns in patients with acute cardiorenal syndrome

Abstract

Objective: This study intends to investigate the medication patterns of traditional Chinese medicine (TCM) for the treatment of acute cardiorenal syndrome (ACRS) through clinical data mining.

Methods: A retrospective study was conducted at China-Japan Friendship Hospital, encompassing hospitalized patients with ACSR admitted from June 1, 2013, to June 30, 2022. Patient treatment records, including TCM prescriptions, were gathered to establish a comprehensive prescription database. The prescriptions underwent analysis using the ancient and modern medical case cloud platform, incorporating the frequency, properties and flavors and channel tropism of each herbs, and clustering patterns, combination relationships, and complex network analysis of the whole.

Results: A total of 330 prescriptions from eligible hospitalized patients were included, which totally involves 324 kinds of different herbs. The therapeutic effects primarily emphasized descending qi and eliminating turbidity, promoting diuresis and reducing swelling, drying dampness and dispelling phlegm, and promoting the ascension of Yang Qi. The properties were largely warm, netural, slightly cool and cold, with warm being predominant. The flavors were chiefly sweet, spicy, and bitter, with sweetness being the most common. The major channel tropism were the lung and spleen meridians, followed by the stomach, liver, heart, and kidney meridians. Combination analysis identified 30 pairs of combinations, with higher associations found in combinations such as Jiegeng, Huangqi, Chaihu, Baizhu, Zhimu, and Dangshen. Cluster analysis categorized high-frequency herbs into 4 groups: Gualou–Fabanxia–Chuanxiong–Chishao, Fuling–Baizhu–Zhigancao–Chenpi, Maidong–Guizhi–Huangqi–Chaihu–Shengma–Zhimu–Shanzhuyu, and Huangqi–Dangshen–Jiegeng–Chaihu–Shengma–Zhimu–Shanzhuyu. Complex network analysis revealed core prescriptions for treating ACRS, including 17 herbs.

Conclusions: In the treatment of ACRS, TCM herbs with the properties of warm and neturality, and the flavors of sweet and spicy are commonly utilized. The prescribed herbal formulas have the effect of descending qi and eliminating turbidity, tonifying qi, activating blood and resolving stasis, resolving phlegm and promoting water.

Keywords

acute cardiorenal syndrome / data mining / medication rules / TCM prescription

References

[1] Ronco C , McCullough P , Anker SD , et al. Cardio-renal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J. 2010; 31 (6): 703- 711.

[2] Zeng A , Ma Q . Progress on the diagnosis and treatment of cardiorenal syndrome. Prog Cardiovasc Dis. 2017; 38 (02): 214- 218.

[3] Liu D , Guo Y , An Y . Clinical characteristics and prognostic analysis of cardiorenal syndrome in surgical intensive care patients. Chin J Crit Care Med. 2018; 30 (12): 1161- 1166 (in Chinese).

[4] Jose P , Skali H , Anavekar N , et al. Increase in creatinine and cardiovascular risk in patients with systolic dysfunction after myocardial infarction. J Am Soc Nephrol. 2006; 17 (10): 2886- 2891.

[5] Yu Q , Li J , Li Z , et al. Research on the construction of an ontology-based traditional Chinese medicine case knowledge service and sharing system. Chin J Digit Med. 2017; 12 (05): 103- 105 (in Chinese).

[6] Ibanez B , James S , Agewall S , et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018; 39 (2): 119- 177.

[7] Kellum JA , Lameire N , KDIGO AKI Guideline Work Group . Diagnosis, Evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care. 2013; 17 (1): 204.

[8] National Pharmacopoeia Committee . Pharmacopoeia of the People's Republic of China. China Medical Science and Technology Press; 2020 (in Chinese).

[9] Wang XT , Miao MS , Sun YX . Chinese Herbal Dictionary. Shanxi Science and Technology Press; 2017 (in Chinese).

[10] Editorial Board, Chinese Herbal Medicine, State Administration of Traditional Chinese Medicine . Chinese Materia Medica. Shanghai Science and Technology Press; 1999 (in Chinese).

[11] Zhong GS . Traditional Chinese Pharmacology. 9th ed. China Traditional Chinese Medicine Press; 2016 (in Chinese).

[12] Dzubur A , Gacic E , Mekic M . Comparison of patients with acute myocardial infarction according to age. Med Arch. 2019; 73 (1): 23- 27.

[13] Wang WX , Du WX . Analysis and exploration of the theory of four qi and five flavors in traditional Chinese medicine and its relevance. Chin Ethnic Folk Med. 2017; 26 (24): 61- 63 (in Chinese).

[14] Yang Y , Mei QX , Huang R , et al. Exploration of the processing methods of Aconitum carmichaeli. Eval Anal Drug Use Hosp China. 2021; 21 (04): 505- 507+512 (in Chinese).

[15] Gao H , Pang M , Yu R , et al. Professor Bai Changchuan's discussion on regulating meridians medicine and guiding prescription. Chin J Tradit Chin Med, 2022, 40 (01): 66- 69 (in Chinese).

[16] Liu SF , Cai H , Yang YJ , et al. Research progress on grey relational analysis model. Syst Eng Theory Pract. 2013; 33 (08): 2041- 2046 (in Chinese).

[17] Liang HJ . Observation on the therapeutic effect of combined modified Si Jun Zi Tang and Aspirin in treating acute myocardial infarction with heart failure and restenosis after PCI. Pract J Tradit Chin Med. 2019; 35 (02): 217- 218 (in Chinese).

[18] Lu YK , Chen YY , Zhuang XM , et al. Mechanism study of Si Jun Zi Tang intervention on heart failure rats based on regulating gut microbiota imbalance. Chin J Tradit Chin Med Inf. 2021; 28 (04): 81- 87 (in Chinese).

[19] Teng J . Clinical Efficacy of Sheng Jie Tong Yu Granules in Unstable Angina Pectoris and Its Influence on Inflammatory Factors. Beijing University of Chinese Medicine; 2020 (in Chinese).

[20] Pan GM , Cui JY , Yao GZ , et al. Efficacy analysis of Sheng Jie Tong Yu decoction granules in the treatment of intractable angina pectoris with blood stasis syndrome. J Trop Med. 2018; 18 (06): 761- 765 (in Chinese).

[21] Li CY , Shi ZX . Clinical efficacy of Sheng Jie Tong Yu granules in patients with stable angina pectoris of Qi deficiency and blood stasis syndrome and its influence on blood lipids. Chin J Tradit Chin Med. 2017; 32 (04): 1534- 1537 (in Chinese).

[22] Yuan GZ . Clinical study on modified sheng Xian Qu Yu Tang in the treatment of chronic heart failure of Qi Sinking and blood stasis type. China Acad Chin Med Sci. 2019 (in Chinese).

[23] Wu J , Lu YD , Yuan GZ , et al. Effects of Sheng Jie Tong Yu decoction on pulmonary vascular and right ventricular remodeling in rats with pulmonary arterial hypertension induced by colchicine. Chin J Tradit Chin Med. 2019; 34 (12): 5873- 5876 (in Chinese).

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