| Summary: | 碩士 === 長庚大學 === 傳統中國醫學研究所 === 97 === Systemic lupus erythematosus (SLE) can affect nearly any organ system, and is frequently an evolving disease with varied manifestations. Traditional Chinese medicine (TCM) physicians have identified various SLE common patterns and designed the main therapeutic strategies or formulas based on their long clinical experience. Due to the changing manifestations of SLE, more than 35 patterns have been identified in SLE, depending on the experience of different TCM physicians. Thus a model is required to determine the disease patterns in such a way as to sum up traditional experience.
The SLE patients who were diagnosed by a rheumatologist in the teaching hospital were recruited in this study. They were treated by a senior TCM physician and three younger physicians. Our study gathered medical records treated by the senior TCM physician to build up a clinical database. This study applied a TCM disease pattern coding system, known as “B-code,” to accommodate disease patterns and formulas for statistical analysis. The clustering analysis such as latent class model was used to conclude the major clusters of disease patterns and formulas. Correlation analysis such as cross tabulation and nonlinear canonical correlation analysis were used to evaluate the correlation between disease patterns and formulas.
Our study gathered 261 valid medical records to build up a clinical database. “Yin vacuity and damp-heat” was concluded as the major pattern, which counted 86.6% in our database. “Anemarrhena, Phellodendron, and Rehmannia Pill” (zhi bai di huang wan) was the most common formula used for SLE, which counted 52.1% in our database. Four clusters of main disease patterns and related formulas were classified, including “Liver - Kidney Yin Vacuity, Damp-Heat, and Impediment,” “Liver Yin and Blood vacuity, Damp-Heat, and Depression,” “Yin Vacuity and Damp-Heat,” and “Qi, Yin, and Blood Vacuity, Damp-Heat, Impediment, and Water-rheum.” After analyzing the correlation of the B-codes between disease patterns and formulas, “Kidney,” “Bi,” and “Water-rheum” were the B-codes with higher correlation, which were above 50 %.
This study tried to construct a clinical database on SLE from a senior TCM physician. This study model helps to sum up the clinical experience and logic of senior TCM physicians, and it may have the potential to help the development of TCM clinical education.
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