Understanding traditional Chinese medicine via statistical learning of expert-specific Electronic Medical Records

doi:10.1007/s40484-019-0173-x

Quantitative Biology

2019, Vol. 7

Issue (3): 210-232 https://doi.org/10.1007/s40484-019-0173-x

本期目录

Understanding traditional Chinese medicine via statistical learning of expert-specific Electronic Medical Records

Yang Yang^1,², Qi Li¹, Zhaoyang Liu¹, Fang Ye³, Ke Deng¹(

)

¹. Center for Statistical Science & Department of Industry Engineering, Tsinghua University, Beijing 100084, China
². Department of Mathematical Sciences, Tsinghua University, Beijing 100084, China
³. Zhou Zhongying’s Studio, Nanjing University of Chinese Medicine, Nanjing 210046, China

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Abstract：

Background: Traditional Chinese medicine (TCM) has been attracting lots of attentions from various disciplines recently. However, TCM is still mysterious because of its unique philosophy and theoretical thinking. Due to the lack of high quality data, understanding TCM thoroughly faces critical challenges. In this study, we introduce the Zhou Archive, a large-scale database of expert-specific Electronic Medical Records containing information about 73,000+ visits to one TCM doctor for over 35 years. Covering the full spectrum of diagnosis-treatment model behind TCM practice, the archive provides an opportunity to understand TCM from the data-driven perspective.

Methods: Processing the text data in the archive via a series of data processing steps, we transformed the semi-structured EMRs in the archive to a well-structured feature table. Based on the structured feature table obtained, a series of statistical analyses are implemented to learn principles of TCM clinical practice from the archive, including correlation analysis, enrichment analysis, embedding analysis and association pattern discovery.

Results: A structured feature table of 14,000+ features is generated at the end of the proposed data processing procedure, with a feature codebook, a term dictionary and a term-feature map as byproducts. Statistical analysis of the feature table reveals underlying principles about the diagnosis-treatment model of TCM, helping us better understand the TDM practice from a data-driven perspective.

Conclusion: Expert-specific EMRs provide opportunities to understand TCM from the data-driven perspective. Taking advantage of recent progresses on NLP for Chinese, we can process a large number of TCM EMRs efficiently to gain insights via statistical analysis.

Key words： TCM EMRs data-driven perspective Chinese text mining statistical analysis

收稿日期: 2018-08-28 出版日期: 2019-10-14

Corresponding Author(s): Ke Deng

引用本文:

. [J]. Quantitative Biology, 2019, 7(3): 210-232.
Yang Yang, Qi Li, Zhaoyang Liu, Fang Ye, Ke Deng. Understanding traditional Chinese medicine via statistical learning of expert-specific Electronic Medical Records. Quant. Biol., 2019, 7(3): 210-232.

链接本文:

https://academic.hep.com.cn/qb/CN/10.1007/s40484-019-0173-x
https://academic.hep.com.cn/qb/CN/Y2019/V7/I3/210

Fig.1

Tongue Picture	Pluse Type	Lab Tests	TCM Patheogenesis	TCM Therapy	Herbs
503	142	393	1,033	1,699	1,515
Dark	Thin pulse	B ultrasound	Impairment of both Qi and Yin	Invigorating Qi and nourishing Yin	Rhizoma pinellinae praeparata
Dark red	Slippery pulse	Biochemical test	Weakness of liver and kidney	Tonifying liver and kidney	Pseudostellariae radix
Yellow, thin and greasy tongue fur	Stringy pulse	CT	Syndrome of liver and stomach disharmony	Regulating liver and spleen	Radix glycyrrhizae
Red	Small pulse	Blood examination	Dampness-heat obstruction syndrome	Clearing dampness-heat	Salvia miltiorrhiza
Thin, yellow and greasy tongue fur	Rapid pulse	Echogatstroscope	Kidney deficiency and sthenic liver-energy	Clearing dampness-heat and stasis toxin	Red paeonia
Yellow tongue fur	Soft pulse	Liver function test	Dampness-heat in the interior	Catharsis and thanhhoa	Boiled bombyx batryticatus
Thin and yellow tongue fur	Deep pulse	BP	Deficiency of liver and kidney	Dissipating phlegm and removing blood stasis	Poria cocos
Yellow and greasy tongue fur	Relaxed pulse	ALT	Impairment of both liver and spleen	Strengthening body and anti-cancer	Processed rhizoma
Light yellow, thin and greasy tongue fur	Weak pulse	Fatty liver	Phlegm stagnation in collateral	Invigorating spleen and stomach	Unprocessed rehmannia root
Thin tongue fur	Feeble pulse	Liver function retest	Weakness of both Qi and Yin	Nourishing upper warmer	Coptidis
Dark violet	Left slippery pulse	Urinalysis	Yin deficiency of liver and kidney	Regulating the thoroughfare	Fried atractylodes macrocephala koidz
Reddish	Right slippery pulse	HP	Phlegm and blood stasis	Diffusing and clearing upper warmer	Glehniae radix
Light yellow and greasy tongue fur	Right thin pulse	AST	Spleen deficiency and stomach weakness	Treating both cause and symptoms	Ophiopogonis radix
Cracked	Left stringy pulse	CA199	Wind-phlegm stagnation	Relieving liver and gallbladder	Dried orange peel
Violet	Right stringy pulse	WBC	Combination of dampness-heat and stasis toxin	Activating blood and dredging	Ligusticum wallichii
Toothed	Left thin pulse	Routine urine test	Lower weakness in liver and kidney	Hyperactivity nourishing heart to calm mind	Astragali radix
Thin and greasy tongue fur	Uneven pulse	CEA	Endogenous wind rise	Treating symptoms first	Rhizoma anemarrhenae
Light yellow tongue fur	Irregular pulse	CA125	Impairment of both body fluids and Qi	Nourishing liver and kidney	Caulis spatholobi
Dark and light purple	Left small pulse	HBsAg	Occurrence of cancer toxin	Nourishing blood and thinning liver	Andeophorae radix
Tongue tip red	Right small pulse	MRI	Kidney deficiency and liver depression	Strengthening spleen in transportation	Barbary wolfberry fruit

Tab.1

Term	Count	Term	Count	Term	Count	Term	Count	Term	Count
Dry mouth	3,353	Abdominal distension	482	?Insomnia	259	Edema of lower limbs	168	Hidden pain in liver	139
Deep-colored urine	1,448	Belching	461	Feel agitated	256	Headache	168	Numb hand	137
Fatigue	1,158	Pathology	413	Vomiting	230	Dreaminess in night	168	Feverishness in palms and soles	137
Sensation of chill	983	Cough	378	Gasteremphraxis	223	Stiff neck	168	Short of breath	136
Poor sleep	934	Good appetite	371	Hypertension	220	Unnormal stool	166	Cholecystitis	135
Poor appetite	893	Frequent urinary	357	Dreaminess	213	Not painful	165	Color in yellow	135
Dizziness	769	A little dry mouth	355	Out of breath	213	Not a lot stool	162	Down more than quantity	134
Good defecation	763	Backache	331	Yellow face and poor looking	210	Unobvious dry mouth	158	Stomache	133
Oppression in chest	758	Slightly decayed stool	310	Sore throat	209	Dry throat	156	Eat a little	133
Soreness of waist	757	Slightly regular bowel	308	Feeble leg	207	Frequent passing of flatus	156	Emaciation	131
Normal bowel	746	Borborygmus	300	Feel tired	199	Heating palm	152	Fatty liver	131
Regular bowel	658	Sweating	299	Feel fatigue	193	Noisy heart	151	Much poor sleep	131
Bitter taste in mouth	612	Acid regurgitation	290	Inhibited defecation	189	Poor breathing	150	Limb leg	131
Dry mouth and want to drink	568	Tinnitus	288	Normal hepatic region	185	Constious fatigue	149	CT	130
Dry and hard stool	564	Dry stool	286	Sick to vomiting	176	A lot of menstruation	148	Dry mouth at night	128
Sweat easily	562	Undry mouth	286	Not too many self-conscious Symptoms	176	Deep sore throat	145	Drink a little	127
Slightly dry stool	533	Taste food well	274	Blurred eye	173	Not much expectoration	145	Normal stool with shape	126
Dry and bitter taste in mouth	528	Nauseating	271	Loose stool	172	Dry and bitter mouth	141	Little in menstruation	125
Palpitation	504	Dizziness	269	Poor looking	172	Odor in mouth	140	Sweatly a lot	125
Normal appetite	492	Not dry stool	264	Quite good appetite	172	Get cold easily	140	Poor appetite	122

Tab.2

Symptoms		Body parts		Disease names		Lab tests		Medical treatments		Background terms
14,346		3,665		2,050		956		437		60,623
Dry mouth	Dry stool	Hand	Gastral cavity	High blood pressure	Gastrosis	Blood pressure	Hemameba	Chemotherapy	Take TCM	Stool	Past days
Cough	Loose stool	Abdomen	Lower limb	Hepatitis B	Myoma of uterus	CT	Protein	Radiotherapy	Gallbladder removal	Pain	Examination
Fatigue	Bitter taste in mouth	Stomach	Brain	Adenocarcinoma	HLP	liver function test	MRI	After chemotherapy	Take prednisone	Surgery	Treatment
Debility	Nausea	Heart	Liver	Gastritis	Cervical spondylosis	health examination	Liver function test	Chemotherapy after surgery	Gallbladder surgery	Normal	Hospital
Vertigo	Poor appetite	Head	Nose	Diabetes	Gastric cancer	Gastroscope	Liver function	Chemotherapy and radiotherapy	4 cycles of chemotherapy	Now	Test
Sensation of chill	Dyspepsodynia	Eye	Lymph	Capsulitis	Enteritis	B ultrasound	Urine test	6 cycles of chemotherapy	After radiotherapy	Obviously	Unwell
Oppression in chest	Headache	Chest	?Joint	Cholecystitis	Squamous cancer	Glucose	Stool volume	Take insulin	Gamma knife treatment	Sometimes	Discover
Deep-colored urine	Belching	Waist	Bone	Liver cirrhosis	Rhinitis	Ascites	Enteroscope	Colon cancer surgery	1 time of chemotherapy	Less	Usually
Fatigue and debility	Dizziness	Foot	Ear	Hypertensive disease	Hepatitis B disease	Fatness in liver	CT scan	Do chemotherapy	2 times of chemotherapy	Self constious	Transfer
Abdominal distension	Insomnia	Lung	Upper body	Gallstones	Coronary heart disease	Menstrual blood volume	Heart rate	Induced abortion	Western medicine control	Last year	Currently
Palpitation	Gasteremphraxis	Back	Hepatic region	Hepatopathy	Nephritis	Blood volume	Electrocardiogram	Rectal cancer surgery	2 cycles of chemotherapy	This year	Worse
Soreness of waist	Swelling pain	Gallbladder	Hand and foot	Lung cancer	Lipemia	Body weight	Occult blood test	Take antihypertensive drug	Hormone treatment	Disease history	Long time
Dull pain	Numbness	Intestine	Lymph gland	Intestinal cancer	Hyperlipemia	Three positive	ALT	Take western medicine	Take chemotherapy medicine	Recently	Urine and stool
Poor sleep	Catching cold	Gland	Shoulder	Hepatitis	Liver cancer	test blood pressure	Renal function	TCM treatment	6 times of chemotherapy	Appetite	Left side
Stomachache	Well gas	Neck	Face	Cerebral infarction	Breast cancer	urine volume	Blood type	4 cycles of chemotherapy	Successive chemotherapy	Discomfort	After treatment

Tab.3

Fig.2

Tab.4

Tab.5

Tab.6

Tab.7

Tab.8

Fig.3

Fig.4

Fig.5

Fig.6

Fig.7

Symptoms	Herbs
Dry mouth	Glehniae radix, andeophorae radix
	Dried rhizome of rehmanni, salivia chinensis
	Dendrobium
	Radix trichosanthis, asparagus cochinchinensis, ophiopogonis radix
	Radix trichosanthis, rhizoma anemarrhenae
	Calcined oyster, calcined fossil fragment
	Asparagus cochinchinensis, ophiopogonis radix
	Figwort root, flos chrysanthemi indici
	Hiraute shiny bugleweed herb, alismatis
Poor sleep	Tuber fleeceflower stem
	Cooked date seed
	Asparagus cochinchinensis, lilium davidii, cooked date seed
	Cortex albiziae
	Asparagus cochinchinensis, cooked date seed
	Asparagus cochinchinensis, lilium davidii, cooked date seed, cortex albiziae
Stomach distension	Processed rhizoma, caulis perllae
	Coptidis
	Fried Fructus aurantii immaturus, rhizoma pinellinae praeparata
	Dried orange peel, rhizoma pinellinae praeparata
	Dried orange peel, immature tangerine peel
Debility	Eclipta alba, processed glossy privet fruit
	Fried atractylodes macrocephala koidz, poria cocos, codonopsis, radix glycyrrhizae
	Red paeonia, processed rhizoma, vinegar-baked bupleurum root
	Fried atractylodes macrocephala koidz, poria cocos, radix glycyrrhizae, pseudostellariae radix
	Asparagus cochinchinensis, ophiopogonis radix
Belching	Rhizoma pinellinae praeparata
	Coptidis
	Fructus amomi
Gastralgia	Processed rhizoma, caulis perllae
	Rhizoma pinellinae praeparata
	Fructus amomi, costus root
Dizziness	Tribulus terrestris, gastrodiae, ligusticum wallichii
	Tribulusterrestris, chrysanthemum, gastrodiae
	Gastrodiae, ligusticum wallichii
Sensation of chill	Radix glycyrrhizae, processed cassia twig
	Parched white peony root, processed cassia twig
	Cinnamon
Palpitation	Salvia miltiorrhiza, ligusticum wallichii
Palpitation	Salvia miltiorrhiza
Headache	Tribulusterrestris, gastrodiae, ligusticum wallichii
Headache	Ligusticum wallichii
Poor appetite	Fried atractylodes macrocephala koidz, poria cocos, radix glycyrrhizae
Poor appetite	Pseudostellariae radix, coloured malt, fried millet sprout
Yellowish complexion	Astragali radix
Yellowish complexion	Chinese angelica
Cough	Glehniae radix, ophiopogonis radix
Cough	Glehniae radix
Dry stool	Fructus trichosanthis
Dry stool	Roasted Fructus aurantii immaturus, fructus trichosanthis
Vertigo	Barbary wolfberry fruit, gastrodiae
Deep-colored urine	Radix sophorae flavescentis
Bitter in mouth	Fructus evodiae, coptidis
Abdominal distension	Dried orange peel, immature tangerine peel
Feel agitated	Asparagus cochinchinensis, lilium davidii
Borborygmus	Fructus evodiae, coptidis
Loose stool	Fried atractylodes macrocephala koidz, codonopsis
Cough, oppression in chest	Rhizoma pinellinae praeparata
Oppression in chest	Red paeonia, processed rhizoma, vinegar-baked bupleurum root
oppression in chest, palpitation	Salvia miltiorrhiza
Nausea, vomiting	Rhizoma pinellinae praeparata

Tab.9

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