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    Analysis on the law of differentiating and treating insomnia by physicians based on cluster analysis of drug syndrome

    2022-02-19 12:53:44HuiChiYingGao
    Journal of Hainan Medical College 2022年1期

    Hui Chi,Ying Gao

    Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China

    Keywords:Insomnia Treatment based on syndrome differentiation Law of drug symptoms Cluster analysis Data mining

    ABSTRACT Objective:To explore the general differentiation and treatment of insomnia by Professor Gao Ying through drug clustering and group correspondence analysis,and provide reference for clinical diagnosis and treatment.Methods:Collect retrospective case data from outpatient system,use SPSS20.0 software to perform frequency and cluster analysis on high-frequency symptoms and drug data,and perform corresponding analysis on the clustered drug syndrome groups.Results:A total of 349 consultations in 204 patients were included.Cluster analysis of 35 symptoms and 40 flavors with a frequency of more than 10% resulted in a corresponding relationship between 7 symptom groups,6 drug groups and 5 drug syndrome groups.The medicine symptom group has a high degree of matching;the doctors distinguish and tre at insomnia with calming,clearing heat,nourishing yin,liver,spleen,qi and phlegm as the core treatment,with consistent decoction,two to pill,lily ground Huang Tang,Lily Zhimu Decoction,Wendan Decoction,Sini San,Xiao Chai Hu Tang,Xiaoyao San,etc.are commonly used prescriptions;the physician's experience is to add or subtract Danshen and Zao Ren drink,which has a wide range of applicability to various insomnia syndrome.Conclusion:Based on the cluster analysis of drug symptoms and group correspondence analysis,it can reveal the pathogenesis,treatment and class information hidden in the data of drug symptoms,which can reflect the general law of physicians' syndrome differentiation and treatment of insomnia.This method has a reference for the exploration of TCM clinical experience significance;The results of this study can provide feedback to guide the clinical diagnosis and treatment of insomnia.

    1.Introduction

    Insomnia,known in Traditional Chinese medicine as"sleeplessness",is a common condition in today's society,which seriously affects people's study,work and quality of life.At present,most of the research on the experience of insomnia diagnosis and treatment focuses on the exploration of drug rules [1,2] or the observation of prescription drug efficacy [3-7],and there are fewer studies on the relationship between drugs and symptoms.The dialectical treatment of Chinese medicine is a thinking path including elements such as "symptom-machine-treatmentprescription-medicine",and important identification and treatment information such as "disease mechanism-treatment-formula"is implied between the medicines,which is the embodiment of the speculative process and diagnosis and treatment experience of Chinese medicine practitioners,and there is an inherent correspondence between the medicines,but this relationship exists in the form of a kind of hidden knowledge [8],which needs to be excavated with the help of appropriate analytical methods.Therefore,this study uses systematic clustering methods to analyze the drug data in order to summarize the main laws of physician identification and treatment of insomnia,and provide a reference for clinical diagnosis and treatment.

    2.Data and Methods

    2.1 Case data

    All case data are from the outpatient case database of Professor Gao Ying of Dongzhimen Hospital of Beijing University of Chinese Medicine,using the observational case series study design,the case data of all insomnia patients from May 2015 to April 2019 were selected,and a total of 204 cases (349 consultations) were included,including 135 cases (66.2%) and 236 consultations (67.6%),the age of the patients was 51.2± 14.1 [19,86],and the shortest course of the disease was 1 month,up to 48 years,median course of 2.5 years.

    2.2 Row standards

    Inclusion criteria:(1) patients with insomnia as the main complaint and the first diagnosis as insomnia;(2) age over 18 years;(3)patients with complete medical records,including demographic characteristics,main complaints and medical history,four diagnosis information,and treatment plan.

    Exclusion criteria:(1) in the diagnosis or medical history record,combined with other organic lesions that have not been effectively controlled and obstruct sleep,such as neurological organic diseases,severe respiratory and circulatory diseases,severe pain,severe mental disorders and other diseases;(2) patients during pregnancy or lactation.

    2.3 Method

    2.3.1 Data collection

    Select cases that meet the research criteria from the outpatient case database,and export the patient's general data and diagnosis and treatment information to an Excel file.This structured database is entered synchronously by the accompanying physician and contains the patient's complete diagnosis and treatment information,and the original medical records and prescriptions are archived in the database,and the original data can be consulted and checked when the data is in doubt.

    2.3.2 Data preprocessing

    Formulate pretreatment rules with reference to relevant standards and consensus in the industry [9-11],and unify and standardize the symptoms and drug names.For example,tongue red,red tongue,red tongue body are unified as red tongue; sloppy stool,loose stool,and stool formless are unified as loose stools;eclipta alba and herba ecliptae are unified as eclipta ;raw dragon bones and oysters are divided into raw fossil fragment and raw oyster shell.2.3.3 Statistical analysis and data mining

    The general description of the collected information is carried out,the measurement data of the normal distribution is described by,the nonnormal distribution measurement data is described by the median and quartile,and the counting data is described by frequency and composition ratio.SPSS Statistics 20.0 software was used to analyze symptom data and drug data for frequency and clustering,and the results were displayed in a dendritic chart.

    3.Results

    3.1 Frequency analysis

    3.1.1 Frequency of symptoms

    This study divides the symptoms of insomnia into three categories:primary symptoms (hereinafter referred to as main symptoms),concomitant symptoms (hereinafter referred to as secondary symptoms) and tongue pulse manifestations (hereinafter referred to as tongue pulse),covering a total of 139 kinds of symptoms and manifestations of insomnia,including 6 main symptoms (Table 1),107 secondary symptoms,and 26 kinds of tongue pulses.Combining clinical,secondary symptoms and tongue pulse information on the suggestive significance of symptom characteristics is more significant,so this study mainly analyzed secondary symptoms and tongue pulse information.A total of 35 sub-symptoms and tongue and pulses with a frequency of more than 10% (occurrences 35)were selected,of which 21 sub-symptoms (Table 2) and 14 tongue and pulses (Table 3).

    Table 1 Frequency distribution of insomnia symptoms

    3.1.2 Frequency of drugs

    A total of 186 kinds of Chinese medicines are covered,of which 40 flavors of Chinese medicines with a frequency of >10%(occurrences>35) (Table 4),of which the top 10 (occurrences>120,frequency >34%) are:wild jujude seed,albizzia bark,raw fossil fragment,raw oyster shell,Salvia miltiorrhiza,radix bupleuri,Schizandra,vine of tuber fleeceflower,Angelica,pearl powder .

    Table 2 Frequency distribution of insomnia

    Table 3 Frequency distribution of tongue and pulse images of insomnia

    Table 4 Frequency distribution of the top 40 Chinese medicines

    3.2 Cluster analysis

    3.2.1 Symptom clustering

    The cluster analysis of 35 symptoms (including tongue veins)with a frequency of >10% was performed,and the Ward connection method in the systematic clustering method was used,and the metric was selected from the square Euclidean distance of the binary classification,and the following 7 symptom groups were obtained(Figure 1):

    Figure 1 Symptom clustering dendrogram Chinese and English comparison table of Symdroms is attached in Appendix 1

    C1:Less moss,Chest distress,Dryness of eye,Feverish palms and soles,Frequent urination,Vertigo,Tinnitus,Sunken pulse

    C2:Fine vein,Dark tongue,Thin moss

    C3:Depression,Amnesia,Red tongue,Sweating,Dysphoria,Yellow moss

    C4:Greasy moss,lassitude,Slippery vein

    C5:Anxiety,Rapid pulse,Thirst,Mouth bitterness

    C6:String vein

    C7:Loose stools,Palpitations,red tip of tongue,Headache,Languor,dizziness,dejection,Obese tongue,Teeth-Marked tongue,Anorexia

    3.2.2 Drug clustering

    The 40-flavor drugs with a frequency of more than 10%(occurrences >35) are systematically clustered to obtain the following 6 types of drug clusters (Figure 2).

    Figure 2 Drug clustering dendrogram Chinese and English comparison table of Medicines is attached in Appendix 2

    F1:Szechwan chinaberry fruit,Wolfberry,Radix glehniae,Liriope,Radix rehmanniae recen,Rhizoma anemarrhenae,Lily bulb,

    F2:Schisandra,Angelica,Vine of tuber fleeceflower

    F3:Bamboo Shavings,Unripe bitter orange,Poria,Pseudostellaria,Lotus Leaf,Amber Powder,Polygala tenuifolia,Citrus Aurantium,Mix-fried licorice,Lotus plumule,Calcined magnet,Female virgin,Eclipta,Curcuma aromatica,Cyperus rotundus

    F4:Gardenia,Peony peel,Raw white atractylodes,Stir-fried white atractylodes,White Peony root,Poria with hostwood,Pearl powder

    F5:Raw fossil fragment,Raw oyster shell,Wild jujude seed,Albizzia bark,Salvia miltiorrhiza

    F6:Scutellaria,Rhizoma pinelliae preparata,Radix bupleuri

    4.Discussion

    4.1 Symptom Clustering Analysis

    Itemset C1:Less lichen,dry eyes,hand and foot heart fever suggest yin deficiency,mostly liver and kidney yin deficiency;frequent urination,dizziness,tinnitus and other symptoms are also commonly seen in the evidence of liver and kidney yin deficiency;pulse sedimentation is more suggestive of evidence.The core pathogen of this collection of symptoms is yin deficiency,such as the "Jingyue Quanshu Sleepless" cloud:"The true yin essence blood is insufficient,the yin and yang do not intersect,and the gods are uneasy about their ventricular ears";the "Ancient and Modern Medical System ? Not Sleeping" also says:"There is a lack of kidney water,the true yin does not rise and the heart and yang are hyperactive,and they cannot sleep."

    Itemset C2:The main qi and blood of the fine veins are two deficiencies,and the losses are weak.Simple thin moss is mostly normal moss,or between less lichen and ordinary moss,and other tongue images are more common in clinical evidence;in those with dark tongue,the main bruises are common in blood stasis,and many intractable insomnia in the clinic are often related to blood stasis [12,13].Fine vein,dark tongue,thin moss mainly suggests the disease mechanism of weakness and stasis,cluster diagram shows that the set and C1 set have a certain correlation between groups,the comprehensive analysis of the two sets together reflects the yin deficiency or qi yin two deficiency of the pathogenesis,and suggests that blood stasis should be paid attention to,clinical due to weakness of stasis or long-term stasis are common.

    Itemset C3:red tongue,sweating,dysphoria,yellow moss is the main manifestation of heat evidence,such as heart meridian fever,hepatic depression fever,phlegm heat disturbance,etc.,with real heat is more common,some patients with yin deficiency internal heat can also see the above symptoms,so the cluster diagram suggests that the disease set has a certain correlation with the collection of C1 and C2.

    Itemset C4:greasy moss,slippery vein main prompt phlegm wet disease.Phlegm is full of turbidity,hindering the gas engine,the qi in and out of the camp guard is abnormal,so insomnia is seen;wet and sticky,more prone to spleen sleepiness,spleen loss of good luck,clean qi does not rise,the body is out of nourishment,so it is weak.

    Itemset C5:The combination of anxiety,thirst,and mouth bitterness mainly reflects shaoyang syndrome,such as article 263 of the "Treatise on Typhoid Fever":"Shaoyang is a disease,bitter mouth,dry throat,dizziness",some scholars [14] believe that the pathogenesis of insomnia is closely related to the disadvantage of Cardinal Shaoyang,and should be treated from Shaoyang,and it is appropriate to cure shaoyang and reconcile Shaoyang,and to reach cardinal.Shaoyang is mostly related to the liver and gallbladder,the evil offender Shaoyang,the bile fire is depressed,the cardinal is unfavorable,and the above symptoms are easy to see.String veins are also the main hepatobiliary,and cluster diagrams suggest that this symptom set is strongly associated with the chords of C6 sets.Sun Zhuo [15] et al.believe that the key to the clinical selection of Xiao Chai Hu Tang for the treatment of insomnia is string vein,mouth bitterness,thirst,dry stool,and dysphoria.The rappid pulses is more likely to indicate heat evidence,and it is more common in hepatobiliary diseases such as hepatic depression fever and gas depression fire.This episode mainly reflects the core pathogenesis of liver depression and shaoyang.

    Itemset C6:String veins appear most frequently in the veins.The string vein is the main vein of hepatobiliary disease,the main drainage of the liver regulates emotional activity,and emotional disorders are closely related to insomnia [16],so the string vein is the most common in insomnia.Secondly,the string vein is also the main sputum drinking,pain,dendritic chart shows that the set of symptoms and C4,C5 have intergroup correlation,often with sputum wet evidence,heat evidence,comprehensive pulse image is mostly manifested as string slip vein,rapid string vein or rapid string slip vein.

    Itemset C7:Obese tongue and tooth marks around the tongue are accompanied by many appearances,and both are accompanied by fatigue,loose stools,poor sodium and other symptoms,such as insufficient focus and weak spleen and stomach.Weak temper,no rising sun,or spleen deficiency and wet sleepiness,wet evil,can appear tired,dizzy.Depressed mood is commonly seen in the evidence of liver qi discomfort and liver depression;liver depression is even more prone to heat,so heat images such as red tip of the tongue can be seen.The episode as a whole reflects the core pathogenesis mainly based on liver depression and spleen deficiency.

    In summary,symptom analysis suggests that yin deficiency,internal heat,liver depression,qi stagnation,spleen deficiency,and sputum are the core pathogens of physicians to distinguish insomnia.

    4.2 Drug Cluster Analysis

    Group F1:Mainly composed of heat-clearing yin medicines,which are born in the heat and cool blood,tonify the kidneys and yin;radix glehniae,liriope,wolfberry,lily nourish the liver and kidneys,nourish the yin shengjin,szechwan chinaberry fruit clear the liver fever,rhizoma anemarrhenae clear the heat and remove the annoyance,and the various medicines play the role of nourishing the yin and clearing the heat.

    Similar formulas:Yiguan Decoction,Lilii and Rehmanniae Decoction,Lily and Anemarrhena Decoction

    Lily Dihuang Decoction is originally a common prescription for the treatment of heart-lung yin deficiency internal heat evidence of lily disease,and is also commonly used in modern times to treat insomnia,experimental studies [17] show that lily and rehmanniae decoction plays a role in treating insomnia and regulates the content of inhibitory neurotransmitter GABA and excitatory neurotransmitter Glu in rats.Consistently frying and nourishing the liver and kidneys,soothing the liver and clearing the heat;lily Zhimu decoction to supplement the deficiency of heat,nourish the yin and dryness,the above three parties are the representative of the yin and clear the heat,a number of clinical studies [18-21] show that the above formula has a good effect on the yin deficiency fire type insomnia.

    Group F2:Composed of drugs to nourish the heart and calm the mind,nourish the blood and invigorate the blood,and tonify the kidney and calm the heart,the cluster diagram suggests that the group and the F1 group have a more obvious correlation between the groups,which can be combined and analyzed.Among them,angelica tonifies liver blood and nourishes liver yin,and F1 szechwan chinaberry fruit and other 5 flavor drugs together to form Yiguan Decoction;Vine of tuber fleeceflower nourishes the heart and calms the spirit;schisandra converges and solidens,tonifies the kidney and calms the heart,and jointly plays the effect of nourishing yin,tonifying the kidney,nourishing the blood and calming the spirit.

    Group F3:the most drugs,by the town of shock and tranquility,gasification phlegm,liver soothing depression,nourishing yin,tonic qi and other drugs together,of which bamboo shavings,unripe bitter orange,poria gasification phlegm of the spleen,for the main medicine of wendan decodtion,the main treatment of phlegm sheng evidence;unripe bitter orange,citrus aurantium promote qi and make spleen healthy;pseudostellaria,mix-fried licorice promote qi,lotus leaf sheng ti qing qi,lotus plumule pure heart peace of mind,female virgin and eclipta grass for Erzhi pill composition,is also commonly used to nourish the yin medicine pair.Curcuma aromatica and cyperus rotundus attached to use together,for the liver rational qi to relieve depression commonly used medicine.The concentrated qi and rational qi drugs are more concentrated,which can not only relieve liver depression,but also regulate the rise and fall of the gas machine,reflecting the importance of the doctor to the gas machine.

    Similar formula:Wendan decoction,Counterflow Cold Powder,Erzhi pill

    Wendan decoction gasify phlegm,clear the gall and stomach,good treatment of biliary and stomach discord and phlegm disturbance of the evidence,the certificate is not sleepy common disease mechanism,such as "Zhang's medical tong can not lie down" cloud:"The pulse slip number is strong and can not lie down,there is a vegetarian stagnant phlegm fire,this is stomach disharmony is lying uneasy also." Counterflow Cold Powder relieve liver depression,reconcile liver and spleen,and apply to insomnia of hepatic depression and hepatic and spleen disharmony.Modern pharmacological research [22] found that tetratrophoid and its monoscentric drugs have a certain effect of improving sleep disorders,and their pharmacodynamic substances are mainly based on saigosaponin,hesperidin,glycyrrhetinic acid,etc.,which can act on the prefrontal cortex,thalamus,hippocampus region,etc.in rats or mice,and the main mechanism of action is to increase the content of serotonin in cerebrospinal fluid and prolong slow-wave sleep.Erzhi pill has the function of tonifying the liver and kidneys,nourishing the yin and nourishing the blood,and is suitable for the evidence of liver and kidney yin deficiency or yin deficiency and fire.

    Group F4:It is composed of antipyretic,qi-and spleen-strengthening drugs.Among them,gardenia,Peony peel clear heat,raw white atractylodes,and stir-fried white atractylodes make spleen healthy and anti-diarrhea,Poria with hostwood and white peony root nourish blood soft liver,jointly target the spleen deficiency and blood weakness of the disease machine,such as "class evidence treatment sleepless" said:"Thinking about hurting the spleen,spleen blood loss,not sleeping for many years." Pearl powder focuses on flat liver and calming shock,in order to help calm the gods,and is a commonly used drug for Gao Ying to calm the gods.This collection of medicines together achieves the work of strengthening the spleen,clearing heat and calming the spirit,and is suitable for insomnia with spleen deficiency.

    Similar formula:Free Wanderer Powder,Moutan and Gardenia Free Wanderer Powder Modern clinical research[23,24] found that the Free Wanderer Powder series has a curative effect on hepatic depression stagnation type,hepatic depression and spleen deficiency type,liver depression fire type insomnia,which can significantly improve sleep quality and improve clinical symptoms,which is worth clinical application.Experimental studies[25] suggest that its mechanism of action may be to activate the PI3K/Akt/mTOR signaling pathway,thereby achieving the purpose of regulating the nervous system to treat insomnia.

    Group F5:Mainly calming drugs,its composition has the effect of heavy town,nourishing the heart,invigorating blood,and relieving depression.Among them,the sour jujube kernel is sweet and moist,calming the heart,nourishing the liver,sweating and rejuvenating,and is a medicine for tranquilizing the gods,and the frequency of application ranks first,reaching more than 90%.The "Materia Medica" is called "rescuing qi and calming the spirit";the "Beilu"says that it is "the main annoyance cannot sleep",and it is mostly used clinically for symptoms such as sleeplessness,panic and dreams,weakness and sweating;in the "Golden Essentials",acid jujube kernel soup is also used to treat "fatigue and fatigue can not sleep".Modern pharmacological studies [26] have shown that jujube saponins have significant activities in calming and calming nerves and treating neurological diseases.Salvia,acacia peel to activate blood to relieve depression,raw fossil fragment,raw oyster shell to flat liver and yang,to calm the spirit,Wild jujude seed to nourish the heart and calm the spirit,all kinds of medicines together for the blood to relieve depression,nourish the heart and calm the spirit.

    Combined with the results of frequency analysis,the group of salvia,Wild jujude seed,Raw fossil fragment,raw oyster shell,acacia peel take the highest frequency,the frequency of application of more than 65%,frequency analysis and cluster analysis results combined,it can be considered that the group is a doctor's common experience in the treatment of insomnia,feedback to the doctor after being confirmed by me.The party is Professor Gao Ying inherited from Academician Tung Chee-hwa's experience in the treatment of insomnia decoction-Danshenzaoren Drink[27],the original formula still has Vine of tuber fleeceflower,arborvitae seed,the whole prescription is peaceful,taking into account a variety of disease mechanisms,the medicine is simple and specialized,clinical application for many years,the efficacy is quite good.The cluster diagram shows that the correlation between the group and other drug groups is weak,and combined with the drug properties analysis of the group,it suggests that the group can be applied independently.

    Group F6:Composed of liver thinning,heat clearing,and phlegmreducing drugs,Radix bupleuri make liver detoxification,Rhizoma pinelliae preparate make phlegm descending and reversing,help Radix bupleurito adjust the qi;Scutellaria clear the fire of Shangjiao,in order to eliminate the heat of disturbing the mind,the three are mostly found in Minor Bupleurum Decoction.The cluster diagram suggests that the set has a certain intergroup correlation with the F5 set,and the raw keel and raw oysters in the F5 set are mostly found in the Bupleurum Decoction Plus Dragon Bone and Oyster Shell.Similar formula: Minor Bupleurum Decoction,Bupleurum Decoction Plus Dragon Bone and Oyster Shell

    Both parties are mainly reconciled,both have the effect of reaching the liver qi and relieving the gods,Minor Bupleurum Decoction is partial to harmonization and relief,and Bupleurum Decoction Plus Dragon Bone and Oyster Shell is partial to reconciliation and sedation,which is applicable to the evidence of Shaoyang Cardinal's disadvantage.Literature studies [15] show that the pathogenesis of Minor Bupleurum Decoction in the treatment of insomnia is shaoyang biliary fever and internal depression,heat disturbs the mind,and the key to clinical prescription is pulse string,bitter mouth,dry mouth,dry stool,and irritability;ancient formula is more compatible with antipyretic drugs,and modern more with wu tranquilizers.Multiple meta-analyses [28,29] also showed that Bupleurum Decoction Plus Dragon Bone and Oyster Shell plus or minus in the treatment of insomnia has good clinical efficacy and safety.Clinical studies [30] suggest that Bupleurum Decoction Plus Dragon Bone and Oyster Shell has a significant effect on the treatment of qi depression insomnia,and can improve anxiety and depression,and control insomnia symptoms.

    The comprehensive application of drugs is the embodiment of the treatment method,and the application frequency of high-frequency drugs is relatively high,reflecting the importance of doctors to the qi machine.In the testimony,the physician often adds lotus plumule to purify the heart and calm the spirit for those who are fiery in the heart;for those who do not rise in the qingyang with stool or dizziness,they often add lotus leaf to lift the clear qi to help stop diarrhea,and jointly adjust the qi machine with the rational qi medicine;those with weak heart qi often use the Pseudostellaria to replenish the heart qi,and rarely use astragalus,ginseng,etc.to prevent temperature and dryness;pearl powder is commonly used for tranquility,and for those with heavy insomnia,it is often easy to be amber powder,or add magnets and other heavy products to enhance the effectiveness of tranquility.

    In summary,drug analysis suggests that calming the spirit,nourishing the yin,clearing the heat,thinning the liver,dissolving phlegm,walking qi,and strengthening the spleen are the core treatment methods for physicians to treat insomnia.

    It is worth noting that cluster analysis belongs to unsupervised learning,and the principle of its algorithm is to calculate the degree of similarity or affinity according to the difference in the distance between classes,so although multiple prescriptions can contain the same flavor of the drug,the drug can only be gathered in a certain item set,it is impossible to appear in multiple itemsets,but it cannot be excluded from being associated with other itemsets.For example,although chai hu appears in the group F6,as the main drug of the four reverse scatter and the idle scatter,it should also be closely related to the drugs of the F3,F4 and other itemset.

    4.3 Corresponding laws of drug clustering

    Symptoms reflect the disease mechanism,drug disclosure treatment,according to the symptom clustering and drug clustering results,combined with professional knowledge,found that most of the symptom groups and drug groups have a more significant correspondence,further analysis and refinement to obtain the correspondence between the five types of drug groups (symptom set? drug set),revealing the hidden information of "disease mechanism-treatment -class formula" between the symptoms,reflecting the five main rules of diagnosis and treatment of insomnia by physicians.Respectively:1) C1 and C2 ? F1 and F2,suitable for people with yin deficiency and internal heat,to nourish the liver and kidneys,nourish yin and clear heat as the method,the commonly used formula is consistent frying,two to pills,lily yellow soup,lily zhimu soup;2) C3 ? F1,suitable for real heat disturbance,with heat and yin as the main treatment,commonly used lily yellow soup and lily Zhimu soup plus or minus;3) C4 ? F3,phlegm turbidity,phlegm rational qi and stomach as the method,commonly used warm bile soup,including chai qian warm bile soup,huanglian warm bile soup,etc.;4):C5 and C6 ? F6 and F5,hepatic depression stagnation,or less yang unfavorable,or liver and spleen irregularities,to relieve liver depression,reconcile Shaoyang,reconcile liver and spleen as the method,the commonly used formula is four reverse scatter,small chai hu soup,chai hu jia keel oyster soup;5):C7 ? F4,liver depression and spleen deficiency,or liver depression fever,treatment should be liver and spleen,relieve depression and heat,commonly used class is idle scatter or Dan Yan loose scatter.In addition,the physician experience formula represented by the drug group F5 set has a peaceful composition and good efficacy,can be combined with other drugs,and has a wide range of applicability for various clinical symptoms of insomnia.Finally,in order to determine the accuracy of the above data mining results,the principle of "humanmachine combination and human-main" is followed [31],and the above analysis results are approved by the physician himself after feedback.

    In summary,this study applied the cluster analysis method to analyze the pharmacological rules of Professor Gao Ying's identification and treatment of insomnia,excavated the empirical prescriptions of physicians,and through the corresponding analysis of drug clustering,explored the identification and treatment information of "disease mechanism,treatment method,and similar formula" implied between drugs,and obtained the core ideas and main laws of physician dialectical treatment of insomnia.The above methods can provide a reference for the application of the method of TCM experience mining,and the analysis results can provide useful reference for the clinical diagnosis and treatment of insomnia.

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