200 IEEE Internatonal Conference on Bonformatcs and Bomedcne Workshops Assocaton Analyss and Dstrbuton of Chronc Gastrts s Based on Assocated Densty Guo-Png u Y-Qn Wang Fu-Feng Ha-Xa Yan Jng-Jng Fu Je Zhao aboratory of Informaton Access and Synthess of TCM Four Dagnoss, Shangha Unversty of Tradtonal Chnese Medcne Shangha, Chna Correspondng author: Guo-Png u aboratory of Informaton Access and Synthess of TCM Four Dagnoss Shangha Unversty of Tradtonal Chnese Medcne Shangha, PR Chna e-mal: tanshanghuo3838@63.com Abstract Purpose:The analyss of syndrome dstrbuton and the assocaton between syndrome-syndrome n chronc gastrts (CG) patents can provde references for research about Tradtonal Chnese Medcne (TCM) dagnoss and treatment of CG. Method:Ths paper apples the nvestgaton method of clncal epdemology, adopts probablty statstcs method and comes up wth the concept of assocated densty to conduct assocaton analyss of syndromes. Result:In the dstrbuton of syndromes patents who have a sngle syndrome occupy 64.7% of the whole sample; patents who have two syndromes make up 32.2%; the stuaton that 3 syndromes happen at the same te has a percentage of.3%. defcency syndrome and lver q stagnaton syndrome are closely assocated. Concluson:ver and spleen are the man dsease locatons of CG and these two organs are assocated wth and nfluenced each other n physology and pathology. Keyword:chronc gastrts,syndrome,dstrbuton, assocaton I. Introducton Chronc gastrts (CG) s a clncal common dsease, belongng to the feld of Tradtonal Chnese Medcne (TCM) spleen and stomach dseases such as gasteralga fullness n Ru-Wen Zhen Sh-Xng Yan Guo-Zheng Department of Control Scence & Engneerng, Tong Unversty Shangha, Chna Guo-Zheng Department of Control Scence & Engneerng Tong Unversty Shangha, PR Chna e-mal: gzl@tong.edu.cn abdomen gastrc upset and so on. Ths paper analyses the assocaton between syndromes and the syndrome dstrbuton of CG patents by applyng the nvestgaton method of clncal epdemology, adoptng probablty statstcs method and comng up wth the concept of assocated densty. The results could provde reference for research about TCM dagnoss and treatment of CG. II. Data set and method A. Research subects ) Selecton of research subects: The chronc gastrts (CG) examples were collected n the clnc, npatent department and gastroscope room of dgestve system department n onghua Hosptal and Shuguang Hosptal of Shangha Unversty of Tradtonal Chnese Medcne, Xnhua Hosptal, Putuo Dstrct Central Hosptal, Shangha Hosptal of Tradtonal Chnese Medcne. There are 935 vald cases by removng those TCM nqury dagnoss scales that lack of nformaton or cannot be dagnosed of CG, among whch 363 patents are male (38.8%, wth average age of 44.37±4.44) and 572 patents are female (6.2%,wth average age of 48.48±2.84). 2)Standards of adoptng cases:.patents who meet the dagnoss standards of 978--4244-8302-0/0/$26.00 200 IEEE 790
CG and TCM syndromes. 2.Patents who are nformed of and agree wth ths nvestgaton. 3)Dagnoss standards: Western Dagnoss Standard: accordng to the Consensus of atonal Semnar on CG held by Chnese Medcal Assocaton Dgestve Dseases Branch n 2000[]. Chnese Dagnoss Standard : Dagnoss Standard ncludes 9 syndromes referrng to Dagnoss, Dfferentaton, Effcacy Standard of Integrated Tradtonal Chnese and Western Medcne n Chronc Gastrts establshed by Chnese Assocaton of Integrated Tradtonal Chnese and Western Medcne Dgestve System Dsease Professonal Commttee[2], Gudelne for Clncal Research of ew Tradtonal Chnese Medcne ssued by the Mnstry of Health[3] The study of Clncal Dgestve Dseases of Integrated Tradtonal Chnese and Western Medcne wrtten by Peng Bo[4] atonal Standard of People's Republc of Chna: Part of TCM Clncal dagnoss and Treatment Termnology ssued by Chna State Bureau of Techncal Supervson[5]. 4)Excluson Crtera:.Mental patents and patents wth other severe system dseases. 2.Patents who have dffculty n descrbng ther condtons. III. Patents who are not nformed or refuse to cooperate. B.Data processng method ) Method of makng TCM nqury dagnoss scales The research group, composed of Shangha senor clncal experts n dgestve system clncal doctors and researchers, ntally worked out the nvestgaton form of clncal epdemology wth access to a wde range of lterature about TCM spleen and stomach dseases and related documents n core magaznes and ournals over the 5 years and referrng to reports about the frequency of symptoms assocated wth syndromes n CG dseases of Chnese. The scales were amended by two rounds of expert consultaton and statstcal tests and at last fxed. 2)Investgaton method The clear defntons of symptoms n the scale and the specfc methods and order of nqury dagnoss are gven. All samplers must take unfed tranng. 3) Dagnoss method 3 senor chef doctors rch n clncal experence dagnose cases whch have complete nformaton, referrng to CG Dagnoss Standards made by our research group. If 2 of them have the same dagnoss results of one case, ths case wll be adopted. If not, we wll dscuss wth the experts untl 2 of them come to a concluson. 4) Data nput and process.buld a database wth Epdata software. 2.Input data two tes ndependently. 3.The Epdata software compares the two data sets and checks out mstakes. 4.Check the nvestgaton form logcally n case of fllng errors. C. Analyss method ) Frequency of syndromes Pl stands for the appearance frequency of the th syndrome n the whole sample, and represents whether the th syndrome appears n the mth case. If the syndrome appears, then equals ; otherwse equals 0. denotes the total number of the cases n the data set. The computng formula of Pl s as follows: 2) Assocated Densty Ths paper proposes the concept of assocated densty to wegh the relevance degree between syndrome and syndrome. In the mth case, f syndrome appears wth syndrome, then H equals ; otherwse H equals 0. stands for the sultaneously occurrng tes of and n the whole sample, then Pl m = = = m = The assocated densty s utlzed to elnate the nfluence of the appearance frequency of syndromes to relevance degree between them. P descrbes the assocated densty between syndrome and syndrome, P = IV. m = Results A dstrbuton There are two methods to calculate the H 2 79
dstrbuton of the syndromes n the 935 CG patents. One s to classfy the cases accordng to how many syndromes appear n the same patent and to calculate the frequency of each stuaton, and the other s to count the appearance frequency of every syndrome n the CG dsease. The results of the two methods are as follows. Result of the frst method The result shows that n the dstrbuton of syndromes 605 cases appear to have a sngle syndrome, occupyng 64.7% of the whole sample; the total number of patents who have two syndromes s 30, occupyng 32.2%; 3 syndromes happen at the same te n 3 patents who make up.3%; the other 6 cases wth a percentage of.7 cannot be dagnosed of obvous syndromes. The specfc data s n Table. Orde r TABE I dstrbuton Frequen cy Percentage % Sngle syndrome 605 64.7 2 Two syndrome 30 32.2 3 Three syndrome 3.3 4 o obvous syndrome 6.7 Total 935 00 2 Result of the second method Accordng to the calculated appearance frequency of syndromes n CG patents, the order of syndromes s that defcency > stagnaton of dampness > spleen-stomach dampness heat > lver q depresson > stagnated heat n lver-stomach > spleen-stomach defcency cold > stomach yn nsuffcency > blood stagnaton n stomach vessel. The frequency of every syndrome s dsplayed n Table 2. B.Assocaton Between and The assocated densty formula s utlzed to analyse the syndromes wth accompanyng syndromes. The nner connecton between syndromes can be dscovered by fndng out frequently accompanyng syndromes when one syndrome occurs. The syndromes of hgh assocated densty are lsted n Table 3. TABE II Frequency of syndromes spleen-stomach defcency heat stagnaton of heat defcency stagnated heat n lver-stomach stomach yn nsuffcency TABE III. Spleen-stomach q defcency Accompanyng defcency 8.77% 2.28% defcency.0% 5.3% 4.47% defcency 5.39% defcency 4.7% 2.78% spleen-stomach defcency cold 0.00% 0.00% Assocaton between syndrome and syndrome Frequen cy Percentage % 438 46.8 Stagnaton of dampness 367 39.3 Spleen-stomach dampness heat 79 9. ver q depresson 57 6.8 Stagnated heat n lver-stomach Spleen-stomach defcency cold 83 8.88 32 3.42 Stomach yn nsuffcency 0.07 Blood stagnaton n stomach vessel V. Dscusson 3 0.32 A. Analyss of Dstrbuton Chronc gastrts (CG ) belongs to the feld of spleen-stomach dseases n TCM. Some reports show that spleen defcency syndrome wth a proporton of about one-thrd s the most common one n CG dseases[6] ; some demonstrate that spleen-stomach 3 792
dampness heat syndrome wth a percentage of 68.63% s the most representatve of superfcal gastrts[7]. From these research results, t comes to a concluson that syndromes assocated wth spleen-stomach occupy a larger proporton n the syndrome dstrbuton of CG. Other research results ply that lver-stomach dsharmony pattern and lver q stagnaton syndrome are the most unverse n Chronc Superfcal Gastrts dseases[8] [9]. Even scholars put forward that syndrome dstrbuton of CG has changed, that s the man syndromes of CG transt from spleen-stomach syndromes to lver-stomach syndromes and lver-spleen syndromes assocated wth lver q stagnaton. The results of ths paper show that, n the 935 CG patents, the frequency of defcency syndrome and stagnaton of dampness syndrome ranks top and 2 whle n the accompanyng syndromes lver q stagnaton syndrome and stagnated heat n lver-stomach syndrome make up a large percentage. Generally spleen-stomach q defcency s the most common n all syndromes of CG wth the most frequently accompanyng syndrome of lver q stagnaton, whch harmones wth the reports above. However, more dscusson of whether syndrome dstrbuton has changed s needed. Meanwhle the characterstcs of syndrome dstrbuton n ths paper fully reflect the theory of TCM--the pathologcal characterstc of CG dseases s prary defcency and secondary excess, whch means that the pathology of CG s spleen-stomach defcency whle lver q excess s the outsde feature. B.Analyss of Assocaton Between and Ths paper apples the assocated densty formula proposed by our research group to analyse the assocaton between syndromes and ther accompanyng syndromes wth an expectaton of fndng out the nner pathologcal connecton of syndromes. The assocaton densty values of defcency syndrome and lver q stagnaton syndrome are 4.47% and 5.39% respectvely, whch are hgher than values of other syndromes, so t s concluded that these two syndromes have the closest assocaton. Physologcally, lver s hghly related to spleen. The two organs cooperate to dgest ntakes and to produce store and transport blood. The spleen's functon of transportng and transformng foodstuff and the spleen-stomach's functon of upbearng and downbearng rely on the lver's functon of free coursng and the lver can keep ts functon normal only by dependng on the refned nutrents obtaned from the spleen-stomach's functon of transportng and transformng food and drnk. If the lver cannot work normally, the functon of spleen-stomach wll be nfluenced and thus lver-spleen and lver-stomach dsharmony syndromes such as abdomnal dstenton darrhea loose stools and so on wll appear. Inversely, dys-splensm and ndgeston due to retenton of food may lead to slow free coursng of lver-gallbladder and even rrtable behavours assocated wth. Therefore, from the pathologcal perspectve, lver and spleen nfluence each other. Ths paper utlzes the method of clncal epdemology to analyse the syndrome dstrbuton and assocated densty between syndrome and syndrome of CG dseases. Accordng to research results, t comes to a concluson that lver and spleen are the man dsease locatons of CG and these two organs are closely assocated n physology and pathology, whch s consstent wth prevous reports and TCM theory. However, the assocaton between some syndromes cannot be well explaned. For example, the current knowledge of the physologcal and pathologcal relatons between stomach yn defcency syndrome and spleen-stomach defcency cold syndrome s not enough to account for the hgh assocaton between the two syndromes. Wth the deepenng of study and the ncreasng number of clncal cases, further dscusson wll contnue. Acknowledgements Ths proect was supported by atonal atural Scence Foundaton of Chna(o. 3090897,6005006) Shangha Muncpal Health Bureau Youth research proect(o.2008y28) Shangha Specal Fund n Scentfc Research for Tranng Excellent Young Teachers n colleges (o. syz08003) the Shangha 3th eadng Academc Dscplne Proect (o. S30302). References []Chnese Medcal Assocaton Dgestve Dseases Branch.Consensus of atonal Semnar on Chronc 4 793
Gastrts.Chnese Journal of Dgeston.2000; 20(3): 99~20. [2]Chnese Assocaton of Integrated Tradtonal Chnese and Western Medcne Dgestve System Dsease Professonal Commttee. Dagnoss, Dfferentaton, Effcacy Standard of Integrated Tradtonal Chnese and Western Medcne n Chronc Gastrts (The Tentatve Scheme). Chnese Journal of Integrated Tradtonal Chnese and Western Medcne [J],990; 0(5):38-39. [3]Mnstry of Health of the People's Republc of Chna. Gudelne for Clncal Research of ew Tradtonal Chnese Medcne. Beng: Mnstry of Health of the People's Republc of Chna, 993:24-5 [4]B Peng, The study of Clncal Dgestve Dseases of Integrated Tradtonal Chnese and Western Medcne. Frst Edton. Beng. Chna Press of Tradtonal Chnese Medcne, 997, 64-72. [5]State Bureau of Techncal Supervson. atonal Standards of Peoples Republc of Chna Part of TCM Clncal Dagnoss and Treatment Termnology.997. [6]B.H.We. Exploratory Development of Theory of the Spleen and Stomach n Tradtonal Chnese Medcne. Beng : Beng Publshng House, 993. [7]K.F.We,Y.S.Yang, C.B.Yang.Relatonshp between chronc atrophc gastrts and syndrome of splenogastrc hygropyrexa : Clncal Analyss of 53 Case Reports. Journal of Fuan College of Tradtonal Chnese Medcne, 993, 3 (4) :23-24. [8]F.Y.Tu, M.e,Q.Z.Zheng, et al. Relatonshp Between of Tradtonal Chnese Medcne and Pathologcal Change of Stomach Mucosal Bopsy n Patents wth Chronc Gastrts. Chnese Journl of Integrated Tradtonal and Western Medcne on Dgeston, 2004, 2 (6) : 323 325. [9]S.S.Zhang, T.Mu, H.B.Wang, et al. Research on the Dstrbuton of s n Chronc Superfcal Gastrts. Chnese Journal of Tradtonal Chnese Medcne.2007,22():8-2 5 794