Prescription and treatment rules for the prescriptions containing Poria cocos an

Gan-Lin Sun,Yun-Tong Wang,Yin-Zi Kong,Hong Gui,Lei Zhang

School of medicine,Jianghan University,Wuhan 430056,China.

Abstract

Keywords: Couplet medicine of Poria cocos-Atractylodes macrocephala,Trasitional Chinese Medicine set prescription preparation,Syndrome and treatment rule,Traditional Chinese Medicine Inheritance System

Introduction

Drug pair,also known as drug pair,refers to the relatively fixed combination of two traditional Chinese medicines commonly used in clinical practice,which is the most basic form of TCM compatibility application summarized by generations of doctors under the guidance of traditional Chinese medicine theory and from the accumulation of medication experience of physicians in previous dynasties.In ancient times,there were many monographs on drug pair,such asLeigong Yaodui,Yaodui,and so on,which are of clinical significance for the compatible use of traditional Chinese medicine.Jinmo Shi is a famous TCM clinician educator in China.He is good at using medicine to treat diseases in the process of clinical treatment and prescription application."Shijinmo Duiyao" [1] mentioned "Fuling-Baizhu(Poria - Rhizoma atractylodes macrocephala)" drug pair,one warm and healthy one permeates the dampness,can make water and humidity have a way out,so spleen health,dampness removal,swelling,drinking,disease evil are all removed.This medicine can treat the phlegm caused by spleen deficiency,then stop drinking water dampness,drink evil stop in the heart,distention and fullness and vomiting and diarrhea,loss of appetite,dizziness,or spleen deficiency and urine adverse,water dampness invades the muscle surface and so on."Fuling-Baizhu(Poria - Rhizoma atractylodes macrocephala)" medicine comes from Fuling (Poria) soup inJingyue Quanshu.Fuling (Poria) soup is the basic prescription of "Fuling-Baizhu (Poria - Rhizoma atractylodes macrocephala)",which is used for diarrhea caused by damp-heat or unclean diet.In theShanghan Lun,the combination of "Baizhu (Rhizomaatractylodis macrocephalae)" with Guizhi (Ramulus cinnamomic) and Gancao(Radix glycyrrhizae) was regarded as Linggui Zhugan Decoction,which had the effect of warming yang and invigorating spleen and relieving dampness.The combination of Fuling (Poria) and Baizhu (Macrocephala) can improve the efficacy of Fuling (Poria) .Generally speaking,the main prescription of the compatibility of "Fuling-Baizhu (Poria-Rhizoma atractylodes macrocephala)" has not been used to strengthen the spleen and permeating dampness.At present,the Chinese herbal medicine made by "Fuling-Baizu (Poria-Rhizoma atractylodes macrocephala)" medicine pairs are widely used in internal,external,gynecological and pediatric departments."traditional Chinese medicine prescription preparation" [2] is the national standard of the Chinese herbal prescription preparation,which contains 4052 kinds of Chinese herbal prescriptions and constitutes an important part of the clinical practice of modern Chinese medicine,In this paper,through the TCM inheritance assistance platform (V2.5),a comprehensive and systematic analysis was made of the formulation of all the TCM prescriptions including Fuling (Poria) and Baizhu (Rhizoma atractylodes macrocephala),and the rule of syndrome treatment,so as to provide a basis for the guidance of clinical medication and new drug research and development.

Materials and methods

1.Data selection

Selection and identify the preparation containing "Fuling-Baizhu (Poria-Rhizoma atractylodes macrocephala)" fromPrescription preparation of traditional Chinese Medicine.Enter it into the database of "Fuling-Baizhu (Poria-Rhizoma atractylodes macrocephala)" in Excel.

2.Standardize and unify the names of Traditional Chinese medicine

Based on the textbook of TCM in the 13th five-year Plan,the names of traditional Chinese medicine,the names of TCM diseases and the classification of syndromes in the above prescriptions were uniformly standardized.Refer to theTextbook of traditional Chinese MedicineandChinese Pharmacopoeia[3]to standardize the names and properties of drugs.Unify the names of traditional Chinese medicine with other names,such as "Guixin " as "Rougui (Cortex Cinnamomic)" and "Shuyu" as " Shanyao (Rhizome Dioscoreae)",etc.For the standardized treatment of the wrong words of traditional Chinese medicine names and diseases contained in some prescription preparations,such as "Fufu " and "Fuhuo" as "Fuling (Poria)","loss of eyes" as "insomnia",etc.

3.Prescription entry and verification

The unified and standardized prescription preparations were screened,and some preparations with the same composition and external use in the database were deleted,and finally sorted out into documents,with a total of 337 prescriptions.Enter "Chinese Medicine inheritance Auxiliary platform" (V2.5) [4].In order to ensure its reliability,the two groups were input and checked.After the input was completed,the other group reviewed the data to ensure the accuracy of the research results.

4.Statistical analysis

On the"Chinese Medicine inheritance Auxiliary platform" (V2.5),"statistical statements" were used to carry out the statistics of TCM diseases and syndromes,and then through the function of "data analysis",to analyze the laws of TCM diseases,syndromes and compatibility of traditional Chinese medicine treated by these prescriptions.The network visualization was conducted to deal with the relationship between high frequency syndromes and diseases under the support degree of various screening.And carries on the statistical analysis to the corresponding compatible traditional Chinese medicine frequency,four qi and five flavors and the meridian tropism of traditional Chinese medicine.

Results

1.Frequency statistics

1.1 Treating TCM diseases

According to statistics,there are 66 kinds of traditional Chinese medicine diseases that are mainly treated by 337 kinds of prescription preparations containing "Fuling-Baizhu (Poria - Rhizoma atractylodes macrocephala)".It involves a wide range of common diseases,including internal,external,gynecological and pediatric diseases,in which spleen and stomach diseases are more common,followed by gynecological and pediatric common diseases with higher frequency,the highest frequency is lack of appetite,followed by irregular menstruation.The 20 main diseases with frequency ≥ 18 are shown in Table 1.

Table 1.Statistics on the frequency of diseases treated by prescription preparations containing "Fuling-Baizhu (Poria - Rhizoma atractylodes macrocephala)" (frequency ≥ 18)

1.2 Attending syndrome

The main treatment syndromes of 337 kinds of prescription containing "Fuling-Baizhu (Poria - Rhizoma atractylodes macrocephala)" were screened,a total of 107 kinds were counted,among which the first two with high frequency were qi and blood deficiency syndrome and spleen and stomach weakness syndrome respectively.For 10 kinds of attending syndromes with frequency ≥ 19,in Table 2.

Table 2.Statistics on the frequency of main syndrome of prescription preparations containing "Fuling-Baizhu(Poria - Rhizoma atractylodes macrocephala)" (frequency ≥ 19)

2 Syndrome of weakness of spleen and stomach 74 7 Kidney yang deficiency syndrome 21 3 Syndrome of disharmony between spleen and stomach 31 8 Syndrome of obstruction of phlegm-dampness 21 4 Syndrome of food accumulation 28 9 Syndrome of deficiency of kidney essence 19 5 Syndrome of qi stagnation of spleen and stomach 25 10 Syndrome of stagnation of liver qi 19

1.3 Frequency of compatibility with Chinese medical herbs of prescription preparation containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )"

According to the statistics,463 flavors of Chinese medical herbs were included in the compatibility of the prescription preparation containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" and a total of 18 high- frequency compatible Chinese medical herbs (frequency ≥ 63),including qitonifying drugs: Huangqi (Radix Astra -gali),Shanyao (Rhizoma Dioscoreae),Gancao (Radix Glycyrrhizae),Dangshen (Radix Salviae Miltiorrh -izae),Renshen (Radix Ginseng); blood-tonifying drugs: Danggui (Radix Angelicae Sinensis),Baishao(R -adix Paeoniae Alba),Shu Dihuang(Radix Rehmanniae Preparata),qi-regulating drugs: Chenpi (Pericarp -ium Citri Reticulatae),Muxiang (Radix Aucklandiae),Xiangfu (Rhizoma Cyperi); blood-activating and stasisresolving drugs: Chuangxiong (Rhizoma Chuanxiong),Niuxi (Radix Achyranthis Bidentatae); dampresolving drugs: Sharen (Fructus Amomi),Houpo (Cortex Magnoliae Officinalis); phlegm warming and resolving drugs: Banxia(Rhizoma Pinelliae); interiorwarming drugs:Rougui(Cortex Cinnamomi); digestionpromoting drugs: Shanzha(Fructus Crataegi).Details are shown in Table 3.

Table 3.Chinese medical herbs commonly used in prescription preparations containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" (frequency ≥ 63)

9 Shanyao (Rhizoma Dioscoreae) 111 18 Niuxi(Radix Achyranthis Bidentatae) 63

2.1.4 Rule of prescription for mulation containing"Fuling - Baizhu (Poria-Rhizoma

Atractylodis Macrocephalae )"In the formula rule of the software,the number of support degree was set as 152 (support degree 45%),and the confidence degree was set as 0.9.17 combinations of Chinese medical herbs were analyzed and screened out,as shown in table 4.Association under several support degrees after Network Visualization processing and screening,as shown in Figure 1.

Table 4.Common combinations of Chinese medical herbs in prescription preparations containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" (frequency ≥ 155)

7 Baizhu (Rhizoma Atractylodis Macrocephalae ),Danggui (Radix Angelicae Sinensis),Fuling (Poria) 189 16 Baishao (Radix Paeoniae Alba),Fuling (Poria) 155 8 Chenpi (Pericarpium Citri Reticulatae),Baizhu (Rhizoma Atractylodis Macrocephalae )170 17 Baizhu (Rhizoma Atractylodis Macrocephalae ),Baishao (Radix Paeoniae Alba),Fuling (Poria) 155 9 Chenpi (Pericarpium Citri Reticulatae),Fuling (Poria) 170 18 Baishao (Radix Paeoniae Alba),19

Figure 1.Relevance network of Chinese medical herbs combinations used commonly in prescription preparations containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )"

As can be seen from Figure 1,when the support degree is set to 25%,the combination of compatible Chinese medical herbs is widely and comprehensively distributed;when the support degree is set to 35%,the high-frequency Chinese medical herbs combination network appears;when the support degree is increased to 45%,the peripheral Chinese medical herbs decreases and the core combination is highlighted.The core combination of Chinese medicine herbs compatible with“Fuling(Poria)- Baizhu(Rhizoma Atractylodis Macrocephalae)”includes Gancao(Radix Glycyrrhizae),Danggui(Radix Angelicae Sinensis),Baishao(Radix Paeoniae Alba),Chenpi(Pericarpium Citri Reticulatae).

2.2 Analysis of the law of syndrome and treatment

2.2.1 Compatibility law of Chinese medicine herbs in prescription preparations of high frequency main treatment syndromes

The first two syndromes of "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" medicine in the prescription preparations:syndrome of both qi and blood deficiency (100 times) and syndrome of spleenstomach weakness (74 times),were processed by association rules.

（1）Compatibility law of Chinese medicine herbs in prescription preparations of Qi and blood deficien -cy syndrome Use "Qi and blood deficiency syndrome" to enter the query,and click "group formula",set the confidence level to 0.9,and the number of supports to 20 (the support level is 20%),Chinese medicine herbs combination is similar to Taishan Panshi San to remove glutinous rice and replace Huangqin (Radix Scutellariae) for Dangshen (Radix Codonopsis),add Jianpi pill (remove Huanglian (Rhizoma Coptidis),Shenqu(Medicated Leaven),Maiya(Fructus Hordei Germinatus),Shanzha(Fructus Crataegi),Doukou (Alpinia katsumadai Hayata),add Dihuang Yinzi (remove Bajitian (RadixMorindae Officinalis),Shanzhuyu(Fructus Corni),Roucongrong(Herba Cistanches),Shichangpu (Rhizoma Acori Tatarinowii)),add Ejiao(Colla Corii Asini),Yimucao (Herba Leonuri),Sheng Dihuang (Radix Rehmanniae),Niuxi (Radix Achyranthis Bidentatae).When the number of support is changed to 40 (that is,the degree of support is 40%),highfrequency compatibility of the prescription Bazhen decoction,remove Renshen (Radix Ginseng) and add Huangqi (Radix Astragali),Chenpi (Pericarpium Citri Reticulatae),Dangshen (Radix Salviae Miltiorrhizae),to strengthen its qi-replenishing effect.When the number of supports is increased to 60 (that is,the support degree is 60%),the high-frequency prescription Bazhen decoction is used to remove Renshen (Radix Ginseng) and plus Huangqi (Radix Astragali).The basic prescription containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" drug pairs for treating Qi and blood deficiency is Bazhen decoction,"Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" are not monarch drugs in this prescription and Bazhen Tang,but they are fixed combinations in this kind of prescription.The combined network of commonly used Chinese medical herbs for prescription preparations containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" drug pairs for treating qi and blood deficiency syndromes is shown in Figure 2.Commonly used compatible Chinese medical herbs are shown in Table 5.

In the treatment of deficiency of both qi and blood syndrome,the drug pair of "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" that are often compatible with the Chinese medical herbs and their representative Chinese medical herbs (see Table 5): qi-tonifying drugs Gancao(Radix Glycyrrhizae),Huangqi (Radix Astragali),Dangshen (Radix Salviae Miltiorrhizae),Renshen (Radix Gins -eng),Shanyao (Rhizoma Dioscoreae),blood-tonifying drugs Danggui (Radix Angelicae Sinensis),Shu Dihuang (Radix Rehmanniae Preparata),Baishao (Radix PaeoniaeAlba),blood-activating analgesic drugs Chuangxiong (Rhizoma Chuanxiong),qi-regulating drugs Chenpi (Pericarpium Citri Reticulata -e),yangtonifying drus Duzhong(Cortex Eucommiae) and interior-warming drugs Rougui (Cortex Cinnamomi).The meridian tropism of Chinese medical herbs about "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" drug pairs for treatment of qi and blood deficiency syndrome (Frequency ≥ 443): spleen meridian 1042 times,liver meridian 926 times,kidney meridian 762 times,heart meridian 692 times,lung meridian 534 times and stomach meridian 443 times.

Figure 2.Correlation network of common combination of Chinese medical herbs containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" in treatment of deficiency of qi and blood syndrome

Analysis of high frequency compatibility of Chinese medical herbs for Spleen and Stomach Weakness Syndrome.Use "pleen and Stomach Weakness Syndrome" to enter the query,and click "group formula",set the confidence level to 0.9,and the number of supports to 15 (the support level is 20%),then,the law of its organization is obtained: high-frequency compatible Chinese medical herbs combination like the Hefang that Shenling Baizhu powder (removing Jiegeng (Radix Platycodonis) and Jianpi pill (removing Huanglian (Rhizoma Coptidis) and Doukou(Alpinia katsumadai Hayata)) plus Huoxiang Zhengqi powder (removing Dafupi (Pericarpium Arecae),Baizhi (Radix Angelicae Dahuricae),Zisu (Folium Perillae),Jiegeng (Radix Platycodonis) plus Dangshen (Radix Salviae Miltiorrhizae) for invigorating spleen and nourishing blood.Set the number of supports to 30 (the degree of support is 40%),high-frequency compatible Chinese medical herbs combination like Yigong San that change Renshen (Radix Ginseng) into Dangshen (Radix Codonopsis),and add Chenpi (Pericarpium Citri Reticulatae),Shanyao (Rhizoma Dioscoreae).Set the number of supports to 44 (the degree of support is 60%),the combination of high frequency compatibility of traditional Chinese medicine is Yigong San to remove Renshen (Radix Ginseng).To sum up,we can know Yigong powder is the basic prescription for the treatment of spleen and stomach Qi deficiency Syndrom,such as high frequency compatibility with Chenpi (Pericarpium Citri Reticulatae) regulating qi and Dangshen (Radix Codonopsis),Shanyao (Rhizoma Dioscoreae) invigorating qi and strengthening the spleen.The combined network of commonly used Chinese medical herbs for prescription preparations containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" drug pairs for treating spleen-stomach weakness syndromes is shown in Figure 3.Commonly used compatible Chinese medical herbs are (see Table 6): qi-tonifying drugs Gancao (Radix Glycyrrhizae),Dangshen (Radix Salviae Miltiorrhizae),Shanyao (Rhizoma Dioscoreae),Baibiandou (Semen Lablab Albu),digestion-promoting drugs Shanzha (Fructus Crataegi),Shenqu(Medicated Leaven),Maiya (FructusHordeiGerminatus),qiregulating drugs Chenpi (Pericarpium Citri Reticulatae),damp-resolving drugs Sharen (Fructus Amomi),phlegm warming and resolving drugs Banxia (Rhizoma Pinelliae).The meridian tropism of Chinese medical herbs about "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" drug pairs for treatment of syndrome of spleen and stomach weakness (Frequency ≥ 218): spleen meridian 761 times,stomach meridian 510 times,lung meridian 406 times,kidney meridian 270 times,heart meridian 226 times and liver meridian 218 times.

Table 5.Commonly used Chinese medical herbs containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" in the treatment of deficiency of both qi and blood syndrome (frequency ≥ 29)

Table 6.Commonly used Chinese medical herbs containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" in treatment of deficiency of syndrome of spleen and stomach weakness (frequency ≥ 20)

Figure 3.Correlation network of common combination of Chinese medical herbs containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" in treatment for spleen and stomach weakness

2.2.2 Analysis of the law of drug use in high-frequency attending diseases

Data mining analysis was carried out on the first two cases of anorexia (94 times) and irregular menstruation (76 times) of the prescription preparation containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)"

2.2.2.1 Analysis of high frequency Combination of Traditional Chinese medicine with anorexia

After inputting "loss of appetite" into the "Data Analysis" module,click "Group rule",set the confidence level to 0.9,and the number of supports to 19 (support level to 20%) to obtain the group rule.The high frequency combination of traditional Chinese medicine was the addition and subtraction of Shiquandabu decoction (removing Rougui (Cortex Cinnamomi) and Chuangxiong (Rhizoma Chuanxiong)) and Jianpi pill (removing Huanglian (Rhizoma Coptidis),Doukou (Semen Alpiniae Katsumadai)).In the formula,Renshen (Radix Ginseng) is replaced by Dangshen (Radix Salviae Miltiorrhizae),adding the dampness of Banxia (Rhizoma Pinelliae),Baibiandou (Semen Lablab Albu) and Lianzi (Semen Nelumbinis),the number of support was set at 28 (the degree of support was 30%).The high frequency Chinese medicine combination was similar to the Chinese medicine combination of Xiangsha Liujunzi decoction (Renshen (Radix Ginseng)) was replaced by Dangshen (Radix Salviae Miltiorrhizae) and Baishao (Radix Paeoniae Alba),Danggui (Radix Angelicae Sinensis),Shanyao (Rhizoma Dioscoreae).The number of support was set to 38 (the degree of support was 40%).The high-frequency Chinese medicine combination was Yigong powder that change Renshen (Radix Ginseng) into Dangshen (Radix Salviae Miltiorrhizae),and add Danggui (Radix Angelicae Sinensis) for enriching blood.In conclusion,It can be seen that Yigong powder is a basic prescription for the treatment of anorexia and it is high-frequency combined with tangerine peel to regulate qi and Dangshen (Radix Salviae Miltiorrhizae) to supplement qi.Figure 4 shows the correlation network of high frequency compatibility of traditional Chinese medicine for the treatment of anorexia."Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" for the treatment of loss of appetite and the types of traditional Chinese medicine that are often combined and used and their representative traditional Chinese medicine (see Table 7) are as follows: blood tonic medicine Danggui (Radix Angelicae Sinensis),Shu Dihuang (Radix Rehmanniae) Baishao (Radix Paeoniae Alba); mend angry medicine Gancao(Radix Glycyrrhizae),Huangqi(Radix Astragali) Baibiandou (Semen Lablab Albu),Shanyao (Rhizoma Dioscoreae),Dangshen (Radix Salviae Miltiorrhizae); digestant drug Shanzha (Crataegus pinnatifida Bunge),Shenqu (Medicated Leaven),Maiya (Fructus Hordei Germinatus),and Qi regulating Drug Chenpi (Pericarpium Citri Reticulatae),Muxiang (Radix Aucklandiae) .In the treatment of anorexia,the combination of "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" with traditional Chinese medicine (frequency ≥ 366): spleen meridian 967 times,stomach meridian 582 times,lung meridian 499 times,heart meridian 380 times,kidney meridian 377 times,liver meridian 366 times.

2.2.2 Combination analysis of irregular and highfrequency Chinese medicine in menstruation

In the heart of the "data analysis "module" menstruation to be not moved" after the input query,click on the "formula" law,set up the confidence of 0.9,support the number of 15 (support degree was 20%),its characteristics: high frequency system of traditional Chinese medicine combination for Shiquan Dabu decoction and Xiangfu pill (remove Shanzhuyu (Fructus Corni),Dazao (Fructus Jujubae),Tiandong (Radix Asparagi)),Chaihu Shugan powder (remove Zhiqiao (Fructus Aurantii) ).The confidence was set as 0.9,the number of support was set as 30 (the support was 40%),and the combination was Bazhen Yimu pill,remove the Dangshen (Radix Salviae Miltiorrhizae) ; add Sharen (Fructus Amomi),Xiangfu (Rhizoma Cyperi),Chenpi (Pericarpium Citri Reticulatae),EJiao (Colla Corii Asini) .The confidence was set as 0.9,the number of supports was 46 (the support was 60%),and the combination was Bazhen decoction (remove Renshen (Radix Ginseng)).Figure 5 shows the correlation network of high frequency compatibility of traditional Chinese medicine for the treatment of irregular menstruation.Treat menoxenia with "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" medicine to cooperate and use of traditional Chinese medicine (TCM) type and often on behalf of the Chinese traditional medicine (see Table 8) : blood-replenishing potion (Danggui (Radix Angelicae Sinensis),Shudi (Radix Rehmanniae),Baishao (Radix Paeoniae Alba),Ejiao (Colla Corii Asini)); qi-tonifying drug (Gancao (Radix Glycyrrhizae),Huangqi (Radix Astragali),Dangshen (Radix Salviae Miltiorrhizae),Renshen (Radix Ginseng); medicines for regulating vital energy (Chenpi (Pericarpium CitriReticulatae),Xiangfu (Rhizoma Cyperi)) and so on.In the treatment of irregular menstruation,the combination of traditional Chinese medicine with "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" was used (frequency ≥407) : spleen meridian 863 times,liver meridian 858 times,kidney meridian 603 times,heart meridian 578 times,stomach meridian 413 times and lung meridian 404 times.

Figure 4.Association network of common Traditional Chinese medicine combination containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" for the treatment of anorexia

Table 7.Compatibility of Traditional Chinese medicine with "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" for the Treatment of anorexia (frequency ≥20)

Table 8.Compatibility of Traditional Chinese medicine with "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" in the treatment of irregular menstruation (frequency ≥24)

Figure 5.Association network of common Traditional Chinese medicine combination containing "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae )" for treatment of irregular menstruation

Discussion

Fuling (Poria) is the dry sclerotium of poria poriaceae fungi.It is a traditional Chinese medicine that benefits water infiltration and dampness,invigorates the spleen and pacifies the spirit.It is sweet,mild and smooth in nature,and is soothing to the heart,spleen and kidney.Modern pharmacological studies have shown that Fuling (Poria) has diuretic,anti-tumor,anti-liver fibrosis,immune regulation,anti-inflammatory,antioxidation,anti-aging and other effects [6].Baizhu (Atractylodes atractylodes)is warm,sweet and bitter,and is the dry root stem of atractylodes atractylodes in the composite plant.It belongs to the spleen meridian and stomach meridian,and can strengthen the spleen and benefit qi,dry dampness and water,stop sweating and calm fetus.Its effective components include volatile components,glycosides,lactones,polysaccharides and amino acids [7].Studies have shown that Baizhu (Atractylodes atractylodes) have diuretic,antiinflammatory and antibacterial effects,anti-aging effects,anti-tumor effects,immune regulation and other effects,as well as certain regulatory effects on gastrointestinal movement,uterine smooth muscle and nervous system [8].In this study,the drug pairs are composed of Baizhu (Atractylodes atractylodes)for invigorating qi and spleen and Fuling (Poria) cobolia for invigorating spleen and dampness.In clinical practice,the two should be compatible with each other,mainly for tonifying temperament,and tonifying spleen and reducing dampness while tonifying qi,which is a common drug pair for treating spleen deficiency and dampness [9].

It is recorded inMedical Originthat tuckahoe - atractylodes atractylodes as a drug for the treatment of watery diarrhoea.In the theory of drug pairs "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" is classified as a tonic drug pair,which has the effect of invigorating qi and Yang.The spleen likes dryness but hates dampness; Baizhu (Atractylodes atractylodes) is sweet but benefits the spleen; bitter and warm but is dryness and dampness.Fuling (Poria) invigorates the spleen,lightening the dampness,and improving the spleen through infiltration.The combination of the two drugs,one dryness and one permeability,and the combination of Fuling (Poria) can make the water wet and the temper healthy,and the temper beneficial and the dampness transported.They are used in the treatment of spleen deficiency dampness and are widely used clinically [10].Many classic prescriptions are based on the compatibility of Fuling (Poria) and Baizhu (Atractylodes atractylodes).For example,theYixue Jijiesays: "Fuling Baizhu decoction: Fuling (Poria) and Baizhu (Atractylodes atractylodes) can treat the heart drink." In this study,it was found that the main prescription of "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" was derived from the following classic prescriptions.For example,it was recorded inFormula for The Syndrome of Children's Medicinethat Yigong powder was composed of "Renshen (Radix Ginseng),Fuling (Poria),Baizhu (Atractylodes atractylodes),Chenpi (Pericarpium Citri Reticulatae),Gancao (Radix Glycyrrhizae) etc.",and it was mainly used for spleenstomach weakness and qi stagnation.In recent years,view of "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" formula law study was reported more,Jianjun Lv et al [11] conducted data mining for Baizhu (Atractylodes atractylodes) inPrescription preparation of traditional Chinese Medicineand find Baizhu (Atractylodes atractylodes) preparation high frequency of the syndrome of qi deficiency syndrome,spleen deficiency syndrome; high-frequency Chinese medicine combination containing Baizhu (Atractylodes atractylodes) respectively Bazhen decoction and Sijunzi decoction subtraction.In the prescription preparation of Baizhu (Atractylodes atractylodes) found that the high frequency of indications for diarrhea,menstrual disorders.The combination of traditional Chinese medicine for the treatment of diarrhea and irregular menstruation is respectively based on the formula of Yigong powder and Bazhen Decoction.Some scholars also made statistics on the prescription rules of qi and blood deficiency syndromes inPrescription preparation of traditional Chinese Medicineand found that the high-frequency indications of TCM prescription for qi and blood deficiency syndrome were menstrual disorder,insomnia and fatigue,which also reflected the characteristics of TCM treatment of different diseases from one side [12].

To sum up,based on the TCM inheritance assistance platform,a systematic analysis was made of the syndrome management rules of the TCM prescription preparation containing the pair of "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" in thePrescription preparation of traditional Chinese Medicine.There were a total of 337 prescriptions,including 66 kinds of TCM diseases and 107 kinds of syndromes.The first two high frequency syndromes were qi and blood deficiency syndrome and spleenstomach weakness.The first two high frequency diseases of TCM are loss of appetite and irregular menstruation.By longitudinal comparison of syndromes and diseases,it can be found that the first three high-frequency TCM syndromes compatible with spleen-stomach weakness and anorexia are all the spleen,stomach and lung meridional.The basic formula is Yigong powder.The four high frequency traditional Chinese medicines that are compatible with qi and blood deficiency syndrome and menstrual disorder all belong to the spleen,liver,kidney and heart meridians,and their basic prescriptions are all Bazhen decoction.In the medicinal preparation containing "Poria cobole-Atractylode",the four qi are mostly warm,flat and cold,and the five tastes are mostly sweet,bitter and spicy.The main diseases of TCM were spleen and stomach diseases and gynecological diseases.This study aims to provide theoretical basis for clinical application and new drug development of "Fuling - Baizhu (Poria-Rhizoma Atractylodis Macrocephalae)" drug pairs.