The Causality Research between Syndrome Elements by Attribute Topology

Background. The traditional Chinese medicine (TCM) is an empirical medical system and has its own diagnosis and treatment method. The syndrome elements are atoms to modern TCM diagnosis proposed by Professor Zhu Wenfeng. Researching and analyzing the syndrome element system is one of the active issues for TCM research. At present, most related researches focus on the correlativity and hierarchical relationship of the diseases and symptoms, but the causality researches between syndrome elements themselves have not been reported so far. Methods. To explore the causality between syndrome elements, a method named causality by attribute topology (CAT) is proposed. Based on the subordinate relations in attribute topology, the inference method analyzes and reasons the dependency relationship between the sets of objects which contain attributes. Through the removal of attributes in the attribute topology, the formal context is updated constantly. Thus, the causal relationship among the attributes is deduced. In this method, 500 records are mathematically transferred to a binary context for syndrome element analysis. Through the analysis and verification of the potential causal relationship between the syndrome elements, knowledge discovery of the diagnostic data of traditional Chinese medicine based on attribute topology structure diagram is conducted. Results. This paper has verified the causal transformation between these syndrome elements. The experimental results between the female group data and the male group data show that different genders have different characteristics and relations of syndrome elements. The experimental results are basically consistent with the traditional Chinese medicine theory. Conclusion. The experiment shows that causality by attribute topology (CAT) is feasible to describe the causality between TCM syndrome elements. Further research on possible knowledge discovery in TCM diagnostic data should be conducted through the analysis of the potential causal relationship between TCM diagnostic data and each syndrome element.

The Score Model Containing Chinese Medicine Syndrome Element of Blood Stasis Presented a Better Performance Compared to APRI and FIB-4 in Diagnosing Advanced Fibrosis in Patients with Chronic Hepatitis B

This study aims to explore a useful noninvasive assessment containing TCM syndrome elements for liver fibrosis in CHB patients. The demographic, clinical, and pathological data were retrospectively collected from 709 CHB patients who had ALT less than 2 times the upper limit of normal from April 2009 to October 2012. Logistical regression and area under receiver-operator curve (AUROC) were used to determine the diagnostic performances of simple tests for advanced fibrosis (Scheuer stage, F ≥ 3). Results showed that the most common TCM syndrome element observed in this CHB population was dampness and Qi stagnation, followed by blood stasis, by heat, and less by Qi deficiency and Yin deficiency. The logistical regression analysis identified AST ≥ 35 IU/L, PLT ≤ 161 × 109/L, and TCM syndrome element of blood stasis as the independent risk factors for advanced fibrosis. Therefore, a score model containing these three factors was established and tested. The score model containing blood stasis resulted in a higher AUC (AUC = 0.936) compared with APRI (AUC = 0.731) and FIB-4 (AUC = 0.709). The study suggested that the score model containing TCM syndrome element of blood stasis could be used as a useful diagnostic tool for advanced fibrosis in CHB patients and presented a better performance compared to APRI and FIB-4.