050816-CR098.docx American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 1 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE UNRAVELING THE WISDOM OF "JINGYUE QUANSHU PHLEGM DRINKS" IN TRADITIONAL CHINESE MEDICINE 1Dr. Wei Zhang, 2Prof. Li Mei, and 3Dr. Xin Chen 1North China University of Science and Technology 2Tangshan Hospital of Traditional Chinese Medicine 3Shandong University of Traditional Chinese Medicine Abstract: Phlegm, as described in traditional Chinese medicine, represents a pathological manifestation arising from disruptions in bodily fluid metabolism, characterized by its sticky, viscous nature and tendency to obstruct the normal flow of bodily functions. Its presence can lead to various health issues, including disturbances in cognition, impaired blood flow, and even the development of tumors. This article delves into the historical and theoretical aspects of phlegm-related conditions, shedding light on their multifaceted nature. Keywords: Traditional Chinese Medicine, Phlegm, Bodily Fluid Metabolism,,Pathological Manifestation, Health Implications 1. Introduction The "phlegm" described by traditional Chinese medicine is the pathological product of body fluid metabolism disorders and qi and blood stasis. It is characterized by poor flow, stickiness, foul secretion, Accumulation of condensation, Pathogenic weirdness. And it also has the characteristics of disturbing the mind, Blocking the flow of blood, blocking the brain, leading to tumor formation by the Accumulation [1]. There were first records of "water drinking" and "Ji drinking" in the Neijing. Zhang Zhongjing of the Eastern Han Dynasty in his Synopsis of the Golden Chamber pioneered the name of phlegm drinking disease, but it has its limitations detailed in drinking and slightly in phlegm. In the theory of various diseases described the etiology, pathogenesis and types of sputum in detail. renzhai zhi zhi fang pointed out that "phlegm and drinking, by self, its shape is also different, the nature of phlegm is viscous, drinking is water" [2]. Zhang Jingyue's discussion on phlegm retention is detailed and thorough. He advocated that phlegm retention and body fluid are of the same origin, both of which are changed by cereal essence. If it is positive, it will be collected in the blood gas, strong body, and supplement the battalion and Ying-wei. If it is not positive, it will cause the disease of zangfu, and the imbalance of body fluid will lead to phlegm and salivation [3]. Zhang believed that although phlegm and drink belong to the same species, their essence is also different. Drinkingis a kind of waterdampness, its texture is clear and thin, mostly due to the feeling of cold dampness, lost in transport by the spleen and stomach, or stay in the limbs, chest and skin. Phlegm is mainly composed of condensed body fluid, its quality is thick and sticky, and it is often caused by feelin of the fire and mailto:topacademicjournals@gmail.com American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 2 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE heat. It can be produced even if the five viscera are damaged, and it can be found everywhere with the rise and fall of human qi [4]. The disease of phlegm retention can occur repeatedly, and even spread to the whole body, showing symptoms such as wheezing, chest tightness, vomiting, limb numbness, head dizziness, and so on. It is inseparable from the five zangfu, nine orifices and three jiao of human body. According to modern medicine, phlegm turbidity is closely related to obesity, hyperlipidemia, abnormal carbohydrate metabolism, and abnormal hemorheology, and accumulation drink is close to airway mucus hypersecretion, pleural effusion, and pericardial effusion in respiratory diseases [5]. 2. Data and methods 2.1. Data Collection and Specifications Collect the prescriptions involved in JingYueQuanShu · phlegm retention, and the name of the drug in the prescription shall uniformly refer to the Chinese Pharmacopoeia. For example, "wheat gate winter" is unified as "wheat winter", "white Poria" cocos" is "Poria", "raw licorice" is unified as "licorice" and so on. 2.2. Data processing and verification Using Office Excel 2019, the database of 111 prescriptions was established according to the software requirements. And upload the data to the "TCM inheritance computing platform V3. 0". Inorder to avoid possible errors in the single entry, after all the entry, two people will check theinput data to ensure the correct data. 3. Results and analysis 3.1. Frequency of medication Statistics on the frequency of 111 prescriptions in JingYueQuanShu · phlegm retention. The drugs with frequency ≥8 were imported into the Excel table and the following conclusions were drawn, Drugs with frequency ≥8 had 20 flavors, as shown in Table 1. Table 1: Analysis of medication frequency in JingYueQuanShu · phlegm retention (frequency ≥8) order number medicinal frequency order number medicinal frequency 1 Pinellia ternata 50 11 Radices saussureae 11 2 Poria cocos 47 12 Rhizoma alismatis 11 3 Pericarpium citri reticulatae 39 13 Bile arisaema 10 4 Bighead atractylodes rhizome 34 14 Angelica sinensis 10 5 Liquorice 30 15 Rhizoma zingiberis 10 6 Ginseng 27 16 Rhizoma arisaematis 10 7 Ginger 27 17 Fructus aurantii immaturus 9 mailto:topacademicjournals@gmail.com American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 3 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE 8 Prepared licorice 22 18 Syzygium aromaticum 9 9 Radix rehmanniae praeparata 19 19 Fructus ziziphi jujubae 8 10 Scutellaria baicalensis 11 20 Cinnabar 8 3.2. Four Gas, five flavors and channel tropism By analyzing the summary of each flavor of medicine, we can derive the distribution of all the four gas, five flavors and channel tropism, export the results to Excel, and draw a radar chart. The results showed that warm Chinese drugs were applied the most (367 times), followed by flat (146 times) and cold (125 times), see Figure 1; pungent Chinese drugs were applied the most (358 times), followed by sweet (312 times) and bitter (311 times), see Figure 2;1hinese drugs attributed to the spleen meridian were applied the most (501 times), followed by the lung meridian (452 times) and the stomach meridian (309 times), see Figure 3. Figure 1: Four Gas Statistical Radar Chart Figure 2: Five Flavors Statistical Radar Chart Figure 3: Channel tropism Statistical radar Chart diagram mailto:topacademicjournals@gmail.com American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 4 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE 3.3. Efficacy statistics The efficacy frequency of the drugs used in the 111 prescriptions was counted, and the results were exported to Excel to draw the bar chart, as shown in Figure 4.. The analysis results show that:The deficiency supplementing formula were used most frequently, followed by phlegm-expelling formula (107 times) and carminative formula(85 times). Figure 4: Efficacy statistics 3.4. Analysis of square rules based on association rules The "number of support" was set to 11, and the confidence level was set to 0. 8. 29 groups of drug combinations with frequency ≥ 11 were obtained, and the results are shown in Table 2, and the core drug combinations were networked and displayed in Figure 5. 7 association rules with confidence level ≥ 80% were obtained, and the results are shown in Table 3. Table 2: Analysis of core combinations of medicines used in Jing Yue Quan Shu - Phlegm Drink (support ≥11) No. Drug combinations Frequency No. Drug combinations Frequency 1 Pinellia ternata, pericarpium citri reticulatae 26 16 pericarpium citri reticulatae, Radix Glycyrrhizae Preparata 13 2 Poria cocos, pericarpium citri reticulatae 26 17 Poria cocos, pericarpium citri reticulatae, liquorice 13 3 Pinellia ternata, Poria cocos 26 18 Rhizoma Atractylodis Macrocephalae, liquorice 13 4 Poria cocos, Rhizoma Atractylodis Macrocephalae 24 19 Rhizoma Atractylodis Macrocephalae, Dried Ginger 12 mailto:topacademicjournals@gmail.com American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 5 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE 5 Poria cocos, liquorice 20 20 Poria cocos, pericarpium citri reticulatae, Rhizoma Atractylodis Macrocephalae 12 6 Pinellia ternata, ginger 19 21 pericarpium citri reticulatae, Radix Glycyrrhizae Preparata 12 7 Pinellia ternata, Poria cocos, pericarpium citri reticulatae 19 22 Poria cocos, pericarpium citri reticulatae, ginseng 12 8 Poria cocos, ginseng 18 23 Pinellia ternata, Poria cocos, liquorice 12 9 Rhizoma Atractylodis Macrocephalae, ginseng 18 24 Poria cocos, Radix Glycyrrhizae Preparata 12 10 pericarpium citri reticulatae, liquorice 16 25 Pinellia ternata, Dried Ginger 11 11 Pinellia ternata, liquorice 15 26 Poria cocos, Rhizoma Atractylodis Macrocephalae, liquorice 11 12 Poria cocos, Rhizoma Atractylodis Macrocephalae, ginseng 15 27 Pinellia ternata, ginseng 11 13 pericarpium citri reticulatae, Rhizoma Atractylodis Macrocephalae 15 28 liquorice, ginseng 11 14 pericarpium citri reticulatae, ginseng 14 29 pericarpium citri reticulatae, ginger 11 15 Poria cocos, ginger 13 mailto:topacademicjournals@gmail.com American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 6 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE Figure 5: Network diagram of medication combination core associations (support 11, confidence 0. 8) Table 3: Analysis of medication association rules (80% confidence) No. Rules confidence level 1 pericarpium citri reticulatae, ginseng->Poria cocos 0. 86 2 Rhizoma Atractylodis Macrocephalae, liquorice->Poria cocos 0. 85 3 Rhizoma Atractylodis Macrocephalae, ginseng->Poria cocos 0. 83 4 Poria cocos, ginseng->Rhizoma Atractylodis Macrocephalae 0. 83 5 pericarpium citri reticulatae, liquorice->Poria cocos 0. 81 6 pericarpium citri reticulatae, Rhizoma Atractylodis Macrocephalae- >Poria cocos 0. 8 7 Pinellia ternata, liquorice->Poria cocos 0. 8 3.5. Analysis of new prescriptions based on K-means clustering The "number of clusters (K)" was set to 4, and the extracted combinations yielded 4 possible potential core drug combinations. The results are shown in Table 4. The schematic diagram of K-means algorithm and regression model is shown in Figure 6. Table 4: New combinations of medicine clustering analysis in Jing Yue Quan Shu - Phlegm Drink No. New combination 1 Pinellia ternata, Poria cocos, Rhizoma Atractylodis Macrocephalae, pericarpium citri reticulatae, liquorice, ginseng 2 ginger, Pinellia ternata, rhizoma arisaematis, Poria cocos, pericarpium citri reticulatae, Radix Glycyrrhizae Preparata 3 ginseng, Radix Glycyrrhizae Preparata, Poria cocos, Angelica sinensis, Rhizoma Atractylodis Macrocephalae 4 arisaema cum bile, rheum officinale, kanziol, semen armeniacae amarae, semen brassicae, bezoar mailto:topacademicjournals@gmail.com American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 7 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE Figure 6: Cluster analysis regression model Fig 4. Discussion To sum up the results of this study, the main ideas of Jing Yue's treatment of phlegm drink are: reinforcing premodial qi, simultaneous application of cooling and tonifying therapy, Yin and Yang mutual aid, Disease presentation and root cause are not treated simultaneously, warmly invigorating spleen and stomach. Jing Yue's treatment of phlegm focuses on nourishing vitality, if it is strong, the phlegm will be less, if the vitality is declined the cereal essence and body fluid can become phlegm [6]. It is important to distinguish the essence of vitality, Strong vitality, the spleen and stomach can be transported properly, Making the water and grain essence micromatter into qi, blood and body fluidtransfusion in the whole body. As is known to all, the lung plays an important role in the transportation of phlegm and drinking. Combined with the combination of high- frequency medication, we can understand the idea of Jingyue. Those who damage the lung should be given qitonic drugs, and the lung qi is full, and the remaining dirty gas is flourishing. And modern studies show that ginseng has the effect of improving memory, anti-aging and regulating immunity [7]. In addition, the wide use of licorice, hot licorice, its taste to sweet, cool and warm. Pharmacological studies show that licorice has anti-tumor, anti- inflammatory sterilization, anti-virus, anti-heart failure, immune regulation and anti-fibrosis [8]. Pay attention to the use of cleaning and supplementing, has been certified by many scholars [9-10], The phlegm drinking described in Zhongjing is actually a drinking certificate, He put forward "sick phlegm drink, should mailto:topacademicjournals@gmail.com American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 8 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE warm medicine and it" for the later treatment of phlegm drink. Pinellia pinellia and tangerine peel compatibility can warm phlegm drinking, clinical commonly used to treat cough phlegm, qi nausea and other evidence, Pinellia pinellia [11] has significant antitumor effects, while tangerine peel [12] has good effects on lowering blood lipid and reducing phlegm. Combined with heat-clearing drugs, such as Scutellaria baicalensis in high-frequency drugs, its taste is bitter and cold, qi is light than taste, bitter than cold, which belongs to the micro Yang in Yin. Many studies [13] have shown that baicalein, Han baicalein and its glycosides have pharmacological activities such as anti-tumor, anti-virus, anti-inflammatory, antioxidant, liver protection and neuroprotection. Pay attention to the harmony of Yin and Yang. The treatment of Yang deficiency, The medicine of tonifying kidney and nourishing essence is equipped with nourishing qi and warming Yang medicine to achieve the effect of harmonizing Yin and Yang. Pharmacological studies [14] show that the active ingredients of Prepared rehmannia have the function of anti-aging and enhancing body immunity. This not only reflected Jing Yue's thought of cultivating and reinforcing Yinessence, but also reflected his wonderful principle of the mutualism of Yin and Yang. Just as JingYue said, "The use of nourishing Yin is the cultivation of Yang. The best way to help Yang isto cultivate Yin and Yang" [15]. The treatment of phlegm should investigate the deficiency and treat both the symptoms and the root cause [16]. Solid phlegm disease light shallow, to go quickly, insufficient for fear, and empty phlegm always by the deficiency of the viscera, gradually become, the disease is difficult totreat, remove also slow. Through the analysis of core drug combination and association rules, Jingyue makes good use of four gentleman soup for virtual phlegm, Studies [17] have shown that sijunzi decoction has pharmacological effects on promoting the absorption of intestinal nutrientsand improving body immunity. And the man is young and strong, Or because of the wine and meat thick taste, or because of the physical gas hot and heat, or because of wind resistance closed muscle Cou, or because of the liver gas on the reverse obstruction, causing phlegm drink, itsvitality is full, appropriate elimination, can be attacked. Witness its thought [18] "without deficiency evidence and phlegm, dispel its damp stagnation phlegm since clear, appropriate two Chen soup Lord". Modern studies [19] believe that, phlegm and dampness is the pathological factor of metabolic diseases, and erchen soup can intervene in the process of metabolic diseases through dryness, dampness and phlegm. All five viscera can produce phlegm, but the source of phlegm is nothing more than spleen and kidney, High- frequency traditional Chinese medicine, poria cocos, sweet and light taste, flat qi. Sex drop and infiltration, Yang in the Yin also. atractylodes, sweet taste, temperature, Yin in Yang, blood in gas. Its nature is warm and dry, so it can replenish qi and replenish Yang and blood, warm stomach and valley, benefit jin fluid, long muscles, solid spleen and stomach, dehumidification and transport phlegm. Atractylodes macrocephala, sweet and pungent in taste, iswarm, with yin in yang and blood in qi. It is warm and dry in nature, so it can benefit the qi and nourish the yang and generate blood, warm the stomach and eliminate grain, benefit the fluids, grow muscles, strengthen the spleen and stomach, remove dampness and transport phlegm, eliminate floating and dispel swelling. Pharmacological research points out that [20] Poria cocos can strengthen the spleen by intervening intestinal flora, mailto:topacademicjournals@gmail.com American Journal of Medical and Physical Education Vol.8, Issue 4; July-August 2023; ISSN: 2994-0524 Impact Factor: 6.14 1252 Columbia Rd NW, Washington DC, United States https://topjournals.org/index.php/AJMPE; mail: topacademicjournals@gmail.com 9 | A m e r i c a n J o u r n a l o f M e d i c a l a n d P h y s i c a l E d u c a t i o n | https://topjournals.org/index.php/AJMPE while Rhizoma Atractylodis Macrocephalae [21] has the function of protecting liver, regulating immunity and spleen and stomach. Therefore, the first phlegm warm spleen strong kidney, phlegm is not treated and go. Four new prescriptions were obtained based on K-means clustering analysis: (1) Pinellia ternata-Poria cocos- Rhizoma Atractylodis Macrocephalae-pericarpium citri reticulatae- liquorice- ginseng, (2) ginger-Pinellia ternata- rhizoma arisaematis-Poria cocos-pericarpium citri reticulatae- liquorice, (3) ginseng-liquorice-Poria cocos- Angelica sinensis-Fructus Ziziphi Jujubae-Rhizoma Atractylodis Macrocephalae, (4) arisaema cum bile-rheum officinale-kanziol-semen armeniacae amarae-semen brassicae-bezoar. In this paper, the author shows the medication rule of Zhang Jingyue to treat phlegm retentionThe author's research on the treatment of sputum drinking disease is still unsatisfactory. First of all, the cognitive aspect is relatively narrow, mostly theoretical expression, and the lack of in-depth analysis and summary in the specific application, Secondly, Zhang Jingyue's overall academic thought is inseparable. This research is devoted to the book of Jingyue Quanshu, which ignores the mining and analysis of the relevant contents of Zhang's other works, and more attention should be paid to the internal relevance of his academic thoughts. References Lin Qijia. Theoretical study on the method of dispelling phlegm and opening the orifices and its application [D]. China Academy of Traditional Chinese Medicine, 2018. Li XC, Zhang J. Examination on the origin and clinical application of phlegm drinking [J]. Shanghai Journal of Traditional Chinese Medicine, 2018, 52(01): 40-42. Yang Hui, Sun Shixiao. An introduction to the understanding of "phlegm" in Chinese medicine [J]. Heilongjiang Traditional Chinese Medicine, 2014, 43(03): 11-12. Ma JY. Study on the academic thought of Zhang Jinyue on the treatment of phlegm [D]. Gansu College of Traditional Chinese Medicine, 2014. Ji Xiuli. 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