Analysis of Prescription Medication Rules of Chinese Herbal Medicine for Acute Exacerbation of Idiopathic Pulmonary Fibrosis Based on Data Mining

Summary

This study applied data-mining approaches to characterize Chinese herbal medicine prescribing patterns for acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). Based on 84 prescriptions from Professor Xu Zhiying’s clinical practice, high-frequency herbs, core combinations, and potential formulas were identified, providing structured insights for future clinical and experimental validation.

Abstract

Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a life-threatening complication with limited effective therapeutic options and high mortality. Although Chinese herbal medicine is increasingly used as an adjunctive approach, the prescribing patterns and potential therapeutic principles of experienced traditional Chinese medicine practitioners for AE-IPF remain insufficiently characterized. This study aimed to characterize the prescription patterns of Chinese herbal medicine used by Professor Xu Zhiying for acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) using data-mining techniques. Medical records of patients diagnosed with AE-IPF treated at Zhejiang Provincial Hospital of Traditional Chinese Medicine from September 2019 to December 2020 were retrospectively reviewed. A total of 84 prescriptions from 42 patients were collected and entered into the Traditional Chinese Medicine Inheritance and Computing Platform. Prescription characteristics were analyzed using frequency analysis, association rule mining, and entropy hierarchical clustering. Among 112 identified herbal medicines, the cumulative frequency reached 3,004, and 22 herbs were used more than 50 times. The most frequently used herbs included Radix Scutellariae, Bulbus Fritillariae Thunbergii Miq., Pinellia ternata, Forsythia suspensa, Radix et Rhizoma Salviae Miltiorrhizae, and Magnolia officinalis. The dominant meridian distributions involved the lung, stomach, spleen, liver, and large intestine meridians. Association rule analysis identified 11 core herb combinations with support values ranging from 50 to 84, confidence values ranging from 0.82 to 1.00, and lift values greater than 1, indicating stable positive associations among herbal combinations. Entropy hierarchical clustering further generated four candidate formulas characterized by heat-clearing, phlegm-resolving, toxin-removing, and spleen-supporting effects. This study systematically characterized expert prescribing patterns for AE-IPF and provides hypotheses for subsequent clinical and experimental validation.

Introduction

Idiopathic pulmonary fibrosis (IPF) is the most common type of idiopathic interstitial pneumonia. This progressive, irreversible fibrotic lung disorder is driven by epithelial injury, fibroblast activation, and excessive extracellular matrix deposition, ultimately resulting in declining pulmonary function and respiratory failure¹. Despite advances in antifibrotic therapies, including pirfenidone and nintedanib, the clinical prognosis of IPF remains poor, particularly among patients experiencing acute exacerbation of IPF (AE-IPF), which represents a devastating clinical event with rapid deterioration and high mortality. Its clinical manifestatio....

Protocol

This study was approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (Approval No. 2020-KL-072-01). Due to the retrospective nature of the study and the use of existing medical records, informed consent was waived. Patient confidentiality was maintained throughout data extraction and analysis, and only de-identified information was used for research purposes.

Data source

Medical records of patients diagnosed with AE-IPF treated by Professor Xu at Zhejiang Provincial Hospital of Traditional Chinese Medicine from September 2019 to December 2020 wer....

Results

Herbal frequency analysis

A total of 112 kinds of herbs were identified from the same analytical dataset consisting of 84 TCM prescriptions derived from 42 AE-IPF patients. Frequency analysis was performed on this dataset to characterize the overall distribution and recurrence patterns of herbal use. Among the 112 identified herbal medicines, 22 herbs were used more than 50 times. The seven most frequently used herbs, including Radix Scutellariae, Bulbus Fritillariae Thunbergi.......

Discussion

IPF is a chronic, progressive fibrotic lung disease and a refractory condition of the respiratory system. It is primarily caused by abnormal lung tissue structure and deposition of extracellular matrix in the lungs¹⁹. Patients with IPF often present with typical features such as chronic inflammation, decreased pulmonary function, and pulmonary fibrosis²⁰. Through data-mining methods, this study characterized Dr. Xu's prescribing patterns and identified frequently used h.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Electronic medical record system	Zhejiang Provincial Hospital of Traditional Chinese Medicine	N/A	Hospital information system; Internal clinical database
IBM SPSS Modeler	IBM Corp., Armonk, NY, USA	Version 18.0	IBM SPSS Modeler 18.0
Microsoft Excel	Microsoft Corporation, USA	Microsoft Office 2019	Microsoft Office package
Traditional Chinese Medicine Inheritance and Computing Platform	China Academy of Chinese Medical Sciences	Version 3.5	Commercial software platform
Traditional Chinese Medicine Inheritance and Computing Platform	China Academy of Chinese Medical Sciences	Version 2.5	Commercial software platform