基于数据挖掘探讨慢性心力衰竭伴焦虑、抑郁的中药用药规律

Medication Rules of Traditional Chinese Medicine in Chronic Heart Failure with Anxiety and Depression Based on Data Mining Technology

目的运用数据挖掘的方法对目前临床治疗慢性心力衰竭伴焦虑、抑郁的中医处方用药进行分析,以期发现用药规律,为临床提供参考。方法通过检索中国知网(CNKI)数据库、万方数据库(Wanfang Data)、维普(VIP)数据库、中国生物医学文献服务系统(SinoMed)等,依据纳入与排除标准筛选文献并提取信息,运用Excel建立中药用药数据库,并运用IBM SPSS Modeler软件中Apriori算法进行关联规则和SPSS统计软件中系统聚类对用药规律进行分析。结果最终纳入文献61篇,涉及处方61首、中药110味,其中用药频数居前10位的是柴胡、茯苓、甘草、白芍、白术、川芎、丹参、当归、黄芪和桂枝;性味归经分析显示药物主要归心、肝、脾、肺经,其次为肾经和胃经,且所有药物药性以温、平、寒为主,药味以甘、辛、苦为主;关联规则共得到17组药对,常用药对为柴胡-白芍、柴胡-川芎-甘草等;聚类分析共得到4个聚类,第1类为甘草、白芍、柴胡、白术、茯苓;第2类为黄芪、丹参、人参、附子、桂枝;第3类为郁金、合欢皮、酸枣仁;第4类为香附、川芎、枳壳、陈皮、当归、桃仁、红花。结论治疗慢性心力衰竭伴焦虑、抑郁的中药主要入心、肝经,涉及脾、肺、肾等脏,核心治法是疏肝健脾、补气温阳、解郁安神、行气活血,筛选出治疗该病的核心药物是柴胡、茯苓、川芎、甘草、白芍等。

Objective Data mining method was used to analyze the medication rule for the current clinical treatment of chronic heart failure with anxiety and depression by traditional Chinese medicine(TCM)prescription.Methods By searching China national knowledge infrastructure(CNKI)database,Wanfang data,VIP,China biomedical literature service system(SinoMed),literatures and information were collected according to inclusion and exclusion criteria,to establish TCM drug database.The Apriori algorithm in IBM SPSS Modeler software was used to carry out association rules and SPSS statistical software was used to analyze the rules of drug use.Results Finally,61 literatures,61 prescriptions,110 Chinese medicines were included.The top ten drug use frequency were bupleuri radix,poria,glycyrrhizae radix,paeoniae radix alba,atractylodis ovatae rhizoma,ligustici rhizoma,salviae miltiorrhizae radix,angelicae sinensis radix,astragali radix and cinnamomi ramulus.The analysis of flavor and meridian tropism showed that the drug mainly belonged to the heart,liver,spleen and lung meridian,followed by kidney and stomach meridian.All drugs were mainly warm,neytral,and cold,and the medicinal flavor was mostly sweet,pungent,and bitter.A total of 17 groups of drugs pairs were obtained by association rules,and the common drug pairs were bupleuri radix-paeoniae radix alba,bupleuri radix-ligustici rhizoma-glycyrrhizae radix,etc.Four clusters were obtained from cluster analysis.The first type included glycyrrhizae radix,paeoniae radix alba,bupleuri radix,atractylodis macrocephalae rhizoma and poria.The second type was astragali radix,salviae miltiorrhizae radix,ginseng radix,aconiti tuber laterale and cinnamomi ramulus.The third group was curcumae tuber,albizziae cortex and ziziphi spinosi semen.The fourth type was cyperi rhizoma,ligustici rhizoma,aurantii fructus,citri exocarpium,sinensis radix,persicae semen,and carthami flos.Conclusion In the treatment of chronic heart failure with anxiety and depression,TCM mainly enters the heart,and liver meridians,involving the spleen,lung,kidney and other viscera.The core treatment methods are to soothe the liver and strengthen the spleen,invigorating Qi and warming Yang,solving stagnation for tranquilization,promoting flow of Qi and blood circulation.The core drugs are bupleuri radix,poria,glycyrrhizae radix,ligustici rhizoma,and paeoniae radix alba,etc.The study provides an important basis for the selection of TCM for the treatment of heart failure with anxiety and depression.