基于数据挖掘探析吕国雄治疗失眠的用药规律

An analysis of LV Guoxiong’s medication law for insomnia based on data mining

目的:应用数据挖掘方法分析吕国雄主任医师治疗失眠的用药经验及规律。方法:收集2020年1月―2022年1月江西中医药大学附属医院吕国雄主任医师门诊治疗失眠的有效病例及处方,使用Excel 2016、SPSS Modeler 18.0、SPSS Statistics26.0、Cytoscape等软件建立数据库,进行用药频次分析、性味归经分析、高频药物关联规则分析、系统聚类分析和高频药物关联规则可视化处理。结果:纳入本研究的处方有244张,涉及药物96味。其中频数>40的中药为茯苓、白术、首乌藤、生甘草、珍珠母等28种,高频药物以宁心安神,健脾利湿,清热化痰为主。药物的四气以寒、温为主,五味以甘、苦为主,归经多属心、脾、肝经。通过对244张处方复杂网络和关联规则的组方规律分析,得出最常用的中药组合为茯苓-白术,珍珠母-首乌藤,陈皮-半夏。通过对高频药物聚类分析,得出3个聚类组,主要功效为清热化痰,宁心安神,疏肝理气,清肝泻火,敛阴止汗。结论:吕国雄主任医师认为失眠的病位在心,与肝脾紧密相关,与“痰”“火”等病理因素密切相关,以清热化痰,清肝泻火,宁心安神为基本治则,同时兼顾滋阴、理气等细则,体现了其“以肝为用”“痰湿为本”的学术思想,为日后失眠的诊治提供了新思路。

Objective:To analyze the medication experience and rule of Chief Physician LV Guoxiong in treating insomnia by data mining method.Methods:Effective cases and prescriptions of insomnia treated by Chief Physician LV Guoxiong in Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2020 to January 2022 were collected.Excel 2016,SPSS Modeler 18.0,SPSS Statistics 26.0,Cytoscape and other software wes used to establish the database for drug frequency analysis,property,flavor and meridian returning analysis,high frequency drug association rule analysis,systematic cluster analysis and visualization processing of high frequency drug association rule.Results:There were 244 prescriptions included in this study,involving 96 drugs.Among them,28 kinds of TCM medicine with frequency>40 were Fuling(Poria coia),Baizhu(Atractylote),Shouwuteng(Radix unguicularia),Shenggancao(Radix glycyrrhizae),Zhenzhumu(Mother of pearl),etc.,and the high-frequency drugs were mainly to calm the heart and the mind,strengthen the spleen and dehumidification,clear heat and reduce phlegm.The four properties of medicine were mainly cold and warm,the five tastes were mainly sweet and bitter,and the meridian returning mainly belonged to the heart,spleen and liver meridians.Based on the analysis of the complex network and association rules of 244 prescriptions,the most commonly used TCM medicine combinations were Fuling-Baizhu,Zhenzhumu-Shouwuteng,Chenpi-Banxia(Tangerine peel-Pinellia pinellia).Through the clustering analysis of high-frequency drugs,three cluster groups were obtained,the main effects were clearing heat and phlegm,calming the heart and the mind,soothing the liver and regulating Qi(气),clearing the liver and reducing fire,collecting Yin(阴)and antiperspirant.Conclusion:Chief Physician LV Guoxiong believes that the disease of insomnia is in the heart,and it is closely related to the liver and spleen,and“phlegm”and“fire”and other pathological factors are closely related,therefore,the basic treatment is to clear heat and phlegm,clear liver and fire,calm the heart and the mind,while taking into account the rules of nourishing Yin and regulating Qi,reflecting the academic thought of making full use of the liver and taking phlegm-dampness as the basis,which can provide new ideas for the future diagnosis and treatment of insomnia.