基于中医传承辅助平台探讨侯炜教授辨治脑胶质瘤用药规律

Research on Professor Hou Wei’s Medication Pattern for the Treatment of Glioma Based on the Traditional Chinese Medicine Inheritance Support System

目的基于中医传承辅助平台(V2.5)总结侯炜教授治疗脑胶质瘤遣方用药的规律,传承侯炜教授诊治脑胶质瘤的经验。方法提取侯炜教授治疗脑胶质瘤患者的门诊电子病历数据,采用关联规则、复杂系统熵聚类分析等方法进行数据挖掘和可视化分析,总结药物的性味、归经、应用频次、药对组合,结合深度访谈剖析侯炜教授对脑胶质瘤病因病机、治则治法的认识,明确核心用药,探索辨治规律。结果共纳入病历249份,处方中用药频次较多的有白花蛇舌草、天麻、钩藤、川芎、丹参,用药性味偏平、甘,归经多为肝、脾经,挖掘强关联的药物组合20条,新处方4首。结论侯炜教授治疗脑胶质瘤以"培本固元,祛除伏邪"为治疗原则,在天麻钩藤饮的基础上加减化裁,以平肝熄风、补益肝肾、健补脾气为主要治法,兼以化痰、祛瘀、抗癌解毒。

Objective To summarize Professor Hou Wei′s rules for the treatment of glioma and to present Professor Hou Wei′s experience in the treatment of glioma based on the Traditional Chinese Medicine Inheritance Support Platform(V2.5).Methods We extracted outpatient electronic medical records of patients with glioma treated by Professor Hou Wei and conducted data mining and visualization analysis by using association rules and complex system entropy cluster analysis to sum up the flavor,channel tropism,frequency of application,and combination of medicinals,combined with in-depth interviews to analyze Professor Hou Wei′s understanding of the etiology and pathogenesis of glioma and treatment rules and methods,to clarify the core drugs and explore the rules of treatment.Results A total of 249 medical records were included,and the prescriptions with a high frequency of medication included Herba Hedyotis,Rhizoma Gastrodiae,Ramulus Uncariae Cum Uncis,Rhizoma Ligustici Chuanxiong,and Radix Salviae Miltiorrhizae,with a flat,sweet taste,and a generalized meridian mostly for the liver and spleen meridians.In addition,20 medicinal combinations with strong associations and 4 new prescriptions were tapped.Conclusion Professor Hou Wei′s treatment of glioma is based on the principle of"cultivating the root,consolidating the vital energy and eliminating the evil",modified on the basis of Tianma Gouteng Decoction,with the main treatment method of calming the liver to stop the wind,tonifying the liver and kidney,and strengthening the spleen qi,as well as resolving phlegm,eliminating blood stasis and anti-cancer and detoxification.