基于数据挖掘的田建辉治疗妇科癌用药规律研究

Investigation of Tian Jianhui’s TCM medication regularity for gynecological cancers based on data mining

目的采用数据挖掘方法研究田建辉主任治疗妇科癌的用药规律。方法收集整理田建辉主任治疗宫颈癌、卵巢癌、子宫内膜癌患者的病历资料,通过频次分析、关联规则、熵聚类分析法挖掘处方中相关的核心药物组合及隐匿于处方中的药物配伍规律。结果①本研究共纳入307例病例,其中宫颈癌患者157例,卵巢癌患者100例,子宫内膜癌患者50例;共纳入处方1 133首,涉及药物325种。②使用频次在350次以上的药物有19种,其归经以肝、脾及肾经为主(占所有药物的52.2%);药物功效分类中清热药占29.6%,补虚药占21.5%,利水渗湿药占9.7%,消食药占6.8%,活血化瘀药占5.0%。③基于关联规则分析,挖掘出由熟地黄、山茱萸、牡丹皮、山药、茯苓、泽泻、生黄芪、菟丝子、蜀羊泉、土茯苓、龙葵、莪术、黄柏、败酱草、鸡内金、稻芽、酸枣仁、大枣、炙甘草19味补益肝肾、解毒抗癌、顾护心脾药物组合而成的核心处方。④基于熵聚类分析,得出包含3~4味药物的核心组合40个;在此基础上进行无监督熵层次聚类分析,得出8个新处方。结论田建辉主任治疗妇科癌重在从肝肾论治,核心组方以补益肝肾、攻毒抗癌、顾护脾胃及养心安神为主。

Objective To explore Tian JianHui’s TCM medication rules in treating gynecological cancers with the method of data mining. Methods The medical records of patients with cervical cancer(CC), ovarian cancer(OVC) and endometrial cancer(EC) treated by Tian Jianhui were collected and sorted out. Through frequency analysis, association rules and entropy clustering analysis, the relevant core drug combinations in the prescription and the drug compatibility rules hidden in the prescription were discovered. Results ①In this study 307 cases were included, including 157 cases of CC, 100 cases of OVC and 50 cases of EC. A total of 1,133 prescriptions were included, involving 325 kinds of herbs. ②There were 19 kinds of herbs used more than 350 times, which mainly enter into the liver, spleen and kidney meridians(accounting for 52.2% of all drugs);In the classification of herb efficacy, heat-clearing herbs accounted for 29.6%, deficiency-tonifying herbs accounted for 21.5%, diuresis-promoting and dampness-permeating herbs accounted for 9.7%, digestion-promoting herbs accounted for 6.8%, and blood-activating and stasis-resolving herbs accounted for 5.0%. ③Based on association rule analysis, the core prescription composed of 19 herbs for tonifying liver and kidney, detoxifying, anticancer and harmonizing heart and spleen was found, including Shu Dihuang, Shanzhuyu, Mudanpi, Shanyao, Fulin, Zexie, Sheng Huangqi, Tusizi, Shuyangquan, Tufulin, Longkui, Ezhu, Huangbai, Baijiangcao, Jineijin, Daoya, Suanzaoren, Dazao, Zhi Gancao. ④Based on entropy clustering analysis, 40 core combinations containing 3 to 4 herbs were obtained. On this basis,unsupervised entropy hierarchical clustering analysis was carried out,and 8 new prescriptions were obtained. Conclusion Tian Jianhui’s treatment of gynecological cancers focuses on the treatment of liver and kidney,and the core prescriptions are mainly for tonifying liver and kidney,detoxifying and anti-cancer,harmonizing spleen and stomach,and nourishing heart and tranquilizing mind.