基于数据挖掘探讨中药治疗子宫内膜异位症临床用药规律

Exploration of the Clinical Medication Rules of Traditional Chinese Medicinal in Treating Endometriosis Based on Data Mining

目的运用数据挖掘的方法分析中药治疗子宫内膜异位症的用药规律。方法以中国知网、万方、维普等中文数据库为检索源,收集并整理近10年中药治疗子宫内膜异位症的中文核心文献。将符合纳入标准的文献录入Excel软件,建立原始中药处方数据库,并借助SPSS Statistic 26.0和SPSS Modeler 18对数据进行频数计算和分析,并对其中29味高频中药进行聚类分析和关联规则分析。结果(1)共收集到中文核心文献37篇,涉及中药93味,使用总频次为425次,使用频次最高的前5位中药分别是赤芍、延胡索、当归、莪术、肉桂,主要药类以活血化瘀药为主,其次为补虚药、清热药,中药药性偏温,味多辛、苦、甘,归肝、脾、肾经。(2)聚类分析得出8个有效中药聚类群。(3)关联规则分析:(1)关联规则网络图中强关联药对是三棱-莪术、赤芍-牡丹皮、赤芍-当归等。(2)关联规则中较高支持度和置信度的药对有小茴香-肉桂、红花-桃仁、牡丹皮-赤芍、三棱-莪术。结论基于数据挖掘分析中药治疗子宫内膜异位症的临床用药特点是:(1)以通为用:多运用活血化瘀药类,在辨证论治的原则上以活血祛瘀、散结消癥为主。(2)寓通于补:遵循"衰其大半而止"的原则,使用补气养血的药物,注重固护人体正气的同时,也充分体现了祛瘀生新之意。(3)消补兼施:在治疗子宫内膜异位症的处方中常常将甘味补益的药物与辛味苦味的理气活血、清热凉血的药物相结合,体现了驱邪而不伤正、补益而不恋邪的治疗思路。(4)得温则行:多用温性和平性的药物,酌用微寒,慎用大寒大热。(5)重视肝脾肾:内异症表现的继发性痛经、不孕、月经异常等都可以能通过调理肝、脾、肾功能来治疗。(6)常用药对:小茴香-肉桂、红花-桃仁、牡丹皮-赤芍、三棱-莪术、赤芍-当归。

Objective To analyze the regularity of Chinese medicinal treatment for endometriosis using data mining.Methods CNKI,WanFang,Weipu and other Chinese databases were used as search sources to collect Chinese core essays on the treatment of endometriosis with traditional Chinese medicinal in the past 10 years.Essays that meet the inclusion criteria were entered into Excel software to establish the originalChinese medicinal prescription database,and the frequency calculation and analysis of the data were performed with SPSS Statistic 26.0 and SPSS Modeler 18,and cluster analysis and association rule analysis of 29 high-frequency Chinese medicinals were also performed.Results(1)A total of 37 Chinese core essays were collected,involving 93 Chinese medicinals.The total frequency of using was 425 times.The top 5 Chinese medicinals with the most frequent used were Chishao(Paeoniae Radix Rubra),Yanhusuo(Corydalis Rhizoma),Danggu(iAngelicae Sinensis Radix),Ezhu(Curcumae Rhizoma),Rougu(iCinnamomi Cortex).The main medicinal were stasis-resolving hemostatic medicinal,tonifying and boosting medicinal,heat-clearing medicinal.The nature of traditional Chinese medicinal incline to warmth,the 5 flavors were pungency,bitterness,sweetness and the meridian entry belongs to the liver meridian,the spleen meridian and the kidney meridian.(2)Cluster analysis got 8 effective Chinese medicinal clusters.(3)Analysis of association rules:(1)The strong association medicinal pairs in the association rule network diagram were Sanleng(Sparganii Rhizoma)-Ezhu(Curcumae Rhizoma),Chishao(Paeoniae Radix Rubra)-Mudanpi(Moutan Cortex),Chishao(Paeoniae Radix Rubra)-Danggui(Angelicae Sinensis Radix)etc.(2)The medicinal pairs of the higher support and confidence in the association rules were Xiaohuixiang(Foeniculi Fructus)-Rougui(Cinnamomi Cortex),Honghua(Carthami Flos)-Taoren(Persicae Semen),Mudanpi(Moutan Cortex)-Chishao(Paeoniae Radix Rubra),Sanleng(Sparganii Rhizoma)-Ezhu(Curcumae Rhizoma).Conclusion Based on data mining analysis,the clinical characteristics of traditional Chinese medicinal in the treatment of endometriosis were as follows:(1)It was useful to keep the body’s Qi and blood flowing:the medicinals for promoting blood circulation and removing blood stasis were often used,and activating blood circulation and removing blood stasis,dispelling stasis and eliminating symptoms were the mainstays based on the principle of syndrome differentiation and treatment.(2)Put the purpose of supplementing in the attack method:following the principle of“mostly decay and stop”,the use of Qi and blood nourishing medicinals focused on maintaining the body’s righteous Qi,while also fully embodying the meaning of removing blood stasis and creating new life.(3)Both elimination and supplementation were important:in the prescription for the treatment of endometriosis,the sweet and tonic medicinals were often combined with the pungent and bitter medicinals for regulating Qi and promoting blood circulation,clearing heat and cooling blood,which reflected the treatment idea of exorcising evil without hurting righteousness,and replenishing without liking evil.(4)When the blood was warm,the blood could function normally:use more mild and peaceful medicinals,less use of mild cold,and be cautious with severe cold and severe heat.(5)Pay attention to liver,spleen and kidney:secondary dysmenorrhea,infertility,and menstrual abnormalities in endometriosis could be treated by regulating liver,spleen,and kidney functions.(6)Commonly used medicinals pairs:Xiaohuixiang(Foeniculi Fructus)-Rougui(Cinnamomi Cortex),Honghua(Carthami Flos)-Taoren(Persicae Semen),Mudanpi(Moutan Cortex)-Chishao(Paeoniae Radix Rubra),Sanleng(Sparganii Rhizoma)-Ezhu(Curcumae Rhizoma),Chishao(Paeoniae Radix Rubra)-Danggui(Angelicae Sinensis Radix).