基于数据挖掘的施杞教授治疗腰椎间盘突出症用药经验分析

Analysis on Prescription of Professor Shi Qi in Treating Lumbar Intervertebral Disc Herniation Based on Data Mining

目的:总结分析施杞教授治疗腰椎间盘突出症的用药规律。方法:收集施杞教授治疗腰椎间盘突出症典型医案378份,对所选医案中符合纳入标准的中药运用Excel表进行录入,然后用SPSS 16.0 forWindows统计软件进行频数分析、聚类分析,WeKa 3.6.2怀卡托智能分析软件进行关联规则分析,寻找施杞教授治疗腰椎间盘突出症的用药规律。结果:①共有272份医案纳入研究,共计就诊428次;共得药物173味,出现的总频次为9 623次,常用中药有白芍、柴胡、川芎、当归等27味。②益气活血药、补肾助阳药、祛风解表药、利水渗湿药、化痰通络药及健脾理气和胃药为施杞教授治疗腰椎间盘突出症的常用配伍药类。③圣愈汤、身痛逐瘀汤、独活寄生汤、苓桂术甘汤等为施老治疗腰椎间盘突出症的基本方药。④药物相须配伍,活血化瘀药加理气药、活血化瘀药加祛风湿药、活血化瘀药加解表药和祛风湿药、活血化瘀药加祛风湿和补肾药、解表药加祛风湿药和理气药是其组方配伍的主要规律。⑤施杞教授常用的药对有桃仁与红花、牛膝与羌活、青风藤与络石藤、全蝎与蜈蚣、仙茅与仙灵脾、桂枝与防风、板蓝根与玄参等。结论:施杞教授治疗腰椎间盘突出症体现益气化瘀补肾的学术思想,数据挖掘结果客观反映了施杞教授临床用药的规律。

Objective： To analyze the prescription of Professor Shi Qi in treating lumbar intervertebral disc herniation （LDH）. Methods ： Professor Shi Qi＇ s 378 typical cases for treating LDH were collected. In order to search for the prescription regularity of Shi Qi in treating LDH, the herbs adhering to the inclusion criteria in the selected cases were recorded by Excel table, the frequency and Cluster analysis were applied by SPSS 16.0 for Windows statistical software, and the association rules analysis was applied by Waikato Environment for Knowledge Analysis. Results： （1）A total of 272 medical cases were included in the study, and the visit time was 428; 173 herbs were included, the total appearance frequency was 9 623, and the common 27 herbs included Radix Paeoniae Alba, Radix Bupleuri, Rhizoma Chuanxiong and Radix Angelicae Sinensis, etc. （2）The herbs of supplementing qi and activating blood, waianing kidney-yang, clearing wind and relieving exterior syndrome, promoting urination and removing dampness, resolving stagnation and dredging collaterals, and strengthening spleen and stomach were comnmnly used. （3）＂ Shengyu Decoction＂, ＂Shemong Zhuyu Decoction＂, ＂ Duhuo Jisheng Decoction＂ and ＂ Linggui Zhugan Decoction＂, etc were the basic formulas for Pro. Shi treating LDH. （4）Activating blood and removing stasis herbs combined with regulating qi herbs, activating blood and removing stasis herbs combined with removing wind-dampness herbs, activating blood and removing stasis herbs combined with relieving exterior syndrome herbs and removing wind-dampness herbs, activating blood and removing stasis herbs combined with removing wind-dampness herbs and tonifying kidney herbs, and relieving exterior syndrome herbs combined with removing wind-dampness herbs and regulating qi herbs were the main compatibility regularity. （5）The common herb pairs included Semen Persicae and Flos Carthami, Radix Achyranthis bidentatae and Rhizama et Radix Notopterygii, Caulis Sinomenii and Caulis Trachelosperrni, Scorpio and Scolopendra, Rhizoma Curculiginis and Herba Epimedii, Ramulus Cinnamomi and Radix Saposhnik^wiae, Radix lsatidis and Radix Scrophulariae, etc. Conclusion ： Invigorating qi, resolving stasis and tonifying kidney are the main academic thoughts of Shi Qi in treating LDH, and the results of data mining reflect the prescription rules of Pro. Shi Qi.