基于临床医疗科研信息共享系统中医病-证-中药关联分析方法的研究

Study on Chinese Medicine "Disease-Syndrome-Herb" Association Analysis Method Based on Clinical Medical Research Information Sharing System

目的：基于临床医疗科研信息共享系统，以慢性阻塞性肺疾病急性加重（AECOPD）病-证-中药研究为示范，探索建立-套中医多病种病-证-中药研究方法，指导临床实践。方法：利用我院临床医疗科研信息共享系统构建数据库（数据来自2011年8月～2013年3月间5000份格式化电子病历），数据预处理，运用水晶报表及复杂网络进行数据挖掘，获取AECOPD病-证-中药的频度关系，分析AECOPD不同证型临床用药特点。结果：痰热壅肺、痰瘀阻肺、肺肾气虚3个证候对应的中药均有甘草、陈皮、地龙、紫苏子、黄芩、红花等，痰热壅肺证除有清热、化痰药还有活血药，肺肾气虚证除有益气补肺肾药外兼有活血化痰药。结论：利用临床共享系统可用于临床大数据的处理，挖掘的结果可用于指导临床实践，为中医临床科研提供很好的平台。

Based on the Clinical Medical Research Information Sharing System （CMRISS）, this article took the ＂disease-syndrome-herb＂ study on acute exacerbation of chronic obstructive pulmonary disease （AECOPD） as a model to explore the establishment of ＂disease-syndrome-herb＂ study method on many types of diseases for the guidance of Chinese medicine clinical practice. The CMRISS of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, which contained 5000 format electronic medical records from August 2011 to March 2013, was used as the database. Data preprocessing, crystal reports and complex network were used in data mining to receive the frequency relation of AECOPD ＂disease-syndrome-herb＂ in order to analyze medica- tion features of different Chinese medicine clinical syndromes of AECOPD. The results showed that three syn- dromes, which were phlegm-heat obstructing the lungs, phlegm-stasis obstructing the lungs, and qi-yin deficien- cy, have corresponding Chinese herbs of licorice, orange peel and earthworm. The treatment of syndrome of phlegm-heat obstructing the lungs contains herbs to clear heat, remove phlegm and activate blood circulation. The treatment of syndrome of qi-yin deficiency contains herbs to benefit qi, nourish yin as well as to activate blood circulation and remove phlegm. It was concluded that the application of CMRISS is able to process a large amount of clinical data. The data mining results can be used to guide clinical practice. It provided a better plat- form for the scientific research of Chinese medicine clinical practice.