胆囊癌与胆管癌中药组方规律关联规则与疗效分析

Analysis of the Prescriptions of Traditional Chinese Medicine for Gallbladder and Bile Duct Cancers

目的:分析中药治疗胆囊癌和胆管癌的组方规律,探讨中医药的疗效。方法:收集我院肿瘤中药处方数据库中2011年1月—2014年12月胆囊癌与胆管癌典型中药处方153首,29例病人,运用关联规则Apriori算法,取最小支持度为0.3,最小置信度为0.5开展研究,分析方剂配伍规律及药物之间的关联规则。选取同期接受支持治疗的88例患者作为对照,进行疗效评价。结果:在所使用的151种中药中,高频药物分别为黄芪、白花蛇舌草、白术;常用五类治法治则所代表药对分别为"党参-茯苓-白术"、"茯苓-远志-白术""熟地-白术-黄芪"、"白花蛇舌草-黄芪-白术"和"半枝莲、白花蛇舌草";处方与非处方组生活质量改善率分别为75.86%和40.43%,具有统计学差异(P=0.00),生存率分别为82.8%和67.0%,但未显示出统计学差异(P=1.02)。结论:治疗晚期胆囊癌与胆管癌的中药处方以补益为主,可以改善生活质量。

ObjectiveTo analyze the prescriptions of traditional Chinese medicine for gallbladder andbile-duct cancers.MethodsWe analyzed 153 prescriptions of traditional Chinese medicine that were used in29 cases of gallbladder and bile duct cancers from January 2011 to December 2014.Apriori algorithm was per-formed with 0.3 of minimum support and 0.5 of minimum confidence.Formula compatibility of prescriptions andassociation rules between drugs were analyzed.Patients receiving supportive care in the same period were recruit-ed in a control group.ResultsAstragalus,Hedyotis diffusa and Rhizoma Atractylodis were the most frequent-ly used drugs out of 151 traditional Chinese medicines involved.Five methods and principles of traditional Chi-nese medicine were used and were represented by the drugs of（1）Codonopsis,Poriaplus Rhizoma Atractylodis,（2）Poria,Polygala plus Rhizoma Atractylodis,（3）Rehmannia,Rhizoma Atractylodispius astragalus,（4）Hedyotisdiffusa,Astragalus plus Rhizoma Atractylodis and（5）Scutellaria Barbataplus Hedyotis diffusa.The rates of im-proved life quality were 75.86% and 40.43% in the study group and the control group,respectively,and the dif-ference was statistically significant（P = 0.00）.Survival rates were 82.8% and 67.0% in the study group and thecontrol group,and the difference was not significant（P = 1.02）.ConclusionThe principle of traditional Chi-nese medicine for patients with advanced cancers of gallbladder and bile duct is mainly for nourishing.In addi-tion,traditional Chinese medicine improves the life quality of the patients.