中药治疗肺结核的现代用药规律研究

Study on the modern medication roles in treatment of pulmonary tuberculosis with traditional Chinese medicine

目的了解过去二十年间文献发表的中药治疗肺结核病的组方规律。方法收集了从1997-2016年期间发表在中文期刊上且进入万方医学网收录的有关中药治疗结核病的论文报道,采用中医传承辅助平台V2,将文献报道的相关组方数据输入后,依据改进的互信息法和复杂系统熵聚类方法进行数据挖掘。结果在1998年以后报道的文献中共发现了172个药物组方,共包含257味中药,其中百部(47.7%)、白芨(34.9%)和麦冬(34.9%)使用频次最高,它们在超过1/3的现代中药方剂中有过使用。而组合出现频率超过了20次且置信度大于0.8的中药有13味,其中白芨和百部组合的使用频率最高,其次是麦冬和百部。抗肺结核组方规律的网络关系图中处于核心和复杂网络中心的是麦冬、百部和川贝母这三味中药。在核心组合提取的基础上,运用无监督熵层次聚类算法,得到8个新处方。结论与传统药典中记载的抗结核药物组方相区别,现代刊物发表抗肺结核药物组方在重点药物使用频次、药物间的组合及其关联程度、提取的常用药对和核心组合这些方面存在较大的不同,其深层次原因有待进一步探索。

Objective To investigate the composing principle of Chinese medicine from the published litera- ture in recent twenty years for treating pulmonary tuberculosis. Methods Published papers about traditional Chinese medicine in the treatment of tuberculosis from 1998 - 2016 were included. Those papers were reported by the Chinese periodicals and recorded by Wanfang network. The assistant software Version 2, named the inheritance of traditional Chinese medicine, were used for inputting the prescription data published in the literature. And the data were ana- lyzed by the improved mutual information method and complex system entropy clustering method for data mining. Re- sults Totally, there were 172 prescriptions including 257 Chinese herbs were collected, of which the most top three frequently used herbs were radix stemonae （47. 7% ）, bletilla striata （34.9%） and radix ophiopogonis （34. 9% ）. Of the top 13 anti-tuberculosis herb combinations, the combination of bletfila striata and radix stemona were most fre- quently happened, and then the radix ophiopogonis and radix stemonae. Radix ophiopogo, radix stemonae and Fritil- laria cirrhosa were three core herbs in the network diagram of the anti tuberculosis prescription rule of traditional Chi- nese medicine. On the basis of the core herb combinations 8 new anti-tubereulosis prescriptions were obtained by the method of unsupervised entropy hierarchical clustering algorithm. Conclusion The anti-tuberculosis Chinese medi- cine prescriptions in recent twenty years publication are quite different from those in the traditional Pharmacopoeia records in the used frequency of the key herbs, herb combination and their association degree. The commonly used paired herbs and their core combinations are also different in modem and traditional prescriptions. The reasons for those differences need further exploration.