基于关联规则和复杂系统熵聚类的HBeAg阳性慢性乙型肝炎用药规律分析

An analysis of medication rule for HBeAg-positive chronic hepatitis B based on association rule and complex system entropy clustering

目的探讨HBe Ag阳性慢性乙型肝炎(CHB)的中医用药特点和组方规律。方法检索中国知网、万方数据资源库和维普期刊资源整合服务平台中HBe Ag阳性CHB的中医证治文献,提取医案的中医诊治信息,经过数据标准化处理并建立数据库,运用中医传承辅助系统挖掘其用药规律。结果共纳入文献100篇,医案135例。共使用220种中药,其中用药频数较高的中药为柴胡、丹参、甘草、白术、茯苓等;在药物归经中频数较高的为肝经、脾经、胃经等。分析出治疗HBe Ag阳性CHB的核心药物为柴胡、白术、白芍、郁金、丹参、甘草、茯苓、虎杖、黄芪、茵陈、白花蛇舌草;基于复杂系统熵聚类,推演出药物核心组合20个;并在此基础上,运用无监督熵层次聚类算法,得到新处方10个。结论通过文献挖掘及归纳分析,提示肝郁脾虚证、肝胆湿热证是HBe Ag阳性CHB常见证型,总结出了核心药对和新处方,以供临床借鉴。

Objective To investigate the features of traditional Chinese medicine（ TCM） and prescription rules in the treatment of HBeAg- positive chronic hepatitis B（ CHB）. Methods A systematic search was performed for the articles on the TCM diagnosis and treatment of HBeAg-positive CHB,the information of TCM diagnosis and treatment in medical records were extracted,and a database was established after data standardization. The Traditional Chinese Medicine Inheritance Support System was used to investigate the medication rule. Results A total of 100 articles with 135 medical records were included in this study. A total of 220 types of Chinese materia medica were used,among which Bupleurum chinense,Salvia miltiorrhiza,Radix Glycyrrhizae,Atractylodes macrocephala Koidz.,and Poria cocos were frequently used. As for the meridian entry of drugs,liver meridian,spleen meridian,and stomach meridian were commonly used. The analysis showed that the core drugs for HBeAg- positive CHB were Bupleurum chinense,Atractylodes macrocephala Koidz.,Radix Paeoniae Alba,Radix Curcumae,Salvia miltiorrhiza,Radix Glycyrrhizae,Poria cocos,Polygonum cuspidatum,Astragalus membranaceus,Herba Artemisiae Scopariae,and Hedyotis diffusa. A total of 20 core drug combinations were deduced based on complex system entropy clustering,and 10 new prescriptions were obtained using unsupervised entropy hierarchical clustering. Conclusion In this study,literature mining and inductive analysis show that the syndromes of stagnation of liver qi and spleen deficiency and liver and gallbladder damp- heat are common syndrome types of HBeAg- positive CHB. The medicine suits and prescriptions refined in this study can be used for reference in clinical practice.