基于数据挖掘的黄衍寿治疗眩晕辨证用药规律探讨

Common Patterns and Chinese Medicinal Combination Rules in HUANG Yanshou'S Treatments for Dizziness: A Data-mining Study

目的:探讨广东省名中医黄衍寿治疗眩晕的用药规律。方法:收集广州中医药大学第一附属医院2015年8月至2016年6月黄衍寿教授门诊治疗眩晕病例的处方,应用"中医传承辅助平台"软件,采用数据挖掘方法分析黄衍寿教授治疗眩晕的用药规律。结果:纳入病例150例,处方150首,药物共计118味。处方中高频证型为肝肾不足(54)、瘀血内阻(41);频次最高的前4位药物为川芎(107)、丹参(96)、天麻(92)、生地黄(75);相关度为8、惩罚度为3,应用复杂系统熵聚类的层次聚类分析演化出3~6味药核心组合12组,前三位的组合为"黄芩、栀子、石决明""桃仁、生地黄、当归""桑寄生、益母草、丹参",挖掘了"黄芩、栀子、石决明、黄芪"等新处方6首。结论:黄衍寿教授治疗眩晕多用补肾、活血、平肝之品,善用六味地黄丸为基础方加减,随症加减祛瘀通络与益气除痰药,体现其临证治疗眩晕"补肾平肝、活血祛瘀"的学术思想。

Objective： This study was conducted to analyze and quantify famous TCM doctors of Guangdong province- professor HUANG＇ s clinical experience in treating dizziness in terms of common patterns of the disease. Methods： We collected the prescriptions used for dizziness by Professor HUANG from August 2015 to June 2016 in outpatient service of the first affiliated hospital of Guangzhou university of Chinese Medicine, and then we explored the Professor HUANG＇ s experience by the data-mining methods and analyzed it based on the platform of ＂traditional Chinese medicine inheritance support＂. Results ：150 case histories, 150 prescriptions and 118 herbs of patients diagnosed with dizziness and treated by HUANG were reviewed. The most common patterns were deficiency of liver and kidney （54） and accumulation of blood stasis （ 41 ） ; Chuanxiong （ ligustieum wallichii ） （ 107 ） , Danshen （ Salvia miltiorrhiza ） （ 96 ） , Tianma （ gastrodia elata ） （ 92 ） and Shengdihuang（ dried rehmannia root） （75）were the most frequently prescribed by HUANG; with the 8 of relevancy and 3 of punishment, we found 12 drug combinations within 3-6 herbs which were the most common by the way of complex system entropy cluster and un-supervised hierarchical clustering composing principles. ＂Fluangqin （Seutellaria baicalensis） , Zhizi （fructus gardenia） ,Shijueming（ concha haliotidis ） ＂, ＂Taoren（ Peach Seed）, Shengdihuang（ dried rehmannia root）, Danggui （ Angelica sinensis ） ＂, ＂ Sangjisheng （ Parasitic Loranthus ） , Yimucao （ Herba Leonuri ） , Danshen （ Salvia miltiorrhiza ） ＂, ＂ Huangqin （ Scutellaria baicalensis ）, Zhizi （fructus gardenia ）, Shijueming （ concha haliotidis ）, Huangqi （Astragalus membranaceus）＂ were the top four drug combinations. Mining to get a total of 6 new prescription combination clustering. Conclusion： The way of tonifying kidney, invigorating the circulation of blood and calming liver were HUANG＇ s major therapeutics in treating dizziness, for which ＂Six Ingredient Rehmannia Pill＂ was his basic formulae, assisted by herbs with resolving phlegm to remove stasis and invigorating Qi and removing phlegm, The conclusion corresponded to HUANG＇ s clinical academic thoughts of ＂tonifying kidney and calming liver, invigorate the circulation of blood and remove stasis＂ in treating dizziness.