以脉络学说营卫理论为指导治疗冠心病心绞痛络气虚滞证辨治规律的数据挖掘

Data Mining of Syndrome Differentiation Rule in Treating Patients with Coronary Heart Disease Angina Pectoris Collateral-qi Deficiency and Stagnation Syndrome under the Guidance of Vessel-collateral Theory and Yingfen-weifen Theory

目的采用数据挖掘方法分析以脉络学说营卫理论为指导治疗的冠心病心绞痛络气虚滞证患者的辨治规律。方法围绕冠心病心绞痛病、证、症、法、方、药等多种要素,应用贝叶斯网络、频数分析、聚类分析、描述性分析、Pearson相关分析等综合性数据分析方法,客观揭示脉络学说指导治疗的冠心病心绞痛络气虚滞证患者的临床辨治规律。结果贝叶斯网络提取的与络气虚滞证因果关系较强的症状为心胸隐痛、神疲乏力、脉沉细、心悸懒言、舌有齿痕等;利用频数分析方法分析络气虚滞证的症状及药物,结果显示,心胸隐痛、胸闷气短症状出现的频率较高,分别为7.41%、6.79%,药物频率较高的为西洋参、赤芍等,分别为5.83%、5.59%;药物聚类分析得到炒酸枣仁-合欢花、麦冬-五味子、茯苓-泽泻等有意义的聚类组合;运用描述性分析总结常用药对的药物剂量,其中西洋参-生黄芪常用剂量为12 g∶30 g;采用Pearson相关分析得出了高频药对与症候群之间的关联强度,并且所有组合的关联度均在0.4以上。结论通过数据挖掘治疗冠心病心绞痛病案,进一步阐明以脉络学说指导的冠心病心绞痛络气虚滞证患者的组方用药规律及"络以通为用"的治疗原则。

Objective To analyze the syndrome differentiation rule in treating patients with coronary heart disease（CHD） angina pectoris collateral-qi deficiency and stagnation syndrome under the guidance of vessel-collateral theory and yingfen-weifen theory by data mining method. Methods Around a variety of elements,such as CHD angina pectoris disease,syndrome,symptom,method,recipe and medicine,comprehensive data analysis methods,including Bayesian network,frequency analysis,cluster analysis,descriptive analysis and Pearson correlation analysis,were applied to objectively reveal the clinical syndrome differentiation rule in treating CHD angina pectoris collateral-qi deficiency and stagnation syndrome under the guidance of vessel-collateral theory. Results The symptoms extracted by Bayesian network,which had a strong causal relationship with collateral-qi deficiency and stagnation syndrome were cardiothoracic dull pain,dispiritedness and weakness,deep and thready pulse,palpitation and disinclination to talk,as well as tongue with teeth prints. Frequency analysis method was used to analyze the symptoms and herbs of collateral-qi deficiency and stagnation syndrome. The result showed that symptoms with high frequency were cardiothoracic dull pain,oppression in chest and panting,7. 41% and 6. 79%. Herbs with high frequency were Xiyangshen（Radix Panacis Quinquefolii,西 洋参,5. 83%） and Chishao（Radix Paeoniae Rubra,赤 芍,5. 59%）.Herb cluster analysis showed meaningful clustering combinations,such as Fried Suanzaoren（Semen Ziziphi Spinosae,酸枣仁）-Hehuanhua（Flos Albiziae,合欢花）,Maidong（Radix Ophiopogonis,麦冬）-Wuweizi（Fructus Schisandrae Chinensis,五味子） and Fuling（Poria,茯苓）-Zexie（Rhizoma Alismatis,泽泻）. Herb proportion of commonly used herb pair was summarized by descriptive analysis; the commonly used proportion of Xiyangshen-Shenghuangqi（Radix Astragali seu Hedysari,生 黄芪） was 12 g ∶ 30 g. Pearson correlation analysis showed correlation strength between high frequency herb pairs and syndrome and the correlation degree of all combinations was more than0. 4. Conclusion By data mining in treating CHD angina pectoris cases,the authors further explained the recipemedicine rule in patients with CHD angina pectoris collateral-qi deficiency and stagnation syndrome under the guidance of vessel-collateral theory and the therapeutic principle of ＂taking unblocked transmission as normal functional state of collateral＂.