数据挖掘技术辅助的陈以平治疗特发性膜性肾病用药规律研究

Chen Yiping's medication rules in the treatment of idiopathic membranous nephropathy based on data mining

目的采用数据挖掘技术辅助研究陈以平教授治疗特发性膜性肾病的用药规律。方法收集陈以平教授辨治特发性膜性肾病的门诊病例资料和处方,采用复杂网络工具箱实现网络信息统计及分析,采用基于信息熵的互信息方法进行相关性评估,并引入随机置换检验自动确定关联度的显著性阈值;在此基础上建立复杂网络,采用支持度和置信度衡量药物之间关系的重要性,通过关联规则对方剂中的核心药对进行挖掘。结果 (1)共收集218例患者的资料,提取613首处方,涉及198种药物,药物的累计使用频次为10 140次。(2)使用频次超过60的药物有21种,即白术、黄芪、当归、苍术、山药、茯苓、猪苓、白花蛇舌草、僵蚕、薏苡仁、丹参、党参、半枝莲、芙蓉叶、金樱子、狗脊、淫羊藿、菟丝子、葛根、川芎、重楼,可以视为陈以平教授治疗特发性膜性肾病的基础药物;其中白术、黄芪、当归、苍术、山药、茯苓的使用频率超过90%,可以视为核心药物。(3)补气药、清热药、利水渗湿药、活血祛瘀药、化湿药的使用频次较多。(4)通过关联规则的分析,共得到627个药对,其中AVCH>1的核心药对24个;同时,根据BK算法得到4个基本方。结论陈以平教授治疗特发性膜性肾病多从脾虚湿热、瘀阻脉络入手,采用益气清热、利水渗湿、活血化瘀等治法;核心药物有白术、黄芪、当归、苍术、山药、茯苓,并得出24个核心药对,4个基本方。

Objective To study Chen Yiping＇s medication rules in the treatment of idiopathic membranous nephropathy（IMN） based on data mining. Methods The information and prescriptions of outpatient cases with IMN treated by Chen Yiping were collected and analyzed by complex network toolbox. The relevance was evaluated by mutual information method based on information entropy,and the significant threshold of correlation degree was automatically determined by random permutation test. Based on those above,the complex network was established to measure the importance of relationship between drugs through support and confidence degree,and explore the core couplet medicines through association rules. Results（1）218 cases informations were collected,and 613 prescriptions were extracted,which including 198 medicines,and the accumulated usage frequency was 10 140 times.（2）There were 21 medicines with usage frequency more than 60 times,including Baizhu（Atractylodis Macrocephalae Rhizoma）,Huangqi（Astragali Radix）,Danggui（Angelicae Sinensis Radix）,Cangzhu（Atractylodis Rhizoma）,Shanyao（Dioscoreae Rhizoma）,Fuling（Poria）,Zhuling（Polyporus）,BaihuaS heshecao（Hedyotis Herba）,Jiangcan（Batryticatus Bombyx）,Yiyiren（Coicis Semen）,Danshen（Salviae Miltiorrhizae Radix et Rhizoma）,Dangshen（Codonopsis Radix）,Banzhilian（Scutellariae Barbatae Herba）,Furongye（Hibisci Mutabilis Folium）,Jinying（Rosae Laevigatae Fructus）,Gouji（Cibotii Rhizoma）,Yinyanghuo（Epimedii Folium）,Tusizi（Cuscutae Semen）,Gegen（Puerariae Lobatae Radix）,Chuanxiong（Chuanxiong Rhizoma） and Chonglou（Paridis Rhizoma）,which can be taken as the basic drugs in Professor Chen Yiping＇s treatment on IMN. Among these drugs,the usage frequency of Baizhu,Huangqi,Danggui,Cangzhu,Shanyao and Fuling was over 90%,which can be considered as core medicines.（3）The usage frequency of qi-supplementing medicines,heat-clearing medicines,medicines for diuresis and diffusing dampness,medicines for activating blood and removing blood stasis and dampness resolving medicines was higher.（4）According to the association rules analysis,627 couplet medicines were achieved,and 24 of them were considered as core couplet medicines with AVCH 1. Meanwhile,4 basic prescriptions were achieved by BK algorithm. Conclusion Professor Chen Yiping＇s treatments for IMN focus on spleen deficiency and dampness-heat and blood stasis blocking vessels and meridians, and the therapies of benefiting qi and clearing heat,inducing diuresis and eliminating dampness,promoting blood circulation for removing blood stasis are applied. The core medicines are Baizhu,Huangqi,Danggui,Cangzhu,Shanyao and Fuling,24 core couplet medicines and 4 basic prescriptions are made.