魏品康从痰论治胃癌用药规律研究

Study on Medication Rules of Professor WEI Pin-kang in Treating Gastric Cancer from Phlegm

目的分析魏品康教授治疗胃癌处方用药规律,为临床用药提供参考。方法收集魏品康名老中医工作室门诊病案库(包括电子数据库和纸质病案库)收录的2008年1月-2015年12月魏品康教授于上海长征医院中医科门诊治疗的胃癌病案。运用中医传承辅助平台V2.5软件建立数据库,采用频次分析、关联规则分析、复杂系统熵聚类等数据挖掘方法,分析处方中各种药物的使用频次、药物之间的关联规律和核心药物组合。结果共收集305首处方,包含185味中药,其中使用频次较高的药物有法半夏、制天南星、鸡内金等;温性和寒性药物多见,多为苦、辛、甘味,多入胃经、脾经和肝经;频次较高的药物组合有法半夏-制天南星、法半夏-鸡内金、鸡内金-制天南星等;常见药对有枳壳-枳实、全蝎-蜈蚣等。获得不同药物组合模式的关联规则36条置信度>0.99、核心组合70条、新处方11首。结论魏品康教授治疗胃癌讲究从痰论治,治法以消痰散结为核心,常用药物以消痰散结为主,配合理气和胃、清热解毒。

Objective To explore the medication rules of Professor WEI Pin-kang in treating gastric cancer;To provide references for clinical medication.Methods Gastric cancer cases treated by Professor WEI Pin-kang in TCM outpatient department of Shanghai Changzheng Hospital from January2008to December2015in WEI Pin-kang TCM Studio Outpatient Medical Cases(including electronic database and paper medical cases database).TCM Inheritance Support System V2.5was used to build database.Frequency analysis,association rule analysis,complex system entropy clustering and other data mining methods were used to analyze frequency,medicine association rules and core medicine combination.Results Totally305clinical prescriptions including185kinds of Chinese material medica were collected.The Chinese meteria medica with the high frequency were Pinellinae Rhizoma Praeparatum,Arisaematis Rhizoma Preparatum and Galli Gigerii Endothelium Corneum,etc.High frequency Chinese material medica were with the properties of warm and cold,and with the flavors of bitter,spicy and sweet,to Stomach Meridian of Foot-Yangming,Spleen Meridian of Foot-Taiyin,and Liver Meridian of Foot-Jueyin.The medicine combinations with high frequency were“Pinellinae Rhizoma Praeparatum and Arisaematis Rhizoma Preparatum”,“Pinellinae Rhizoma Praeparatum and Galli Gigerii Endothelium Corneum”,and“Galli Gigerii Endothelium Corneum and Arisaematis Rhizoma Preparatum”.The common medicine pairs were“Aurantii Fructus and Aurantii Fructus Immaturum”and“Scorpio and Scolopendra”.Analysis showed36association rules of the confidence>0.99.70core medicine combinations and11new prescription were obtained.Conclusion Professor WEI Pin-kang treats gastric cancer based on phlegm theory.The dissolving phlegm and eliminating stagnation medicine,regulating qi-folwing for harmonizing stomach medicine and heat-clearing and detoxifying medicine are commonly used.