非小细胞肺癌病案证素分布规律及不同方法辨证结果的对比研究

Comparative study on distribution of pattern elements and results of different methods of pattern differentiation in cases of non-small cell lung cancer

目的通过数据挖掘方法对非小细胞肺癌(NSCLC)病案进行挖掘,总结NSCLC的中医辨证规律,以期为NSCLC临床辨证用药提供参考。方法一方面挖掘出7435份NSCLC病案的四诊信息,通过"文锋-III中医(辅助)诊疗系统"进行证素辨证;另一方面将临床医师记录的病案中医辨证拆分成单一证素。挖掘出非小细胞肺癌的证素分布规律,并比较临床医师辨证和"文锋-III中医(辅助)诊疗系统"辨证的差异。结果医师病案辨证结果表明,病位证素以脾(1910频次)、肺(1608频次)为主,病性证素以气虚(6751频次)、血瘀(6572频次)、火(热、毒)(6331频次)、阴虚(5657频次)、痰(1242频次)等为主;"文锋-III中医(辅助)诊疗系统"辨证结果表明,病位证素以肺(7371频次)、胸膈(1837频次)、肾(1417频次)、心(1358频次)、胃(1074频次)等为主,病性证素以阴虚(3507频次)、气虚(3323频次)、痰(3204频次)、血瘀(2542频次)、火(热、毒)(1622频次)等为主。结论肺癌的病位证素主要在肺,病性证素主要为阴虚、气虚、痰、血瘀、火(热、毒)等,并且"文锋-III中医(辅助)诊疗系统"的证素辨证结果与临床用药分布规律更契合。

Objective To explore case records of non-small-cell lung cancer(NSCLC)through data mining to obtain laws of TCM pattern differentiation of NSCLC,which provide reference for clinical pattern differentiation and treatment of NSCLC.Methods This study excavated information obtained by four diagnostic methods of 7435 non-small cell lung cancer cases,and conducted pattern element differentiation through the"Wenfeng-III Chinese Medicine(Assisted)Diagnosis and Treatment System".It also analyzed pattern elements from case records by clinicians.The distribution of pattern elements in non-small cell lung cancer was identified,and clinician pattern differentiation and"Wenfeng-III Chinese Medicine(Assisted)Diagnosis and Treatment System"pattern differentiation were compared to analyze the differences.Results An analysis of doctors’pattern differentiation in case records showed that the elements concerning the location of the disease were mainly spleen(1910 times),and lung(1608).The elements related to the nature of the disease included mainly qi deficiency(6751),blood stasis(6572),fire(heat,toxin)(6331),yin deficiency(5657),and phlegm(1242).An analysis of pattern differentiation results obtained by"Wenfeng-III Chinese Medicine(Assisted)Diagnosis and Treatment System"showed that the elements concerning the location of the disease were mainly lung(7371),chest(1837),kidney(1417),heart(1358),and stomach(1074).The elements related to the nature of the disease included mainly yin deficiency(3507),qi deficiency(3323),phlegm(3204),blood stasis(2542),and fire(heat,toxin)(1622).Conclusion The element concerning the location of the lung cancer was primarily lung and the elements related to the nature of the disease included mainly yin deficiency,qi deficiency,phlegm,blood stasis,and fire(heat,toxin).The pattern differentiation results by"Wenfeng-III Chinese Medicine(Assisted)Diagnosis and Treatment System"are more in line with the distribution of clinical prescriptions.