周岱翰治疗脾虚痰湿型非小细胞肺癌的用药组方规律探讨

Regularity of Medication and Prescription by ZHOU Dai-Han in Treatment of Non-small Cell Lung Cancer with Spleen Deficiency and Dampness-phlegm Syndrome

【目的】探索周岱翰教授治疗脾虚痰湿型非小细胞肺癌的用药规律。【方法】收集2016年10月至2018年10月周岱翰教授在门诊及住院部治疗非小细胞肺癌的医案资料,录入中医传承辅助平台(V2.5),按照纳入与排除标准筛选脾虚痰湿型非小细胞肺癌相关病例的处方数据,采用软件的关联规则分析、聚类分析等方法分析周岱翰教授治疗脾虚痰湿型非小细胞肺癌的用药规律。【结果】搜集得到病例共113例,记录137首处方,涉及98味中药;所用药物的药味以苦、甘、辛为主,主要归肺、脾、胃经;使用频次居前6味的中药依次为浙贝母、甘草、党参、葶苈子、半夏、守宫,得到核心药物组合6个,新方6首。【结论】周岱翰教授治疗脾虚痰湿型非小细胞肺癌的主要疗法为平补肺脾、温养脾肾、化痰除湿、解毒祛瘀;根据患者病情,"扶正"与"祛邪"各有侧重,强调个体化治疗。

Objective To explore the regularity of medication and prescription by Professor ZHOU Dai-Han in treating non-small cell lung cancer(NSCLC)with spleen deficiency and dampness-phlegm syndrome.Methods Data of medical record related with NSCLC outpatients and inpatients treated by Professor ZHOU Dai-Han from October 2016 to October 2018 were collected and input into the Traditional Chinese Medicine Inheritance Support Platform System(V2.5).Following the inclusion and exclusion criteria,the data of prescriptions were screened,and the regularity of medication and prescription by Professor ZHOU Dai-Han in treating NSCLC with spleen deficiency and dampness-phlegm syndrome was explored mainly by the methods of association rule analysis and clustering analysis.Results A total of 113 cases were collected,and 137 prescriptions involving 98 herbs were recorded.The flavor of the 98 Chinese herbal medicines was characterized by bitter,sweet and pungent,and the herbs had the meridian tropism of lung,spleen,and stomach meridians.The leading 6 frequently-used herbs were Bulbus Fritillariae Thunbergii,Radix Glycyrrhizae,Radix Codonopsis,Semen Lepidii seu Descurainiae,Rhizoma Pinelliae,and Gekko Chinensis.After association rule analysis and clustering analysis,6 core herbal combinations and 6 new candidate recipes were obtained.Conclusion The primary therapies for NSCLC with spleen deficiency and dampness-phlegm syndrome established by Professor ZHOU Dai-Han are mild supplementation of lung and spleen,warming and nourishing spleen and kidney,resolving phlegm and removing dampness,and detoxifying and removing blood stasis.The individualized treatment was emphasized by Professor ZHOU Dai-Han through the appropriate application of supporting healthy qi and dispelling pathogens based on the illness state.