基于数据挖掘分析清代著名医家治疗中风的用药规律

Analysis of Medication Rule of Stroke Treatment by Famous Physicians in Qing Dynasty Based on Data Mining

目的基于数据挖掘分析方法对《清代名医医案精华》中叶天士医案精华、吴鞠通医案精华、曹仁伯医案精华、王旭高医案精华、何书田医案精华、马培之医案精华、张千里医案精华、张聿青医案精华、金子久医案精华、丁甘仁医案精华治疗中风方剂的组方规律剂进行分析、总结,以期有效指导临床。方法以《清代名医医案精华》为数据来源,收集叶天士、吴鞠通、曹仁伯、王旭高、何书田、马培之、张千里、张聿青、金子久、丁甘仁10位名医医案治疗中风的64则医案,采用频数分析、聚类分析、关联规则分析等数据挖掘方法对医案进行分析,对常用药物及药对进行探讨。结果通过对筛选出的64则符合纳入标准的医案进行分析,获得138味中药,680频次,核心药物30味,获得关联药对13条。138味药物按照功效可分为15类,出现频率最高的前6类药物分别是补虚药、化痰药、清热药、平肝熄风药、祛风湿药、理气药,累计频率达74.70%。频率>12%(频次大于8)的核心药物30味,累计频次为397次,占所有药物频次的58.38%。其中陈皮出现的频率最高,达42%。聚类分析得到4类药物:清热化痰开窍类、疏风通络类、滋补肝肾类、健脾利湿类。关联规则分析显示:关联性强的主要为补虚药之间的组合,以及化痰药、平肝息风药、补虚药的组合。结论应用数据挖掘方法可以初步揭示清代名医治疗中风的组方用药规律,为临床实践提供新思路。

Objective To summarize and analysis the medication rule of prescriptions for treating stroke based on the method of data mining in the essence of the famous doctors in Qing Dynasty medical case,including the essence of Ye Tianshi medical case,the essence of Wu Jutong medical case,the essence of Cao Renbo medical case,the essence of Wang Xugao medical case,the essence of He Shutian medical case,the essence of Ma Peizhi medical case,the essence of Zhang Qianli medical case,the medical case of Zhang Yuqing,the essence of Jin Zijiu medical record,and the essence of Ding Ganren medical record,so as to guide clinical practice effectively.Methods The essence of the famous medical cases in Qing Dynasty was used as the data source,64 medical cases of stroke were collected from 10 medical cases,namely,Ye Tianshi,Wu Jutong,Cao Renbo,Wang Xugao,He Shutian,Ma Peizhi,Zhang Qianli,Zhang Yuqing,Jin Zijiu,Ding Ganren.The frequency analysis,cluster analysis,and association rules analysis and other data mining methods were used to analyze the medical records,and the frequency of drugs and drug pairs were probed.Results According to analysis of 64 medical cases that met the inclusion criteria,138 Chinese medicine,680 frequency,30 core drugs,and 13 related drugs were obtained.The 138 drugs were divided into 15 categories according to the efficacy,the highest frequency of the first 6 kinds of drugs were supplementing deficiency,expectorant,heat clearing,antipyretic,dispelling wind dampness and physical Qi,with a cumulative frequency of 74.70%.There were 30 core drugs,the cumulative frequency was 397 times,accounting for 58.38%of all drug use frequency.The frequency of pericarpium pericarp was the highest,reaching 42%.Cluster analysis showed that there were 4 regular drugs:clearing away heat and dissipating phlegm,dispersing wind and dredging collaterals,nourishing liver and kidney,strengthening spleen and promoting dampness.Association rules analysis showed that the strong association was mainly the combination of complementary drugs,as well as the combination of expectorant,smoothing liver regulating wind,and reinforcing deficiency.Conclusion Data mining method can initially reveal the rule of prescriptions in treating stroke,and provide new ideas for clinical practice.