基于数据挖掘探讨于、孙氏学术流派治疗慢性肾衰竭用药规律

Medication law of Yu and Sun′s academic schools in the treatment of chronic renal failure based on data mining

目的:运用数据挖掘和统计学方法,探索于、孙氏学术流派治疗慢性肾衰竭的临证经验和学术思想。方法:收集2017年9月-2019年3月于、孙氏学术流派治疗慢性肾衰竭病案资料,提取病案所记录的症状体征、用药处方等信息,对其进行规范化处理后建立数据库,运用"中医传承辅助平台系统(V2.5)"对药物进行关联度分析和聚类分析,梳理其治疗慢性肾衰竭的用药规律与特色。结果:该研究共纳入病案320个,处方1100首,药物219味,慢性肾衰竭本虚证以脾肾气虚证最多,其他依次分别为脾肾阳虚证、气阴两虚证、肝肾阴虚证、阴阳两虚证;标实证以血瘀证居多,其他依次为湿浊证、湿热证、水气证、气滞证;治则治法中健脾补肾、活血化瘀、利湿泄浊运用频率最高。结论:于、孙氏学术流派临证治疗慢性肾衰竭患者主张以健脾补肾固本培元,活血化瘀、泄浊解毒祛其标,标本兼顾;临证遣方用药时重用补益药、活血化瘀药、利湿泄浊药。

Objective:Using data mining and statistical methods to explore the clinical experience and academic thought of Yu and Sun′s academic schools in the treatment of chronic renal failure. Methods:The clinical records on treatment of chronic renal failure by Yu and Sun′ s academic schools from September 2017 to March 2019 were collected,and the informations of symptoms and signs,medication prescription were conducted and established database,then the correlation degree and cluster analysis of drugs were done using"Chinese medicine inheritance and auxiliary platform system(V2.5)"and regularity and characteristics on the treatment of chronic renal failure were sumarried. Results:320 medical record,1100 prescriptions,219 herbs were included in the study.In deficiency syndrome of chronic renal failure,spleen and kidney deficiency syndrome was more common,followed by spleen kidney Yang deficiency syndrome,qi and Yin deficiency syndrome,liver and kidney Yin deficiency syndrome,Yin and Yang deficiency syndrome;In excess syndrome,blood stasis syndrome was more common,followed by damp turbid syndrome,wet and heat syndrome,dampness,qi stagnation syndrome;In the treatment,invigorate the spleen and kidney,promote blood circulation and remove dampness and turbidity were more common. Conclusion:In the treatment of chronic renal failure patients,Yu and Sun′ s academic schools advocates strengthening the spleen and tonifying the kidney,activating blood circulation to remove blood stasis,and relieving turbidity and detoxification.In the prescription,tonic herbs,herbs for promoting blood circulation and removing blood stasis,herbs of removing dampness and turbidity are used more frequently.