基于系统聚类分析总结沈敏鹤主任医师辨治结直肠癌用药规律

Summary of SHEN Minhe’s Administration Rules in Treating Colorectal Cancer Based on Hierarchical Cluster Analysis

目的:探讨省级名中医沈敏鹤主任中医药治疗结直肠癌的用药规律研究。方法:纳入沈敏鹤门诊治疗结直肠癌患者71例800份医案,将患者临床信息转化为方剂基础数据库,对药物进行频数、药性、药味等分析,并对频数最高的53种药物进行系统聚类分析。结果:通过800份医案的数据挖掘,共涉及用药331种,药性以寒、温、平为多,药味主以甘、苦,聚类分析将53味高频药物分为5类,涉及方剂六君子汤、六味地黄丸合解毒三根汤、甘露消毒丹等。结论:沈敏鹤辨治结直肠癌宗扶正祛邪的总原则,而以健脾益气为主,辅以解毒祛湿。

Objective:To discuss the administration rules in treating colorectal cancer with Chinese medicine by SHEN Minhe,a chief physician of Chinese medicine. Methods:A total of 800 medical cases involving 71 patients with colorectal cancer treated by SHEN Minhe were included. Their clinical information was used to establish a basic database of prescriptions. The frequency,and the nature and flavor of herbal medicines were analyzed. Hierarchical cluster analysis was carried out on the top 53 herbal medicines with the highest frequency. Results:According to the data mining of 800 medical cases,331 kinds of herbal medicines were involved. The nature of herbal medicines was mainly cold,warm and plain,and the flavors were generally sweet and bitter. Through cluster analysis,53 high-frequency herbal medicines were classified into five types,involving prescriptions such as Liujunzi tang,Liuwei Dihuang pills combined with Jiedu Sangen tang,and Ganlu Xiaodu pills. Conclusion:The syndrome differentiation of colorectal cancer by SHEN Minhe follows the general principle of reinforcing the healthy qi and eliminating the pathogenic factors, which mainly focuses on fortifying the spleen and replenishing qi,and is assisted by detoxicating and resolving dampness.