基于数据挖掘探讨盛丽先教授治疗小儿肾病综合征的用药规律

Exploration of medication rule of professor SHENG Lixian in the treatment of children with nephrotic syndrome based on data mining

目的基于数据挖掘探讨盛丽先教授治疗小儿肾病综合征(NS)的用药规律。方法收集2015年1月1日至2019年6月1日盛丽先教授门诊治疗的NS患儿的临床信息,共计98例,371首处方,并将患儿就诊信息转化成有效数据表,对药物累计频数、药物性味、归经及其功效分类进行描述性分析,对前20味高频数药物采用系统聚类、关联规则分析,并对全部药物进行复杂网络分析得出核心处方。结果98例NS患儿、371首处方共用中药153种,累计用药4812次,其中最多者为玉米须,其后依次为甘草、黄芪、防风、白术、茯苓等。药性使用频数最多者为平,药味使用频数最多者为甘,归经使用频数最多者为肺经与脾经,功效分类频数最多者为补虚药。聚类分析将前20味高频数药物分为7类,涉及方剂六味地黄汤、玉屏风散、四君子汤、封髓丹及盛丽先教授验方治咳六味汤;关联规则分析结果涉及方剂防己黄芪汤、玉屏风散;复杂网络分析结果所得核心处方则涉及玉屏风散、四君子汤、封髓丹。结论盛丽先教授治疗小儿NS以益肺健脾滋肾为主,随证辅以滋阴降火、宣肺解表、清热利湿之法,临证用药多以性平、味甘为主。

Objective To explore the medication rule of professor SHENG Lixian in the treatment of children with nephrotic syndrome(NS)based on data mining.Methods From January 1,2015 to June 1,2019,clinical information of children with NS treated in professor SHENG Lixian’s outpatient service was collected,with a total of 98 cases and 371 prescriptions.The patient’s medical information was transformed into an effective data sheet,and descriptive analysis was carried out on the cumulative frequency,medicinal property and flavor,meridian tropism and efficacy classification of the medicinals.Systematic clustering and association rule analysis were used for the first 20 high-frequency medicinals,and all of them were conducted with complex network analysis,whereby the core prescriptions was obtained.Results Among 98 cases of children with NS,there were 371 prescriptions sharing 153 kinds of Chinese materia medica in common with the cumulative medication 4,812 times,the most of which was Stylus Zeae Maydis,followed in turn by Glycyrrhiza uralensis Fisch.,Astragali Radix,Saposhnikovia divaricata(Turcz.)Schischk.,Atractylodes macrocephala koidz.and Poria cocos(Schw.)Wolf etc.The medicinal property with the highest frequency was neutral,the medicinal flavor with the highest frequency was sweet,the meridian tropism with the highest frequency was lung and spleen,the efficacy classification with the highest frequency was deficiency-tonifying medicinal.The top 20 high-frequency medicinals were classified into 7 categories by cluster analysis,involving prescriptions of Liuwei Dihuang Tang(六味地黄汤),Yupingfeng San(玉屏风散),Sijunzi Tang(四君子汤),Fengsui Dan(封髓丹)and professor SHENG Lixian’s proved prescription Zhike Liuwei Tang(治咳六味汤).The results of association rules analysis involved prescriptions of Fangji Huangqi Tang(防己黄芪汤)and Yupingfeng San.The core prescriptions obtained from complex network analysis involved Yupingfeng San,Sijunzi Tang and Fengsui Dan.Conclusion SHENG Lixian’s experience in treating children with NS gives priority to nourishing lung,invigorating spleen and nourishing kidney,and supplemented by the methods of nourishing yin and lowering fire,dispersing lung and relieving superficies,clearing away heat to drain dampness.In clinical practice,most medicinals are neutral in property and sweet in flavor.