基于文献数据分析探讨中医药治疗多发性骨髓瘤用药规律

Discussing the rule of Chinese medicine for multiple myeloma based on literature data analysis

目的:应用文献提取、关联度分析和聚类分析方法,筛选治疗多发性骨髓瘤(MM)的高频药物组合,揭示中医治疗MM用药特点,为临床辨证用药提供参考。方法:以中医药和多发性骨髓瘤为关键词,探索中国知网、万方数据库、维普网(2009年1月至2019年11月)相关文献,整理文献记载的方剂,建立数据库进行统计分析;以2015年版中国药典对所纳中药进行药性药味及归经分类。使用Excel 2016、Clementine 12.0、SPSS Statistics 21.0统计软件对纳入的中药进行关联规则分析和聚类分析。结果:共纳入109首方剂,共含中药285味,频数共1492次。在纳入的133味中药中:频数≥10的中药共42种,频数≥15的中药共26种,前三种分别是熟地黄、当归和黄芪;功效分类以补虚药(尤其是补肾阳药)、活血化瘀药和理气药最为常见;药性药味中,药味以甘、苦居多。药性以温、平、寒居多;归经分类中,以肝、肾、脾经居多。通过关联规则分析可以得到13种关联强度较高的药对组合,通过聚类分析可提取5个聚类。结论:多发性骨髓瘤的中医治疗用药以补虚药尤其是补肾药为主,且多与活血化瘀药联合应用。

OBJECTIVE To screen the high-frequency drug combinations for the treatment of multiple myeloma(MM)by literature extraction,correlation analysis and cluster analysis,reveal the characteristics of traditional Chinese medicine(TCM)in the treatment of MM,and provide reference for clinical dialectical medication.METHODS Using traditional Chinese medicine and multiple myeloma as keywords,the relevant literatures on China Zhiwen,Wanfang database,and Internet(from January 2009 to November 2019)were searched,the prescriptions recorded in the literatures were collated,and a database was established for statistical analysis;the medicinal taste and meridian classification of the included traditional Chinese medicines were performed with the 2015 edition of the Chinese Pharmacopoeia.Association rule analysis and cluster analysis of the included herbs were performed using Excel 2016,Clementine 12.0,and SPSS Statistics 21.0 statistical software.RESULTS A total of 109 prescriptions were included,containing a total of 285 flavors of Chinese medicine,with a frequency of 1492 times.Among the 133 Chinese medicines included:42 kinds of Chinese medicines with a frequency of≥10 and 26 kinds of Chinese medicines with a frequency of≥15.The first three were Shudihuang,Danggui and Huangqi.The efficacy classification was tonic medicine(especially kidney tonifying medicine),blood circulation and stasis medicine,and qi regulating medicine.The medicinal flavors are sweet and bitter.The medicinal properties are mostly warm,flat,and cold.In the classification of meridian,the liver,kidney,and spleen are the most common.Through association rule analysis,13 types of drug pair combinations with high association strength can be obtained,and 5 clusters can be extracted through cluster analysis.CONCLUSION The traditional Chinese medicine treatment of multiple myeloma is mainly based on tonifying deficiency drugs,especially tonifying kidney drugs,and is mostly used in combination with promoting blood circulation and removing blood stasis drugs.