基于关联规则分析罗玲治疗肺结节组方规律

Analysis of the Rule of Lung Nodule Treatment by Chief Physician LUO Ling Based on Association Rules

目的基于关联分析挖掘罗玲主任医师治疗肺结节的常用药物组方规律。方法收集于2018年1月—2019年6月在重庆市中医院名医馆罗玲主任医师治疗肺结节的患者的门诊病例104例,记录相关诊疗信息,包括年龄、性别等一般个人信息,同时记录患者与本次就诊相关的中医四诊和处方用药信息。将中药数据库进行数据标准化,制定统一标准,规范术语应用,进一步采用数据挖掘软件SPSS MODELER 14.1进行频数分析和关联分析等方法对中药处方规律进行分析。结果频数分析显示,处方中共使用药物130味,共2013频次,使用频数在40%以上的药物有17种,共1213频次,累计频率60.26%。核心药物前十味分别是:山药、半夏、夏枯草、莪术、玄参、太子参、浙贝、皂角刺、山慈菇和鳖甲。核心药物分类主要为益气健脾类、燥湿化痰散结类、行气活血化瘀类。关联规则显示,罗玲主任医师治疗肺结节组方中,置信度为100%的药对有两个,分别是"山药、蜂房","山药、山慈菇",三味药物组合体有3个,分别是"山药、鳖甲、浙贝","玄参、山慈菇、莪术"和"玄参、山药、山慈菇",四味药物组合体有1个,是"玄参、山药、蜂房、莪术"。结论罗玲主任医师认为肺结节的主要病机为正气亏虚、痰瘀阻滞、瘀毒互结所致,在治疗以益气健脾,化痰散结,活血化瘀解毒为主。

Objective Based on association analysis,to find out the rules of common drugs used by chief physician Luo Ling in the treatment of pulmonary nodules. Methods 104 outpatients with pulmonary nodules were collected from January 2018 to June 2019,who were treated by Luo Ling,chief physician of Chongqing famous Chinese medicine hospital. The relevant diagnosis and treatment information,including general personal information such as age and gender,was recorded. Meanwhile,the four diagnosis and prescription drug information related to this visit were recorded. The database of traditional Chinese medicine was standardized,unified standards were formulated,and the application of terms was standardized. The frequency analysis and correlation analysis of traditional Chinese medicine prescriptions were further carried out by SPSS modeler 14. 1.Results Frequency analysis showed that 130 drugs were used in the prescription,with a total frequency of 2013. There were 17 kinds of drugs with a total frequency of 1213,with a cumulative frequency of 60. 26%. The top ten core drugs are yam,Pinellia ternate,Prunella vulgaris,curcuma zedoary,Scrophularia,Pseudostellaria,Fritillaria thunbergii,dioscorea,Sagittaria and turtle shell. The core drugs are classified into three categories: Invigorating Qi and spleen,eliminating dampness and phlegm,and promoting Qi,promoting blood circulation and removing blood stasis. According to the association rules,there are two drug pairs with 100% confidence in Luo Ling’s treatment of pulmonary nodules,namely " yam,bee house"," yam,Sagittarius". There are three drug combinations,namely " yam,turtle shell,Zhejiang shell"," Xuanshen,Sagittarius,Curcuma" and" Xuanshen,Sagittarius,Sagittarius". One of the four drug combinations is " Xuanxuan" Ginseng,yam,beehive,zedoary ".Conclusion According to Luo Ling,the main pathogenesis of pulmonary nodule is deficiency of vital energy,stagnation of phlegm and blood stasis,and the combination of blood stasis and toxin. The main treatment is to invigorate Qi and spleen,dissipate phlegm and phlegm,promote blood circulation,remove stasis and detoxification.