基于数据挖掘的国家级名老中医治疗高血压用药规律研究

Analysis on the Medication Rules of National TCM Masters in Treating Hypertension Based on Data Mining

目的基于数据挖掘分析当代国家级名老中医治疗高血压的用药规律,为高血压的临床辨治提供参考。方法检索、收集、整理《国家级名老中医验案——高血压病》《国家级名老中医高血压验案良方》中的高血压医案,提取医案中的中药处方数据。建立标准化医案数据库,采用古今医案云平台系统集成的频次统计、中药属性分析、聚类分析、复杂网络等数据挖掘方法,分析医案的组方用药频次、药性、药对、核心处方等。结果纳入处方222首,涉及药物218种,高频药物有钩藤、牛膝、丹参、天麻、茯苓等,药性以平、微寒、寒性及甘、苦味为主,主要归肝、肾经,功效以强筋骨、补肝肾、平抑肝阳、清热凉血为主。处方中常用药对有天麻-钩藤、钩藤-天麻,牛膝-钩藤等。聚类分析可将药物分为4类,分别为清热平肝、行气活血、健脾祛湿、滋补肝肾等。复杂网络分析得出核心药物组合为钩藤、天麻、牛膝、丹参、白芍、生地黄、川芎、菊花、泽泻、茯苓、甘草、夏枯草。结论当代名老中医治疗高血压药物多为平、微寒、甘、苦及归肝经、肾经,治疗多以补肝肾、强筋骨、平肝潜阳、清热凉血为法,虚实兼顾,标本同治。

Objective To analyze the medication rules of national traditional Chinese medicine(TCM)masters in treating hypertension based on data mining to provide reference for clinic.Methods The hypertension cases in the national TCM masters-hypertension and proven prescription for hypertension of national TCM masters were searched,collected and sorted out.Then the data of TCM prescription in medical cases was extracted.A standardized medical record database was established.Data mining methods integrated by Ancient and Modern Consilia Cloud Platform,including frequency statistics,TCM attribute analysis,cluster analysis,and complex network,were used to analyze the herb medicine frequency,properties,combination,core prescriptions and so on.Results Two hundred and twenty two prescriptions were included,involving 218 kinds of herb medicine.Uncaria,Achyranthes bidentata,Salvia miltiorrhiza,Gastrodia elata and Poria cocos were used more frequently.The tastes was neutral,slight cold,cold,sweet taste,and bitter taste.Their channel tropisms mainly belong to liver and kidney.The main functions were strengthening muscles and bones,nourishing liver and kidney,calming liver Yang,clearing heat and cooling blood.The medicine combinations with high frequency were Gastrodia elata-Uncaria,Uncaria-Gastrodia ecata,Achyranthes bidentata-Uncaria,and so on.The medicine could be divided into four categories by cluster analysis:clearing heat and smoothing liver,promoting qi and blood circulation,strengthening spleen and eliminating dampness,nourishing liver and kidney,and so on.The core prescriptions analyzed by complex network were Uncaria,Gastrodia elata,Achyranthes bidentata,Salvia miltiorrhiza,Paeonia lactiflora,Raw rehmannia,Chuanxiong Rhizoma,Chrysanthemum,Alisma orientalis,Poria cocos,Liquorice,Prunella vulgaris.Conclusion Most of the medicine used for hypertension by contemporary TCM masters were neutral,slight cold,sweet and bitter.The main belonged meridians were liver meridian and kidney meridian.Most of the treatment methods are tonifying liver and kidney,strengthening muscles and bones,calming liver and latent Yang,clearing heat and cooling blood,with consideration to both appearance and essence.