基于中医传承辅助平台米烈汉教授治疗瘿病用药规律分析

Analysis of the medication rule of professor Mi Liehan in the treatment of gall disease based on the auxiliary platform of traditional Chinese medicine inheritance

目的基于中医传承辅助平台管理系统(V2.5)探讨总结米烈汉教授诊治瘿病的特色用药规律。方法收集2017年1月1日至2018年12月31日米烈汉教授门诊中医诊断为瘿病的医案,运用中医传承辅助平台进行数据录入,采用聚类分析、关联规则分析、复杂系统熵聚类、无监督的熵层次聚类等数据挖掘方法,统计得出中药应用特点和组方规律分析结果。双人筛选并录入信息,构建米烈汉教授临证诊治瘿病的医案以及用药数据库,分析用药频次、药物四气五味、归经分布、组方规律及药物组合。结果共记录方剂93首,药物154味,其中位于前6位高频中药为柴胡、白芍、陈皮、川芎、枳壳、浙贝母。药物四气所占比例:寒性药物约为38.26%,温性药物约为36.98%,平性药物约为20.71%,凉性药物约为3.53%,热性药物约为0.53%;药物五味所占比例:苦味药约为37.75%,辛味药约为31.50%,甘味药约为22.20%,酸味药约为5.01%,咸味药约为2.04%,涩味药约为1.51%。中药归经频率>300的归经主要集中于足厥阴肝经、足太阴脾经、手少阴心经、手太阴肺经、足少阳胆经、足阳明胃经。中药药物组合分析结果显示使用频度≥50以上的共18个中药组合,药物组合的关联规则按照置信度由高到低,提取关联规则30条。基于熵聚类的潜在药物组合分析显示通过关联度高的药物组合,系统分析出潜在的多个药物组合共8组,基于复杂系统熵聚类共演化出4组新方。结论应用中医传承辅助平台软件进行米烈汉教授学术经验用药规律挖掘分析,可为治疗瘿病的临床应用、诊疗方案的完善和新药研发提供参考依据。

Objective To discusse and summarize the characteristic medication rules of professor Mi Liehan in the diagnosis and treatment of gall disease based on the auxiliary platform of traditional Chinese medicine inheritance management system(V2.5).Methods The medical records of gall disease diagnosed by professor Mi Liehan from January 1,2017 to December 31,2018 were collected.The auxiliary platform of traditional Chinese medicine inheritance was used for data input,and data mining methods such as cluster analysis,association rule analysis,complex system entropy clustering and unsupervised entropy hierarchical clustering were adopted,then statistical analysis results of application characteristics and formula rules of traditional Chinese medicine were obtained.Double screening and input information were used to construct the medical case and medication database for the diagnosis and treatment of gall diseases according to clinical syndrome by professor Mi Liehan,and then the frequency of medication,four Qi and five flavors of medicine,meridian distribution,prescription rule and drug combination were analyzed.Results A total of 93 prescriptions were recorded,including 154 drugs,among wihch the top six high-frequency Chinese medicine were Bupleurum,Radix Paeoniae Alba,Pericarpium Citri Reticulatae,Ligusticum chua nxiong Hort,Fructus aurantii Immaturus and Fritillaria thunbergii.The proportion of four Qi drugs:cold drugs were about 38.26%,warm drugs were about 36.98%,ordinary drugs were about 20.71%,cool drugs were about 3.53%,hot drugs were about 0.53%;the proportion of five flavors of drugs:bitter drugs were about 37.75%,acrid drugs were about 31.50%,sweet drugs were about 22.20%,sour drugs were about 5.01%,salty drugs were about 2.04%,astringent drugs were about 1.51%.The meridian tropism frequency of traditional Chinese Medicine>300 was mainly concentrated in the liver meridian of foot Jueyin,spleen meridian of foot Taiyin,heart meridian of hand Shaoyin,lung meridian of hand Taiyin,gallbladder channel of foot Shaoyang and stomach meridian of foot Yangming.The analysis results of combination of traditional Chinese medicine showed that there were 18 traditional Chinese medicine combinations with frequency≥50,and 30 association rules were extracted according to the confidence from high to low.The analysis of potential drug combinations based on entropy clustering showed that eight groups of potential drug combinations were systematically analyzed through high correlation drug combinations,and four groups of new prescriptions were evolved based on complex system entropy clustering.Conclusion The application of the auxiliary platform of traditional Chinese medicine inheritance to excavate and analyze the medication rules of professor Mi Liehan's academic experience can provide reference for the clinical application of gall disease treatment,the improvement of diagnosis and treatment scheme and the research and development of new drugs.