基于数据挖掘的中医药治疗小儿肺炎的用药规律研究

Medication Rules of Traditional Chinese Medicine in the Treatment of Pediatric Pneumonia Based on Data Mining

背景小儿肺炎是导致发展中国家儿童死亡的主要原因之一,西药治疗存在不良反应多、抗生素耐药性高、患儿依从性不佳等问题,而中医以辨证论治为原则治疗小儿肺炎常可获得满意疗效。因此,挖掘中医药治疗小儿肺炎的用药规律,总结治疗思路和方法十分必要。目的运用中医传承辅助平台(V2.5)软件分析中医药治疗小儿肺炎的用药规律,挖掘有效的药物组合及潜在新方组合和药物,以为小儿肺炎的临床治疗和遣方用药提供新思路。方法计算机检索中国知网(CNKI)收录的中医药治疗小儿肺炎的相关文献。检索时限为2009—2019年。将筛选后的方剂信息录入中医传承辅助平台(V2.5)软件以建立方剂数据库,分析小儿肺炎方剂中药物的用药频次、性味归经,小儿肺炎方剂的组方规律、核心组合,并挖掘潜在新方组合及药物。结果最终检索文献274篇,涉及方剂294首,中药201味,以寒性药(占43.50%)、苦味药(占37.51%)、入肺经(占32.87%)的药物为主,累计使用频次≥50次的药物有18味,而使用最多的两类药物分别是化痰止咳平喘药(占33.71%)、清热药(占21.41%)。利用中医传承辅助平台(V2.5)软件分析获得小儿肺炎方剂常用药物组合22组,配伍规则21组,核心药物10味,并挖掘出小儿肺炎方剂核心组合28组,潜在新方组合14组。结论基于数据挖掘的方法,运用中医传承辅助平台分析得出中医药治疗小儿肺炎的用药规律,明确了小儿肺炎病位在肺,病机为痰热,治疗应以苦寒、入肺经药物为主,因此治疗方剂以清热化痰、宣肺开闭为主。

Background Pediatric pneumonia is one of the causes of death among children in developing countries.In terms of treatment,western medicine has some problems such as many side effects,high antibiotic resistance,poor patient compliance and so on.However,traditional Chinese medicine(TCM)in the treatment of pediatric pneumonia takes syndrome differentiation as the principle,which can often obtain satisfactory curative effect.Thus,it is necessary to excavat the medication rules and summarize the treatment thoughts and methods of TCM in the treatment of pediatric pneumonia.Objective To provide new ideas for the clinical treatment and prescription of pediatric pneumonia by exploring the TCM prescription rules,discovering effective and potential drug combinations or drugs via the TCM inheritance support system software of version 2.5(TCMISS V2.5).Methods In this data mining study,we used the computer to search literatures about the TCM treatment in pediatric pneumonia included CNKI(time limitation:2009—2019).Input the screened information into the TCMISS V2.5 to establish the database.Analyze the frequency,the nature and flavour of the drugs and find the prescription rules,core and potential combinations of the prescription for pediatric pneumonia.Results After the computer analysis,274 literatures were searched,involved 294 prescriptions and 201 Chinese herbal medicines,including cold drugs(43.50%),bitter drugs(37.51%)and lung meridian(32.87%).There were 18 drugs used more than 50 times,and 2 most frequently used drugs were expectorant cough suppressant and anti-asthmatic drugs(33.71%)and heat-clearing drugs(21.41%).By using TCMISS V2.5,we obtained 22 commonly used drug combinations,21 compatibility rules and 10 core drugs,and excavated 28 core drug combinations and 14 potential new prescription combinations.Conclusion Based on data mining method,used TCMISS to analyze and obtain the medication rules of TCM in the treatment of pediatric pneumonia.Pediatric pneumonia is located in the lung,the pathogenesis is phlegm-heat,the treatment should be based on bitter cold and lung meridian drugs.Therefore,the prescriptions in the treatment of pediatric pneumonia are mainly removing heat-phlegm and facilitating lung.