基于数据挖掘探讨许芝银教授辨治非甲亢期桥本氏甲状腺炎用药规律

Discussion on the Medication Law of Xu Zhiyin in the Treatment of Non-hyperthyroidism Stage of Hashimoto Thyroiditis Base on Data Mining Method

目的基于数据挖掘技术探究许芝银教授辨治桥本氏甲状腺炎非甲亢期的临床用药规律。方法整理筛选出许芝银教授辨治桥本甲状腺炎非甲亢期的238首处方,根据《中华人民共和国药典》《中药别名大辞典》进行药物名称的规范化统一,运用Microsoft Excel 2010构建许教授临床用药数据库,并结合数据挖掘方法,对其辨治桥本甲状腺炎非甲亢期的病机特点、治则治法、临证方案加以总结。结果许芝银教授治疗桥本甲状腺炎非甲亢期的有效处方中,共统计出使用药物156味、用药频数3927次;使用频数≥20次的32味药物中使用频数前6味药物依次是:牡丹皮、赤芍、甘草、半夏、茯苓、陈皮;156味常用药物中药性多温、平,药味多偏甘、苦、辛,归经多属肝、肺、肾经;使用频数≥25次的25味药物系统聚类聚类,结果分别是:G1:茯苓、党参、甘草;G2:附子、半夏;G3:陈皮、白术、麻黄;G4:赤芍、青皮、夏枯草、牡丹皮、郁金;G5:姜黄、续断、地黄;G6:丹参、桃仁、桑寄生;G7:雷公藤、白芍;G8:鹿角、皂角刺、桂枝、当归;药物二项关联度最强的前6组药对为:牡丹皮-赤芍、牡丹皮-白芍、半夏-陈皮、茯苓-陈皮、陈皮-郁金、牡丹皮-郁金;三项关联度最强的前4个组合为:牡丹皮配伍半夏+赤芍、牡丹皮配伍郁金+青皮、陈皮配伍茯苓+半夏、赤芍配伍白芍+茯苓。结论许芝银教授临证围绕疾病进展中病机之间的兼夹、复合、转化、演变,随症加减,其治疗非甲亢期桥本氏甲状腺炎重视疏肝理气养阴以畅气机、健脾涤痰化浊以散瘀邪、温肾益气助阳以荣气血,改善了患者的生活质量,疗效肯定。

Objective Based on data mining method to explore Professor Xu Zhiyin’s clinical experience in the treatment of non-hyperthyroidism stage of Hashimoto thyroiditis.Methods A total of 238 effective prescriptions for treatment of non-hyperthyroidism stage of Hashimoto thyroiditis are sorted.According to the Pharmacopoeia of the People’ s Republic of China and the Synonym Dictionary of Chinese Herbs,the drug names are standardized and unified.The clinical drug database of Professor Xu is constructed by Microsoft Excel 2010,and the pathogenesis characteristics of Professor Xu’s treatment of non-hyperthyroidism stage of Hashimoto thyroiditis are analyzed with data mining method to sum up the treatment principles,treatment methods and clinical treatment plans.Results Professor Xu Zhiyin’s effective prescriptions for the treatment of Hashimoto’s thyroiditis in the non-hyperthyroid stage showed that 156 drugs were used and the frequency of use was 3927 times.Among the 32 drugs with a frequency of ≥20,the top 6 drugs were: Moutan cortex,Red peony,licorice,pinellia,poria,tangerine peel;156 commonly used medicines Chinese medicines are more warm and flat,and the tastes are mostly sweet,bitter,and pungent.The meridians are mostly liver,lung,and kidney meridians;25 flavors with frequency ≥25 The clustering results of the drug system are: G1: Poria,Codonopsis,Licorice;G2: Aconite,Pinellia ternata;G3: Tangerine peel,Atractylodes,Ephedra;G4: Red peony,green peel,Prunella vulgaris,Moutan peel,Turmeric;G5: Turmeric,Dipsacus,Rehmannia glutinosa;G6: Salvia miltiorrhiza,peach kernel,Morus sylvestris;G7: Tripterygium wilfordii,Radix Paeoniae Alba;G8: Antlers,Saponaria japonicus,Guizhi,Angelica;The first 6 groups of drugs with the strongest correlation between the two drugs Pairs are: Moutan bark-Red peony root,Moutan bark-White peony root,Pinellia-Tangerine peel,Poria-Tangerine peel,Tangerine peel-Turmeric,Moutan bark-Turmeric;the top 4 combinations with the strongest correlation among the three are: Mudan bark Compatible with Pinellia + red peony root,Mudanpi with turmeric +green peel,tangerine peel with Poria + Pinellia,red peony with white peony + Poria.Conclusion Professor Xu Zhiyin’ s clinical syndrome focuses on the combination,compounding,transformation,and evolution of pathogenesis during the progression of the disease.The treatment of Hashimoto’ s thyroiditis in the non-hyperthyroid stage emphasizes soothing the liver,regulating qi and nourishing yin,so as to promote vitality and health.The spleen purifies phlegm and turbidity to dissipate blood stasis and evils,warms the kidney and replenishes qi to boost yang and promotes qi and blood,which improves the patient’s quality of life and has a positive effect.