基于数据挖掘的慢性阻塞性肺疾病复方用药规律

Research On The Rules Of Clinical Compound Medication For Chronic Obstructive Pulmonary Disease Based On Data Mining

目的通过运用数据挖掘方法对临床中药复方治疗慢性阻塞性肺疾病(COPD)病例进行归纳分析,总结东直门医院呼吸科病房辨证论治COPD的分型证治方案。方法通过制定COPD的诊断及分期、中医证候、病例纳入及排除等相关标准,整理2018年9月—2019年9月东直门医院呼吸科病房诊治的COPD病例,利用SAS 9.4软件平台进行数据规范,运用频数分布、症状因子分析、中药因子分析等技术,总结出各证型常用方剂及中药。结果症状因子分析结果显示,急性加重期可分为5种基本证候,缓解期分为3种基本证型。中药因子分析提示,临床常用治疗COPD的药物可分为6类。外寒内饮证主方为小青龙汤;气虚外感证主方为参苏饮;风寒袭肺证主方为荆防达表汤;痰热郁肺证主方为千金苇茎汤;痰瘀内阻证主方为血府逐瘀汤;阳虚水泛证主方以真武汤为主;肺阴亏耗证主方为沙参麦冬汤;上盛下虚证主方为苏子降气汤。结论中医药治疗COPD有着丰富的临床经验,通过深入挖掘临床治疗的证治规律,以利于指导临床辨证分型及立法处方。

Objective Through the use of data mining methods to summarize and analyze the clinical cases,summarize the syndrome differentiation and treatment of chronic obstructive pulmonary disease(COPD)in the respiratory ward of Dongzhimen Hospital.Methods By formulating relevant standards for the diagnosis and staging of chronic obstructive pulmonary disease,TCM syndrome diagnosis,case inclusion,case exclusion,etc.,the COPD medical records diagnosed and treated in the respiratory ward of Dongzhimen Hospital from 2018 to 2019 were sorted out using SAS9.4 software platform.Standardize data,establish a database,and use techniques such as frequency distribution,symptom factor analysis,and traditional Chinese medicine factor analysis to summarize commonly used prescriptions and traditional Chinese medicines for each syndrome type.Results The result of symptom factor analysis shows that the acute exacerbation of COPD in clinical practice can be divided into 5 basic syndromes,and the remission stage is divided into 3 basic syndromes.Factor analysis of traditional Chinese medicine suggests that the drugs commonly used in clinical treatment of COPD can be divided into 6 categories.The main prescription for the syndrome of external cold and internal drinking is Xiaoqinglong Decoction;the main prescription for the syndrome of qi deficiency and exogenous induction is Shensu drink;the main prescription for the syndrome of wind-cold attacking the lung is Jingfang Dabiao Decoction;the main prescription for the syndrome of phlegm-heat stagnation is Qianjin Weijing Decoction;the main prescription of phlegm and stasis internal resistance syndrome is Xuefu Zhuyu Decoction.Zhenwu decoction is the main prescription of Yang deficiency and water pan-syndrome;the main prescription of Lung Yin deficiency syndrome is Adenophora Radix Ophiopogon Decoction;the main prescription of upper and lower deficiency syndrome is Suzi Jiangqi Decoction.Conclusion Traditional Chinese medicine has a wealth of clinical experience in the treatment of COPD.Through in-depth exploration of the rules of clinical treatment,it is helpful to guide clinical syndrome differentiation and legislative prescriptions.