基于古今医案云平台的中医药治疗早期糖尿病肾病组方规律研究

Study on Medication Regularity of Traditional Chinese Medicine in Treatment of Diabetic Nephropathy Based on Ancient and Modern Medical Records Cloud Platform

目的基于古今医案云平台研究现代中医药治疗早期糖尿病肾病的用药规律,为临床治疗早期糖尿病肾病提供用药参考。方法通过计算机检索CNKI、万方、维普等数据库中早期糖尿病肾病现代文献的有效验案,经数据筛选、数据清洗、数据标准化处理等处理,建立标准化医案数据库,利用古今医案云平台进行频次统计、关联分析、聚类分析等数据分析方法,利用Gephi进行复杂网络分析、可视化展示,分析中医药治疗早期糖尿病肾病的用药频次、四气、五味、归经、核心处方等用药规律。结果共纳入112篇文献,包含150首方剂,包含271味中药,其中核心用药为六味地黄丸加减包含黄芪、茯苓、山药、泽泻、山萸肉等,药物多为甘平、甘温、苦寒之品,药物多入肝经、肾经、脾经。聚类结果包含7类,使用频次较高的药物组合包括黄芪—茯苓、黄芪—山药、山药—茯苓、山萸肉—黄芪、牡丹皮—茯苓等。结论通过数据挖掘的方法,总结出中医药治疗早期糖尿病肾病多用健脾益气、滋补肝肾之药补虚,同时兼顾活血化瘀、清热利湿治标,标本同治。

Objective Based on the Ancient and Modern Medical Records Cloud Platform,this article studied the rules of modern Chinese medicine in the treatment of early diabetic nephropathy,and provided a reference for clinical treatment of early diabetic nephropathy.Methods We retrieved valid records of traditional Chinese medicine in the treatment of diabetic nephropathy in the databases of CNKI,Wanfang,Weipu and other databases by computer.After data screening,data cleaning,data standardization and other processing,we established a standardized medical records database and used the Ancient and Modern Medical Records Cloud Platform for frequency statistics,correlation analysis and cluster analysis.Gephi was used for complex network analysis and visual display to analyze the frequency,four natures,five tastes,channel tropism,and core prescription of traditional Chinese medicine for the treatment of early diabetic nephropathy.Results A total of 112 pieces of literature were included,including 150 prescriptions,271 kinds of traditional Chinese drugs.The core prescription was Liuwei Dihuang Pil(六味地黄丸),including Huangqi(Astragali Radix),Fuling(Poria),Shanyao(Dioscoreae Rhizoma),Zexie(Alismatis Rhizoma)and Shanzhuyu(Corni Fructus).Most of the drugs had sweet-gentle,sweet-warm and bitter-cold natures and were mainly related to the liver,kidney and spleen meridians.The clustering results included 7 categories,and the drug combinations that were used more frequently included Huangqi(Astragali Radix)-Fuling(Poria),Huangqi(Astragali Radix)-Shanyao(Dioscoreae Rhizoma),Shanyao(Dioscoreae Rhizoma)-Fuling(Poria),Shanzhuyu(Corni Fructus)-Huangqi(Astragali Radix),Mudanpi(Moutan Cortex)-Fuling(Poria),etc.Conclusion Through data mining methods,it is concluded that traditional Chinese medicine treats early diabetic nephropathy with multiple spleen and qi,and nourish liver and kidney,while taking into account promoting blood circulation,removing blood stasis,clearing heat and dampness,and treating the same symptoms.