基于数据挖掘分析李宜瑞教授治疗儿童多动症的用药规律

Analysis of medication rules of professor LI Yirui in the treatment of children with attention deficit hyperactivity disorder based on data mining

目的分析李宜瑞教授治疗儿童多动症的组方用药规律。方法选取2017年9月至2019年12月广州中医药大学第一附属医院李宜瑞教授专家门诊确诊为儿童多动症患儿的处方共85首,利用Excel、SPSS Modeler 14.1、SPSS Statistics 26.0软件,采用频数统计、关联规则、因子分析及聚类分析方法,分析处方中的药物使用频数、药性、药味、药物归经、高频药物用量情况、常用药对等。结果64味药物中使用频数最高的前8位药物为石菖蒲、远志、龙骨、茯苓、太子参、合欢皮、白术、浮小麦;药物归心、肝、脾经最多;药性以平、温为主;药味以甘、苦居多;得到茯苓-龙骨、龙骨-茯苓、白术-太子参等1700个较高关联性药对;提取了7个公因子,其中因子贡献率最高的是酒萸肉、熟地黄、醋龟甲;通过聚类分析,得到6类药物,其中类1(石菖蒲、远志、龙骨、茯苓、太子参、合欢皮、白术)使用频率最高。结论结合小儿特殊生理病理特点,李宜瑞教授治疗儿童多动症以攻补兼施、标本兼治、补泻并用、补而不滞为特点。

Objective To analyze composing prescription and medication rules of professor LI Yirui in the treatment of children with attention deficit hyperactivity disorder(ADHD).Methods From September 2017 to December 2019,85 prescriptions of children with ADHD confirmedly diagnosed by professor Li Yirui in specialist clinic of the First Affiliated Hospital of Guangzhou University of Chinese Medicine were selected,Excel,SPSS Modeler 14.1,SPSS Statistics 26.0 software,frequency statistics,association rule,factor analysis and clustering analysis method were used to analyze medicinal use frequency,medicinal property,medicinal flavors,meridian tropism of medicinals,usage of high frequency medicinals,commonly used couplet medicinals.Results Among the 64 flavors of medicinals,the top 8 most frequently used medicinals were Acori tatarinowii rhizoma,Polygalae radix,Draconis Os,Poria,Pseudostellariae radix,Albiziae cortex,Atractylodis macrocephalae rhizoma and Tritici Levis fructus.The uppermost meridian tropism were heart meridian,liver meridian and spleen meridian.Herbs of mild and warming property predominated in medicinal property.Sweet taste and bitter taste took the majority of medicinal flavors.Totally 1,700 couplet medicinals with higher association were obtained,namely Poria-Draconis Os,Draconis Os-Poria,Atractylodis macrocephalae rhizoma-Pseudostellariae radix,etc.Seven common factors were extracted,among which the highest factor contribution rate were Corni fructus Vinum,rehmanniae radix praeparata and Testudinis carapax et plastrum Acetum.By cluster analysis,six types of medicinals were obtained,among which the first type(Acori tatarinowii rhizoma,Polygalae radix,Draconis Os,Poria,Pseudostellariae radix,Albiziae cortex,Atractylodis macrocephalae rhizoma)was the most frequently used.Conclusion Combined with the special physiological and pathological characteristics of children,professor LI Yirui treats children with ADHD by simultaneous application of purging and nourishing therapeusis,simultaneous treatment of the symptoms and cause,simultaneous application of reinforcing and reducing therapeusis and nourishing without causing stagnation.