基于数据挖掘“疫”病方剂用药规律对新型冠状病毒肺炎防治的用药启发

Medication Rules Study of Prescription for Yi (Pestilence) Disease on Prevention and Treatment of COVID-19 Based on Data Mining

目的:基于数据挖掘技术探究中药复方治疗"疫"病的用药规律,为新型冠状病毒肺炎的防治提供中药配伍的用药启发。方法:以《中国方剂数据库》为检索库,检索治疗"疫"病的中药方剂,筛选中药复方治疗疫证方剂数据库,并采用Excel 2013,SPSS 21.0及SPSS Modeler 18.0等软件进行频数及频率分析、主成分分析、聚类分析、关联分析、相关性分析等,进而对中药复方用药规律进行定量、定性分析。结果:共收集治疗"疫"病方剂177首,对古代方剂功效主治分析发现,"疫"病方剂主要用于头痛、发热、咳嗽、腹泻等临床情况与新型冠状病毒感染所致的肺炎症状相似,具有参考意义。其中,复方多见于汤、散、丸、丹等剂型;高频中药54味,甘草、半夏、陈皮、白芍、藿香等中药较为常用;且新型冠状病毒肺炎诊疗各阶段推荐处方中高频药物的数量分布频率较高;177首方剂含有药物数量集中在4味~11味之间,而方剂中含有高频率药物集中在3味~8味之间;解表药、清热药、补虚药最常选用;四气以温、微寒、寒为主,五味以辛、苦、甘为主,归经以归肺经、脾经、胃经、肝经为主;主成分分析提取了18个公因子,累积贡献率达69.04%,结果显示以厚朴、藿香、羌活、陈皮、白芷等药为主;聚类分析结果显示分为5类;关联分析共得到34条关联规则,药对以厚朴→甘草、麝香→冰片、白芍→半夏等为常用,三味药组以厚朴+陈皮→甘草,厚朴+苍术→甘草,厚朴+藿香→甘草等为常用。相关分析有显著意义的共410个药对,分别为连翘+天花粉(0.75)、雄黄+朱砂(0.72)、玄参+天花粉(0.71)正相关最显著。结论:古代治疗"疫"病多用温、寒,辛、苦、甘味药,从肺脾胃入手,以祛邪扶正为主要治则,多采用解表散寒、清热解毒结合温阳益气,滋阴养血、化痰止咳、行气活血等方法选取相应中药组方治疗。

Objective: Based on data mining technology, to explore the medication rules of traditional Chinese medicine compound in the treatment of "Yi(Pestilence)" disease, to provide a reference of prevention and treatment for Corona Virus Disease 2019(COVID-19) with traditional Chinese medicine(TCM) compatibility. Methods: The Chinese prescription database was taken as the retrieval database, and searched for the traditional Chinese medicine(TCM) prescription for treating "Yi" syndrome. Excel 2013, SPSS 21.0 and SPSS Modeler18.0 software were used for frequency analysis, principal component analysis, cluster analysis and correlation analysis, etc. Furthermore, quantitative and qualitative analysis was carried out to study the medication rules and its possible mechanism. Results: 177 TCM compounds for pestilence were screened. Analysis of TCM compounds efficacy showed that the formulae for "Yi" syndrome were mainly used for headache, fever, cough, diarrhea and other similar symptoms, and was a reference for pneumonia symptoms caused by COVID-19 infection. Among them, the compounds preparations were mainly decoction, powder, pill, pellet and other types. 54 herbs with high frequency were found, such as Liquorice, pinellia, tangerine peel, white peony, Huoxiang. The number and distribution frequency of these high-frequency drugs in the recommended prescriptions in the treatment of each stage of COVID-19 from Diagnosis and Treatment Protocol for COVID-19 were found high. In 177 prescriptions, the number of drugs for the "Yi" formulae was mostly between 4 and 11, while the number of high frequency drugs for the "Yi" formula was between 3 and 8. The most commonly used drugs were Jiebiao, Qingre and Buxu drugs, the main drug properties were Wen, Weihan and Han, the main tastes were Xin, Ku and Gan, the main tropism channel were lung, spleen, stomach and liver. In principal component analysis, 18 common factors were extracted, and the cumulative contribution rate was 69.038%, principal drugs were mainly Magnolia officinalis, Agastache, Notopterygium, Tangerine peel, Angelica dahurica and so on. Cluster analysis results showed 5 clusters. In association analysis, 34 association rules were obtained. In drug pairs, Magnolia officinalis-liquorice, musk-borneol and Paeonia alba-pinellia were commonly used, while in three drug groups, Magnolia + Tangerine peel→Liquorice, Magnolia + Atractylodes Rhizoma→Liquorice and Magnolia + Patchouli→Liquorice were mostly used. 410 drug pairs with significant positive correlation were found, the pairs with highest significant positive correlation were Forsythia + Smallpox(0.75), Realgar + Cinnabar(0.72) and Figwort + Smallpox(0.71). Conclusion: In ancient times, TCM drugs treating "Yi" syndrome were mainly Xinwen, Ku and Ganhan drugs, the main tropism channel were lung, spleen and stomach, the main treatment principle was Quxiefuzheng, and the therapy methods, Jiebiaosanhan, Qingrenjiedu combined with Wenyangyiqi, Ziyinyangxue, Huatanzhike, Xingqihuoxue, etc. also were performed.