数据挖掘法探讨胃炎与胃癌用药规律及经验总结

Experience Summary and Medication Regularity of Gastritis and Gastric Cancer with Traditional Chinese Medicine

目的数据挖掘法,浅析吴勉华老师"和胃健中、调畅气机"治疗慢性胃炎及"攻补兼施、通降为顺"治疗胃癌用药规律,并行相关经验总结。方法筛选2017年8月—2018年8月跟师收集治疗慢性胃炎与胃癌的有效方剂,运用"中医传承辅助系统(V2.50)",行方剂数据挖掘、用药规律分析。结果慢性胃炎组入方剂165首,胃癌组入76首,总结两组处方用药规律,得出两组用药均随疾病的不同转归及演变而变换。结论根据临床用药规律,结合疾病的关联性及特殊性可见"和胃健中、调畅气机"贯穿于慢性胃炎与胃癌不同治疗阶段;而胃癌用药规律在此基础上,则据疾病所处不同阶段对"攻""补"进行主次分配,手术阶段以补脾益胃、调补气阴之"补"法为主,化疗期间以运脾和胃、通降清解、活血散瘀之"攻""补"同用偏重于"补",后期巩固则据患者体质及病机给予"攻补兼施""消癌解毒"之调护,以达到改善临床不适症状、延长生存周期的目的。

Objective By using the method of data mining,to analyze WU Mianhua′s medication for treating gastric cancer with the method of harmonizing stomach and strengthening the middle and regulating Qi and summarize the relevant experience.Methods The effective prescriptions for the treatment of chronic gastritis and gastric cancer of WU Mianhua were collected from August 2017 to August 2018,and we made the data mining and medication regularity by using "traditional Chinese medicine inheritance auxiliary system(V2.50)".Results Chronic gastritis group included 165 prescriptions and gastric cancer group included 76 prescriptions.We summed up the two groups′ prescriptions medication regularity.Two groups′ medication was accompanied by different prognosis and evolution of the disease.Conclusion According to the rule of clinical medication and the correlation and particularity of the disease,it can be seen that the method of harmonizing stomach and strengthening the middle and regulating Qi can be used in different stages of treatment of chronic gastritis and gastric cancer.On the basis of the medication rule of gastric cancer,"purging" and "tonifying" methods should be allocated according to the different stages of the disease,and "tonifying" method should be used in the operative stage to supplement spleen."Tonifying" method of stomach and regulating Qi and Yin is the main method.During chemotherapy,the activating spleen and harmonizing stomach method,dredging-descending-clearing-reliving method and activating blood and resolving blood stasis method are more important than "tonifying" method.In later consolidation period,according to the patient′s constitution and pathogenesis,purging-tonifying method and eliminating cancer and resolving toxin method are given to improve clinical symptoms and prolong the survival cycle period.