基于关联规则和复杂系统熵聚类探析门氏杂病流派治疗原发性痛经用药规律

Study on the Regularity of the Men’s miscellaneous disease genre’s in the Treatment of Primary Dysmenorrhea Based on Association Rules and Complex System Entropy Clustering Analysis

目的基于中医传承辅助系统(V2.5)软件,探析门氏杂病流派代表性传承人门九章教授治疗原发性痛经(Primary Dysmenorrhea,PD)的处方用药规律。方法收集2017年11月—2018年11月期间就诊于山西中医药大学附属医院国医堂门九章处的PD患者128例,录入"中医传承辅助系统(V2.5)",利用该软件的集成规则分析、改进的互信息法、复杂系统熵聚类、无监督的熵层次聚类、四气五味归经数据分析等方法,分析挖掘门九章教授治疗PD的用药规律。结果对筛选出的152个处方进行数据分析,明确药物使用频次(频次≥10次的药味有19味,其中怀牛膝、白芍、当归的用药频次均>100次)、用方频次(排前三位的方为自拟门氏养荣汤、香砂六君子汤、逍遥散)、药物间的关联规则(药物组合频次在76次以上26组)、核心药物组合深入分析(通过高频次药物及核心药物组合分析,出现四物汤加怀牛膝、牡丹皮、桂枝的药物组合)提取三味、四味隐性核心药物组合各8个,挖掘分析得到治疗PD新方3个。门九章教授治疗PD使用药物四气所占比:温55.60%,寒21.60%,平19.86%,凉1.19%,热1.75%;五味占比:甘32.85%,辛30.32%,苦25.24%,酸10.49%,涩0.57%,咸0.53%;归经占比:脾22.14%,肝18.36%,心14.89%,肾12.91%,胃10.78%,肺10.57%,胆4.75%,膀胱3.17%,大肠1.61%,三焦0.82%,即位于前四位的归经为:脾、肝、心、肾。结论门氏杂病流派治疗原发性痛经时以血分为本,同调脾胃,并兼以疏肝、养心、益肾。

Objective Based on the TCM Inheritance Assistant System(V2.5)software,this paper aims to explore the prescription drug rule of Professor Men Jiuzhang,a representative inheritor of The Men’s miscellaneous disease genre,for the treatment of Primary Dysmenorrhea(PD).Methods Collected 128 PD patients who were admitted to the Jiuzhang Department of the Chinese Medicine Hall of the Affiliated Hospital of Shanxi University of Traditional Chinese Medicine from November 2017 to November 2018,and entered the"Traditional Chinese Medicine Inheritance Assistant System(V2.5)".Analyzing the integration rules of the software,improved mutual information method,complex system entropy clustering,unsupervised entropy hierarchical clustering,four-qi five-flavor return data analysis and other methods to analyze and excavate Professor Men Jiuzhang’s medication rules for the treatment of PD.Results Data analysis of the 152 selected prescriptions was carried out to determine the frequency of drug use(19 flavors with frequency≥10 times,among which the frequency of use of Achyranthes bidentata,raw white peony,and Chinese angelica were all>100 times),prescription frequency(The top three prescriptions are self-made Yangrong Decoction,Xiangsha Liujunzi Decoction,Xiaoyao San),drug association rules(there are 26 groups for drug combination frequency more than 76 times),core drug combination in-depth analysis(through high frequency Analysis of secondary drugs and core drug combinations showed that the drug combination of Siwu Decoction plus Achyranthes bidentata,Moutan Bark,and Guizhi)extracts 8 three-flavored and four-flavored hidden core drug combinations,and excavated and analyzed 3 new prescriptions for the treatment of PD.And the proportion of the four Qi used by Professor Jiuzhang to treat PD:warm(55.60%),cold(21.60%),flat(19.86%),cold(1.19%),and hot(1.75%).Five flavors were sweet(32.85%),pungent(30.32%),bitter(25.24%),acid(10.49%),astringent(0.57%),and salty(0.53%).The proportion of menstruation were spleen(22.14%),liver(18.36%),heart(14.89%),kidney(12.91%),stomach(10.78%),lung(10.57%),bile(4.75%),bladder(3.17%),large intestine(1.61%),and triple focus(0.82%).The first four meridians are:spleen,liver,heart,and kidney.Conclusion In the treatment of primary dysmenorrhea,the Men’s miscellaneous disease genre uses blood as the basis for the treatment of primary dysmenorrhea,coordinating the spleen and stomach,and simultaneously soothes the liver,nourishes the heart,and nourishes the kidney.The treatment of this disease has been extensively tested,and its clinical experience is worthy of clinical application.