基于数据挖掘分析叶天士治疗痰饮病的用药规律

Analysis of Ye Tianshi’s Medication Rules for Treating Phlegm Diseases Based on Data Mining

目的通过描述性统计分析、关联规则算法和聚类分析等方法挖掘叶天士治疗痰饮病的临证用药规律,为临床辨证论治提供新思路。方法搜集整理叶天士所著《临证指南医案》中治疗痰饮病全部医案,采用IBM SPSS 23.0软件对其处方用药进行描述性统计分析,并对高频药物进行关联规则算法和聚类分析。结果纳入69个医案,涉及75味药物(剔除炒川椒、鱼胶、青盐),共用药566频次。高频药物有茯苓、桂枝、半夏、生姜、大枣,用药重在燥湿健脾、益气化痰、利水渗湿。挖掘得到关联规则药物组合18组。聚类药物组合6组。结论叶氏临证辨治痰饮病尤重肺、脾、心、肾,多以温药平补脏腑之阳气以消痰化饮,利水渗湿药以祛痰消饮,急则治标,祛壅滞之痰饮,缓则治本,温补脾肾之阳气,标本兼施,则痰饮自愈。

Objective To introduce new ideas to clinical differentiation of syndrome based on the regularity of drug using by Ye Tianshi in treating the disease of retention of phlegm and fluid explored with descriptive statistics,association rules,clustering analysis and other methods.Method All medical cases of the disease of retention of phlegm and fluid in A Guide to Clinical Practice with Medical Record written by Ye Tianshi were collected,prescriptions of which then studied with descriptive statistical analysis in IBM SPSS 23.0,and high-frequency drugs with the algorithm of association rules and clustering analysis.Results 69 medical records were included,involving 75 drugs(excluding fried Sichuan pepper,isinglass,and green salt),and the frequency of sharing drugs was 566.High-frequency medicines include Poria,Guizhi,Pinellia,Ginger,and Jujube.The focus of the medicine is to dry dampness and invigorate the spleen,invigorate qi and resolve phlegm,and promote dampness.18 drug combinations were explored under the association rules.6 combinations were obtained under clustering analysis.Conclusion Ye’s clinical diagnosis and treatment of the disease of retention of phlegm and fluid emphasizes the lungs,the spleen,the heart and the kidney,and often clears away phlegm and fluid retention with yang-energy tonifying mild drugs and damp-draining and diuretic drugs.It applies symptomatic treatment in acute conditions to remove the stagnant phlegm and fluid,and radical treatment in chronic cases,warming and tonifying the yang energy of the kidney and spleen.Address both the symptoms and root cause of the disease and the retention of phlegm and fluid will repair itself.