基于复杂网络的名老中医治疗肺癌用药个性化差异比较

Comparative Study on the Medication Characteristics of Well-Known Veteran Traditional Chinese Medicine Doctors in the Treatment of Lung Cancer Based on Complex Networks Algorithm

目的基于复杂网络算法对周仲瑛教授和赵景芳教授治疗肺癌辨证用药的个性差异进行比较,为总结与传承名老中医临床经验提供新的研究思路与数据支撑。方法采集周仲瑛教授和赵景芳教授治疗肺癌的门诊电子病历,借助复杂网络算法对两位名老中医的病历数据构建“证-证”和“证-药”复杂网络图谱,以分析两者肺癌辨证用药经验的个性化差异。结果通过分析复杂网络图谱,发现两位名老中医对肺癌的辨证均有气阴两虚证,不同之处为周仲瑛教授还有痰瘀郁肺、热毒痰瘀、癌毒走注、痰瘀互结等证的辨证;而赵景芳教授常辨证型为肺脾气虚、痰热蕴肺、脾虚痰湿、肝郁脾虚等证。周仲瑛教授治疗肺癌的常用药物有北沙参、南沙参、麦冬、山慈菇、泽漆、太子参、仙鹤草、猫爪草、白花蛇舌草、炙僵蚕等;而赵景芳教授常用药物为党参、炒白术、制半夏、茯苓、太子参、南沙参、北沙参、陈皮、薏苡仁、猪苓、谷芽、麦芽、炙枇杷叶等。结论周仲瑛教授辨治肺癌从癌毒学说出发,强调癌毒的辨治;赵景芳教授辨治肺癌基于微调平衡理论,以培土生金法为治疗肺癌的主要治法。

OBJECTIVE To compare the characteristics of medication based on syndrome differentiation in the treatment of lung cancer between Professor Zhou Zhongying(Professor Zhou)and Professor Zhao Jingfang(Professor Zhao)by complex network algorithm,and to provide a new research idea and data for summarizing and inheriting the clinical experience of well-known veteran traditional Chinese medicine(TCM)doctors.METHODS The lung cancer outpatient electronic medical records diagnosed by Professor Zhou and Professor Zhao were collected,and the complex network algorithm was applied to construct"syndrome-syndrome"and"syndrome-medication"complex network maps based on the two doctors'medical records,so as to analyze the individualized differences between their experience in medication based on syndrome differentiation of lung cancer.RESULTS Through the analysis of the complex network map,it was found that the syndromes of lung cancer identified by the two doctors both included deficiency of qi and yin.As for the differences,Professor Zhou identified syndromes as phlegm stagnation and lung constraint,heat toxin and phlegm stagnation,spreading of cancerous toxin,as well as binding of phlegm and stasis,while Professor Zhao identified syndromes as deficiency of lung and spleen qi,phlegm-heat accumulation in lung,spleen deficiency and phlegm dampness,along with liver constraint and spleen deficiency.The medications commonly used by Professor Zhou in treating lung cancer included Glehniae Radix,Adenophorae Radix,Ophiopogonis Radix,Cremastrae Pseudobulbus Pleiones Pseudobulbus,Herba Euphorbiae Helioscopiae,Pseudostellariae Radix,Agrimoniae Herba,Ranunculi Ternati Radix,Hedyotis diffusa Willd,and processed Bombyx Batryticatus,while Professor Zhao commonly used Codonopsis Radix,stir-fried Atractylodis Macrocephalae Rhizoma,processed Pinelliae Rhizoma,Poria,Pseudostellariae Radix,Adenophorae Radix,Glehniae Radix,Citri Reticulatae Pericarpium,Coicis Semen,Polyporus,Setariae Fructus Germinatus,Hordei Fructus Germinatus,and honeyed Eriobotryae Folium.CONCLUSION Treatment of lung cancer from Professor Zhou is based on the cancerous toxin theory,and he emphasizes treatment based on syndrome differentiation of cancerous toxin,while treatment of lung cancer from Professor Zhao is based on the theory of maintaining balance with the moderate regulation,and her main treatment method is banking up earth to generate metal.