基于数据挖掘探析现代医家治疗过敏性鼻炎的用药规律

Explore the Regularity of Medication by Contemporary Doctors on Treating Allergic Rhinitis Based on Data Mining

目的:探析现代医家诊疗过敏性鼻炎的用药规律,为中医临床治疗过敏性鼻炎提供启发。方法:搜集并筛选中国知网、万方数据知识服务平台、维普期刊资源整合服务平台建库以来至2020年6月30日现代医家诊治过敏性鼻炎的相关文献资料,规范证候类型与药物名称,应用古今医案云平台(V2.1)对其中所载过敏性鼻炎证候类型与方剂药物进行描述性统计分析、聚类分析与关联规则分析。结果:纳入符合要求的文献183篇,涉及现代医家122人,包含主要中医证候类型17种、治法27种、方剂18首,所有文献共涉及中药237味,用药频次3136次,药物药性以温为主,药味以辛、甘为主,多归于肺、脾、胃经。聚类分析显示常用药物可分为6类,关联规则分析显示黄芪、白术、防风、辛夷具有显著相关性。结论:现代医家所诊过敏性鼻炎主要涉及肺脾气虚证、风寒犯肺证、肺阳虚证和卫表失固证等证候,治疗强调益气健脾、补肺固表以通利鼻窍,重视解表药和补虚药的使用,亦根据不同病机与证候,兼施温阳、化湿、清热、活血之品,体现了中医扶正祛邪、辨证论治的理念。

Objective:To explore the regularity of medication by contemporary doctors on treating allergic rhinitis(AR),so as to provide an idea for the clinical treatment of AR by traditional Chinese medicine(TCM).Methods:Literature on contemporary doctors treating AR was searched and retrieved from databases including China National Knowledge Infrastructure(CNKI),Wanfang Database Knowledge Service Platform(WF),Weipu Journal Resource Integration Service Platform(VIP)from the inception to June 302020.The nomenclature of syndromes and medicinals were standardized,and were analyzed through descriptive statistical analysis,hierarchical cluster analysis and association rules analysis based on Cloud Platform of Ancient and Modern Medical Case(V2.1).Results:A total of 183 articles were included,involving 122 contemporary doctors,237 medicinals with total frequency of 3136,mainly 17 TCM syndromes,27 treatments,18 TCM formulas.The medicinals are mainly warm in nature,and are pungent and sweet in taste,usually entering lung,spleen and stomach meridians.Hierarchical cluster analysis showed that commonly used medicinals could be divided into 6 categories.Association rules analysis showed that Huangqi(Astragali Radix),Baizhu(Atractylodis Macrocephalae Rhizoma),Fangfeng(Saposhnikoviae Radix),Xinyi(Magnoliae Flos)had significant correlation.Conclusions:The AR treated by contemporary doctors mainly involves deficiency of lung and spleen qi,wind cold attacking lung,deficiency of lung yang and insecurity of defensive qi.Doctors mainly use replenishing qi and invigorating spleen,tonifying lung and consolidating superficies to unblock nasal passage,pay attention to the use of superficies-releasing medicinal and tonics.They also use medicinals for warming yang,resolving dampness,clearing heat and activating blood circulation according to different disease mechanism and syndrome,which reflected treatment concept of TCM,strengthening healthy qi to eliminate pathogens as well as syndrome differentiation and treatment.