基于循证策略结合中医临床实践老年人健脾养胃方的优化

Optimization of Spleen-invigorating and Stomach-nourishing Prescription for the Elderly Based on Evidence-based Strategy Combined with Traditional Chinese Medicine Clinical Practice

目的:基于循证策略结合中医临床实践优化老年人健脾养胃方,为老年脾胃疾病药食两用组方的开发提供科学依据。方法:采集《中医方剂大辞典》中的老年人健脾养胃方,统一并规范药物名称,筛选方剂,并将其录入中医传承辅助平台软件中。通过软件集成的改进互信息法,复杂系统熵聚类以及熵层次聚类等数据挖掘方法,分析老年人健脾养胃方的用药规律。结果:371首健脾养胃方中使用频次>20的药物共有40种,其中按照使用频次从高到低的顺序前十位依次为甘草、陈皮、白术、人参、木香、茯苓、厚朴、干姜、砂仁及青皮。采用关联规则挖掘法,设置支持度个数为20,置信度为0.6,获得常用药及组合20个,按照使用频率从高到低的顺序前十位分别为白术与甘草,人参与甘草,陈皮与甘草,人参与白术,甘草与茯苓,陈皮与白术,甘草与厚朴,白术与茯苓,人参与白术及甘草,人参与茯苓。采用软件集成的熵层次聚类分发,设置相关度为8,惩罚度为2,获得13个潜在新方。结论:老年人健脾养胃方喜用甘草、陈皮、白术及人参等中药,益气健脾、理气和胃为健脾养胃方核心机制。

Objective:To optimize the spleen-invigorating and stomach-nourishing prescription for the elderly based on evidence-based strategy and clinical practice of Traditional Chinese Medicine,and to provide scientific basis for the development of the combination of medicine and food for spleen-stomach diseases in the elderly.Methods:The spleen-invigorating and stomach-nourishing prescriptions for the elderly were collected from the Chinese Medicine Prescription Dictionary,the names of the medicines were unified and standardized,the prescriptions were screened and recorded into the software of the TCM inheritance assistance platform.Through the data mining methods such as improved mutual information method of software integration,entropy clustering of complex system and entropy hierarchy clustering,this paper analyzes the law of the prescription of invigorating spleen and nourishing stomach for the elderly.Results:There were 40 kinds of drugs that were used more than 20 times in 371 spleen-invigorating and wear-nourishing prescriptions,among which the top 10 were licorice root,tangerine peel,atractylodes atractylodes,ginseng,fructus xylosum,Poria cocos,magnolia officinalis,dried ginger,amomum amomum and green peel in order of frequency from high to low.Set up by using association rule mining method,support the number was 20,the confidence level is 0.6,commonly used medicines and combination of 20,according to the frequency order from high to low top ten atractylodes and licorice,respectively,licorice and dried tangerine or orange peel,radix glycyrrhizae and poria cocos,dried tangerine or orange peel and atractylodes,radix glycyrrhizae and magnolia bark,atractylodes and poria cocos,Ginseng with Atractylodes rhizome and licorice,ginseng with Poria cocos.The entropy software integration of hierarchical clustering distribution,set of 8,correlation degree of punishment to 2,get 13 potential prescriptions.Conclusion:The prescription of spleen-invigorating and stomach-nourishing for the elderly prefers liquorice,tangerine peel,Atractylodes macrocephala and ginseng,and the core mechanism of spleen-invigorating and stomach-nourishing prescription is Qi-supplemenling and spleen-strengthering,Qi-regulating and stomach-harmonizing.