基于数据挖掘研究现代中医治疗癫痫的辨证用药规律

The Prescription Rule of Traditional Chinese Medicine for Epilepsy by Data Mining

目的基于古今医案云平台(V2.2.2)对近20年中医治疗癫痫的处方进行整理分析,挖掘现代中医治疗癫痫的辨证用药规律。方法搜索中国知网(CNKI)数据库与万方数据库中2000年1月1日—2020年8月1日收录的有关中医药治疗癫痫临床研究的相关文献,对文献中的数据进行规范化处理,构建数据库,应用古今医案云平台(V2.2.2)中的频次分析、药对分析、关联分析、聚类分析、功效归经分析等分析方法进行数据挖掘,分析现代中医治疗癫痫的辨证用药规律,总结临床经验。结果遴选出的127项中医药治疗癫痫的临床研究共涉及处方133首、中药197味、病位证素6个以及病性证素9个。挖掘出用药频次>平均频次9次的药物49味,使用频次前5位的中药分别为石菖蒲、胆南星、半夏、全蝎、天麻。挖掘出高频药对27对,使用频次前3位的药对为“石菖蒲、胆南星”“半夏、石菖蒲”“全蝎、石菖蒲”。发现高频角药17组,使用频次前3位的角药为“胆南星、全蝎、石菖蒲”“半夏、胆南星、石菖蒲”“茯苓、石菖蒲、半夏”,并且常用药对与角药皆由高频药物组成。证素挖掘发现,病位证素以肝、心、脾为主,病性证素以痰、风为主。结论中医药治疗癫痫辨证用药主要以化痰开窍醒神、息风止痉镇惊为法,与其主要的病性证素痰、风等相关;药物大多归肝、心、脾经,与其主要病位证素相一致。化痰开窍醒神、息风止痉镇惊是现代中医医家治疗癫痫的主导思想。

Objective Based on the Ancient and Modern Medical Case Cloud Platform(V2.2.2),the prescriptions of traditional Chinese medicine(TCM)treatment of epilepsy in the past 20 years were sorted out and analyzed,and the rule of TCM treatment of epilepsy was explored based on syndrome differentiation.Methods Related literatures on clinical studies on TCM treatment of epilepsy collected from January 1,2000 to August 1,2020 in China National Knowledge Infrastructure(CNKI)database and Chinese academic journal database(Wanfang Database)were searched,and the data in the literatures were normalized to construct the database.Data mining was conducted by frequency analysis,drug pair analysis,association analysis,cluster analysis,and efficacy regression analysis in Ancient and Modern Medical Case Cloud Platform(V2.2.2),to analyze the rule of syndrome differentiation for the treatment of epilepsy in modern Chinese medicine,and summarize clinical experience.Results A total of 127 clinical studies on TCM treatment of epilepsy involved 133 prescriptions,197 Chinese medicines,6 syndromes of disease location,and 9 syndromes of disease nature.Forty-nine Chinese medicines were found with higher frequency than the average frequency,and the top 5 Chinese medicines were Rhizoma acori graminei,Bile arisaema,Pinellia ternate,Buthus martensi kirsch,and Gastrodia Elata.Twenty-seven pairs of high frequency drug pairs were found,and the top three drug pairs based on the frequency of prescription were"Rhizoma acori graminei,Bile arisaema""Pinellia ternate,Rhizoma acori graminei""Buthus martensi kirsch,Rhizoma acori graminei".Seventeen groups of high frequency horn drugs were found,and the top three horn drugs were"Bile arisaema,Buthus martensi kirsch,Rhizoma acori graminei""Pinellia ternate,Bile arisaema,Rhizoma acori graminei""Poria cocos,Rhizoma acori graminei and Pinellia ternate",and the common drug pairs and horn drugs were all composed of high frequency drugs.The main syndromes of disease organ were liver,heart and spleen,while the main syndromes of disease nature were phlegm and wind.Conclusion The syndrome differentiation and medication of Chinese medicine in the treatment of epilepsy mainly focus on dissipating phlegm for resuscitation and calming wind and stopping spasm.It is consistent with the main syndromes of the disease nature.Dissipating phlegm for resuscitation and calming wind and stopping spasm are the main therapies of modem Chinese medicine practitioners to treat the disease.