基于数据挖掘探讨腹泻型肠易激综合征组方用药规律

Analysis of Prescription and Medication Regularity for Diarrhea-type Irritable Bowel Syndrome Based on Data Mining

目的:应用中医传承辅助平台(V2.5)软件分析治疗腹泻型肠易激综合征(IBS-D)内服方剂的组方用药规律,以期为临床遣方用药和开发新型中成药提供参考。方法:搜集中文期刊文献中口服中药汤剂治疗IBS-D的处方,采用中医传承辅助平台的数据挖掘方法,通过软件集成的关联规则和复杂系统熵聚类等方法分析组方用药规律。结果:纳入处方430首,涉及中药193味。分析得出,使用频次居前10位的中药依次为白术、白芍、茯苓、陈皮、防风、党参、炙甘草、柴胡、木香、山药,常用中药组合15个,基于关联规则的中药组合14个,新方组合7个。结论:IBS-D治疗原则主要围绕健脾除湿、调肝理脾、温补脾肾三方面,核心处方为痛泻要方,提示肝郁脾虚为本病核心病机;新方分析提示湿热、食积、瘀阻也是重要致病原因。用药多寒热并用,以温药为主,常用甘、辛、苦味,调补脏腑兼以辛开苦降,顺应中焦脾胃生理特点;防风、柴胡等风药的应用,是本病治疗用药特色。

Objective:To analyze the prescription and medication regularity of oral formulas for the treatment of diarrhea-type irritable bowel syndrome(IBS-D)by using software of the Traditional Chinese Medicine Inheritance Support System(V2.5)(TCMISS),in order to provide a reference for clinical medication and the development of new Chinese patent medicines.Methods:The prescriptions of oral Chinese herbal decoction for the treatment of IBS-D in Chinese journal literature were collected,and the data mining method of TCMISS was adopted to analyze the prescription and medication regularity by association rule analysis and complex system entropy clustering.According to the analysis,the top 10 Chinese herbal medicines were Baizhu(Atractylodes),Baishao(Paeoniae Radix alba),Fuling(Poria),Chenpi(Citri Reticulatae Pericarpium),Fangfeng(Saposhnikoviae Radix),Dangshen(Codonopsis Radix),Zhigancao(Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle),Chaihu(Bupleuri Radix),Muxiang(Aucklandiae Radix)and Shanyao(Dioscoreae Rhizoma)in proper order.There were 15 commonly used Chinese herbal combinations,14 Chinese herbal combinations based on association rules and 7 new prescriptions.Conclusions:The treatment principles of IBS-D mainly concentrate on three aspects:invigorating spleen and removing dampness,regulating liver and spleen,warming and replenishing spleen and kidney.The core prescription is Tongxie Yaofang(痛泻要方),indicating liver depression and spleen deficiency as the core pathogenesis.The new formula analysis suggests that damp-heat,food accumulation and blood stasis were also important causes.The combinations of cold and warm medicinals are mainly warm in property,sweet,acrid,bitter in flavor,regulating and tonifying zang-fu organs and bitter,acrid dispersing and bitter descending,conforming to the physiological characteristics of spleen and stomach in the middle energizer.The application of wind-medicine such as Fangfeng(Saposhnikoviae Radix)and Chaihu(Bupleuri Radix)is also the characteristic medication in treating IBS-D.