基于数据挖掘技术探析中医药治疗中晚期非小细胞肺癌的用药规律

Analysis on Medication Regularity of Traditional Chinese Medicine in Treatment of Intermediate and Advanced Non-small Cell Lung Cancer Based on Data Mining

目的:挖掘中医药治疗非小细胞肺癌(NSCLC)的成方规律,以期为临床遣方用药及新药研发提供一定的理论依据。方法:以中国知网(CNKI)中近40年来中医药治疗中晚期NSCLC的临床研究文献作为数据来源,通过筛选后建立方剂数据库,再运用数据挖掘软件进行频数统计、关联规则分析、系统聚类、因子分析及复杂网络构建等。结果:经过纳排标准筛选出307篇临床文献,包含方剂483首。中晚期NSCLC常见证候以气阴两虚为主,证候要素以气虚、阴虚、痰、血瘀、热(火)邪、毒邪、湿邪多见。使用的药物类别以补虚药、清热药、化痰止咳平喘药、利水渗湿药和活血化瘀药较为集中。使用高频次药物为黄芪、甘草、麦冬、浙贝母、茯苓等,其中四气以寒性最为常见,五味以苦、甘、辛味居多,归经主要集中在肺、脾、胃经。关联规则分析发现关联强度较高的规则有17条,因子分析中可提取公因子数为10个,系统聚类分析得出5大类。复杂网络分析提示核心中药处方为六君子汤合益气养阴解毒方加减。结论:益气养阴、健脾化痰、清热解毒、活血化瘀是中医药治疗中晚期NSCLC的基本治则,数据挖掘的核心组合和新方具有重要的指导借鉴意义,但仍需与中医理论相结合,有待进一步的临床及实验研究给予验证。

Objective:To explore medication regularity of traditional Chinese medicine(TCM)in the treatment of non-small cell lung cancer(NSCLC)and thereby to lay a theoretical basis for clinical medication and drug development.Method:Articles on clinical treatment of intermediate and advanced NSCLC with TCM in the past 40 years were retrieved from CNKI,which were taken the data source.Then the articles were screened to establish a formula database,followed by frequency statistics,association rule analysis,cluster analysis,factor analysis,and complex network construction.Result:A total of 307 eligible articles were screened out,involving 483 formulas.The common syndrome of intermediate and advanced NSCLC was the deficiency of both Qi and Yin,with the common syndrome elements of Qi deficiency,Yin deficiency,phlegm,blood stasis,pathogenic heat(fire),toxin,and pathogenic dampness.The frequently used medicinals mainly had the functions of tonifying deficiency,clearing heat,resolving phlegm and relieving cough and dyspnea,promoting urination and draining dampness,and activating blood and resolving stasis.The high-frequency medicinals were Astragali Radix,Glycyrrhizae Radix et Rhizome,Ophiopogonis Radix,Fritillariae Thunbergii Bulbus,and Poria,which were mainly cold,bitter,sweet,and pungent,with tropism at lung,spleen,and stomach.The association rule analysis yielded 17 rules with strong association.Ten common factors were extracted from the factor analysis,and cluster analysis classified the medicinals into 5 groups.Complex network analysis suggested that the core formula was modified Liujunzi Tang and Yiqi Yangyin Jiedu prescription.Conclusion:The treatment principle for intermediate and advanced NSCLC is replenishing Qi and nourishing Yin,invigorating spleen and resolving phlegm,clearing heat and detoxifying,promoting blood circulation and removing blood stasis.The core combinations new prescription discovered by data mining are of important guiding significance,but they should be further verified in clinical practice and by experiments based on the theory of TCM.