陈晓虎教授治疗冠心病室性早搏用药规律的数据挖掘研究

Discussion on Professor Chen Xiaohu′s Medication Rules for Treating Premature Ventricular Contractions in Coronary Heart Disease Based on Data Mining

目的总结陈晓虎教授治疗冠心病室性早搏的用药规律。方法搜集整理2018年3月至2021年5月陈教授治疗冠心病室性早搏的医案处方,构建中药处方数据库,对数据进行规范化处理后,运用统计学软件Excel表对药物进行频数分析;选取使用频次≥30的高频中药,运用Apriori算法进行关联规则分析;使用Cytoscape 3.7.2软件构建中药共现网络的可视化升级,提取核心药物;借助IBM SPSS Statistics 25.0软件进行聚类分析及因子分析。结果纳入的164例有效处方中涉及中药共153种,累计频次2916次,前8味依次为甘松、茯苓、紫草、陈皮、茯神、丹参、红花、木香;常用药物多为性温、平、寒之品,药味以甘味药和苦味药为主,多归肝、肺经,用药以补虚药、活血化瘀药、清热药为主;支持度最高的是紫草→甘松,置信度100%中支持度最高的药对为茯神→茯苓;高频药物聚类得到6个聚类组;采用主成分分析法,提取初始特征值>1的公因子9个。结论陈教授认为冠心病室性早搏以气阴两虚为本,气滞、瘀血为标,辨证施治时以益气养阴,行气活血,安神定悸为主,瘀久化热则配以清热之法,寒温并用,消补兼施,则补而不滞,消而不伤,相得益彰,临床疗效满意。

Objective:To summarize the medication rules of Professor Chen Xiaohu in the treatment of ventricular premature beats in coronary heart disease.Methods:The medical records and prescriptions of Professor Chen for the treatment of ventricular premature beats in coronary heart disease from March 2018 to May 2021 were collected and sorted,and a database of traditional Chinese medicine prescriptions was constructed.After normalizing the data,Excel was used to analyze the frequency of the drugs;the high-frequency traditional Chinese medicines with a frequency of≥30 were selected,and Apriori algorithm was utilized to analyze the association rules;Cytoscape 3.7.2 software was applied to build the visualization of the co-occurrence network of traditional Chinese medicines and to extract the core drugs;cluster analysis and factor analysis were performed with SPSS 25.0.Results:The included 164 effective prescriptions involved a total of 153 kinds of traditional Chinese medicines,with a cumulative frequency of 2916.The top 8 herbs were Gansong,Fuling,Zicao,Chenpi,Fushen,Danshen,Honghua,Muxiang.The commonly used drugs were mostly warm,flat and cold in nature.The flavors were mainly sweet and bitter,and most of them were related to the liver and lung meridians.The drugs were mainly tonic,blood circulation promoting and blood stasis removing,and heat-clearing drugs.The drug pair with the highest support was Zicao→Gansong,and the one with the highest support in the confidence level of 100%was Fushen→Fuling.Six clustering groups were obtained by high-frequency drug clustering.Principal component analysis was used to extract 9 common factors with initial eigenvalues>1.Conclusion:Professor Chen believes that ventricular premature beats in coronary heart disease are mainly the deficiency of both qi and yin,with stagnation of qi and blood stasis as the symptom.Syndrome differentiation and treatment mainly focus on nourishing qi and yin,promoting qi and blood circulation,and calming the nerves and palpitations.For long-term stasis and heat,it should be accompanied by the method of clearing heat.When applying both cold and warm,elimination and tonic,the supplement will not be stagnant,and the elimination will not be harmful.In this way,the treatment complements each other and has a satisfactory clinical effect.