基于数据挖掘的黎月恒治疗胃癌症-证-药规律研究

Study on Symptoms-syndrome-medication Rules of LI Yue-heng in the Treatment of Gastric Cancer by Data Mining

目的基于数据挖掘分析的方法分析黎月恒教授治疗胃癌的用药规律。方法通过收集2019年8月至2021年3月在湖南省肿瘤医院中西医结合科门诊及住院部经黎月恒教授诊治的胃癌患者的有效医案,应用中医传承辅助软件平台进行症状、中医证型、用药频数、性味归经、聚类、关联规则统计分析。结果胃癌患者症状以乏力、胃口差、腹胀、泛酸、胃脘痛、苔白厚、脉沉细为主;中医证型以脾肾亏虚证、脾虚痰湿证为主,兼夹他证,久病成瘀;使用频次较高的药物有陈皮、竹茹、茯苓、鸡内金、佛手、党参、麦芽、稻芽、半枝莲、乌药等;药性以温性为主,药味以甘、苦、辛为主,药物归经以脾、肺、胃、肝、肾为主;基于关联规则分析得关联性强的药对5个;基于聚类方法分析得到24个核心组合、12个新方组合。结论本次数据挖掘结果显示的用药规律与黎月恒教授的用药思路和特点相符,多用健脾、益肾、和胃、理气、化痰、解毒散结之品扶正固本、抗癌祛邪,整体与局部兼顾,并针对伴随症状随症加减。

Objective To investiage the medication rule of Professor LI Yue-heng in the treatment of gastric cancer by data mining.Methods The effective medical records of gastric cancer patients diagnosed and treated by Professor LI Yue-heng from August 2018 to December 2020 in the outpatient and inpatient department of integrated traditional Chinese and western medicine department of Hunan Cancer Hospital were collected.The symptoms,traditional Chinese medicine(TCM)syndrome types,medication frequency,properties and tastes as well as meridian tropism were analyzed by clustering and association rule analysis based on the platform of Traditional Chinese Medicine Inheritance Support System.Results The main symptoms of gastric cancer patients were fatigue,poor appetite,abdominal distension,acid regurgitation,epigastric pain,white and thick tongue fur,and deep and thready pulse.The TCM syndrome types of gastric cancer patients were predominated by spleen and kidney deficiency syndrome,and spleen deficiency with phlegm dampness syndrome,usually complicated with other syndrome types and with the existence of blood stasis for lasting illness.The frequently-used herbs were Pericarpium Citri Reticulatae,Caulis Bambusae in Taenia,Endothelium Corneum Gigeriae Galli,Fructus Citri Sarcodactylis,Radix Codonopsis,Fructus Hordei Germinatus,Fructus Setariae Germinatus,Herba Portulacae Grandiflorae,Radix Linderae,etc.The medicated herbs are mainly warm in nature,and are sweet,bitter and pungent in taste,with the meridian tropism of spleen,lung,stomach,liver and kidney.Based on the analysis of association rules,five herbal pairs with strong association were obtained,and the clustering results showed that 24 core herbal combinations and 12 new candidate prescriptions were obtained.Conclusion The medication rules showed by data mining are consistent with the medication thoughts of Professor LI Yue-heng.It is revealed that for the treatment of gastric cancer,herbs with the actions of strengthening spleen,tonifying kidney,harmonizing stomach,regulating qi,resolving phlegm,detoxifying and dissipating mass are usually adopted for supporting healthy qi and consolidating vital base,counteracting cancer and eliminate pathogenic factors,which take into the general status and focal affection.And modification of the herbs should be performed according to the accompanying symptoms.