基于数据挖掘探讨高颖教授治疗肌萎缩侧索硬化症的组方用药规律

Prescription and Medication Rules of Professor Gao Ying in Treatment of Amyotrophic Lateral Sclerosis Based on Data Mining

目的:运用数据挖掘技术分析高颖教授临床治疗肌萎缩侧索硬化症的组方用药规律,为临床治疗提供参考依据。方法:通过检索2012年7月至2020年9月期间就诊于高颖教授门诊的肌萎缩侧索硬化症患者的临床资料,建立Excel门诊数据库,利用Excel表进行药物频数统计,筛选出核心药物,并对处方药物的性味、归经及功效进行分析;运用SPSS Modeler 18.0软件对核心药物进行网络图分析,建立治疗肌萎缩侧索硬化症的药物关系网络模型;采用Apriori算法对核心药物进行关联分析和聚类分析,筛选出常用药对及有效类方群。结果:本研究纳入208例肌萎缩侧索硬化症患者,共894个处方,累计药味总数225味,其中频次>100次的核心药物有黄芪、茯苓、地黄、山茱萸等32味;处方药物性味以甘温为主,归肾、肝、脾经,药物功效主要为补虚、利水渗湿、收涩、温里及清热。关联规则分析得出常用药对为黄芪-茯苓,巴戟天-山茱萸-地黄,地黄-山茱萸-黄芪,黄芪-白术-茯苓,山茱萸-淫羊藿-黄芪等,且通过聚类分析将高教授门诊治疗肌萎缩侧索硬化症的核心药物分为3个有效类方群。结论:高颖教授治疗肌萎缩侧索硬化症主以“健脾益气、滋补肝肾”为治则,标本兼治。

Objective:To use data mining technology to analyze Professor Gao Ying′s prescription and medication rules for the clinical treatment of amyotrophic lateral sclerosis,and to provide reference for clinical treatment.Methods:By retrieving the clinical data of patients with amyotrophic lateral sclerosis who visited Professor Gao Ying′s outpatient clinic from July 2012 to September 2020,an Excel outpatient database was established.And analyze the nature,taste,meridian and efficacy of high-frequency drugs;use SPSS Modeler 18.0 software to analyze the network diagram of high-frequency drugs,and establish a drug relationship network model for the treatment of amyotrophic lateral sclerosis;use Apriori algorithm to analyze high-frequency drugs.Drug association analysis and cluster analysis were performed to screen out commonly used drug pairs and new prescription combinations.Results:This study included 208 patients with amyotrophic lateral sclerosis,a total of 894 prescriptions,and a total of 225 medicinal flavors.Among them,the core drugs with a frequency of more than 100 times included 32 flavors such as Huangqi(astragalus),Fuling(poria),Dihuang(rehmannia glutinosa),Shanzhuyu(cornus officinalis),etc,which mainly belongs to the Kidney,Liver or Spleen meridians.The main functions of the drugs are tonifying deficiency,diuresis and Dampness,astringent,warm and Heat-clearing.Association rule analysis indicates that the commonly used drug pairs are Huangqi-Fuling(astragalus-poria),Bajitian-Shanzhuyu-Dihuang(morinda officinalis-cornus officinalis-rehmannia),Dihuang-Shanzhuyu-Huangqi(rehmannia-cornus officinalis-astragalus,Huangqi-Baizhu-Fuling(astragalus-atractylodes-poria),Shanzhuyu-Yinyanghuo-Huangqi(cornus officinalis-epimedium-astragalus),etc.The core drugs for outpatient treatment of amyotrophic lateral sclerosis are divided into 3 new prescription combinations.Conclusion:Professor Gao Ying′s treatment of amyotrophic lateral sclerosis mainly takes"strengthening the Spleen and nourishing the Qi as well as nourishing the Liver and Kidney"as the treatment principle,and treats both the symptoms and the symptoms.