基于临床医案的藏医治疗查隆病(原发性高血压)用药规律研究

Study on Regularity of Tibetan Medicine in the Treatment of Khrag Rlaung Disease(Essential Hypertension)based on Clinical Medical Records

目的:对藏医查隆病的临床医案进行数据挖掘,归纳藏医治疗查隆病的用药经验,为藏医防治查隆病提供依据与思路。方法:收集、整理山南市藏医院和青海省藏医院2019年12月至2020年12月期间的住院病历。筛选出第一诊断为查隆病的有效病案200则,通过中医传承辅助平台,建立组方数据库,采用关联规则、复杂系统熵聚类、无监督熵层次聚类等数据挖掘方法对其进行分析。结果:藏医治疗查隆病的临床有效方剂为122首,使用藏药种类320味,应用频数>20的藏药共计25味,主要有诃子、木香、红花、余甘子、豆蔻等;核心药物组合主要有诃子-木香、诃子-余甘子、红花-天竺黄、诃子-红花、诃子-肉豆蔻等;核心组合方5个。结论:藏医治疗查隆病以祛隆养心、调和气血、平衡三因为原则,以诃子、木香、红花、余甘子、豆蔻等药物为主。

Object:To conduct data mining on the clinical medical records of khrag Rlaung disease in Tibetan medicine,summarized the medication experience of Tibetan medicine in the treatment of khrag Rlaung disease,and provided basis and ideas for the prevention and treatment of khrag Rlaung disease.Methods:The inpatients cases of Shannan and Qinghai Tibetan Hospital from December 2019 to December 2020 were collected and sorted out.The first 200 cases of effective medical records diagnosed as khrag Rlaung disease were selected,and the prescription database was established through the auxiliary platform of traditional Chinese medicine inheritance.It was analyzed by data mining methods such as association rules,complex system entropy clustering,unsupervised entropy hierarchical clustering and so on.Results:There were 122 clinically effective prescriptions among those clinical medical records and 320 kinds of Tibetan drugs were used.A total of 25 Tibetan drugs with a frequency of more than 20 were used,mainly including Hezi(Chebule),Muxiang(Costusroot),Honghua(Carthamus),Yuganzi(Emblic),Doukou(Katsumada’s galangal seed),and etc.The core drug combinations mainly include Hezi(Chebule)-Muxiang(Costusroot),Hezi(Chebule)-Yuganzi(Emblic),Honghua(Carthamus)-Tianzhuhuang(Bamboo sugar),Hezi(Chebule)-Honghua(Carthamus),Hezi(Chebule)-Roudoukou(Nutmeg),and etc.There are five core combinations.Conclusion:Tibetan medicine treated khrag Rlaung disease based on the principle of dispelling Long and nourishing heart,harmonizing Qi and blood and balancing the three caouses.The mainly durgs in prescription were Hezi(Chebule),Muxiang(Costusroot),Honghua(Carthamus),Yuganzi(Emblic),Doukou(Katsumada’s galangal seed)and other drugs.