基于数据挖掘探讨李佩芳治疗失眠的用药规律

Li Peifang’s medication rule in the treatment of insomnia based on data mining

目的:应用数据挖掘方法分析李佩芳主任医师治疗失眠的用药规律。方法:收集2019年1月至2021年1月李佩芳主任医师门诊治疗失眠的有效病例及首诊中药处方,使用Excel软件建立数据库,进行频次、频率等统计;运用IBM SPSS Modeler 18.0软件的关联规则分析常用药物组合;运用SPSS Statistics 23.0软件对频次较高的中药进行聚类分析。结果:共收集符合标准的病例112例,纳入中药处方112个,涉及药物151味。其中使用频次≥30次的中药有23味,排名前8位的依次为夜交藤、茯苓、牡蛎、茯神、龙骨、煅磁石、川芎、炒酸枣仁;高频药物功效以养心安神、重镇安神、活血行气、健脾和胃为主。通过复杂网络和关联规则的组方规律分析,得出最常用的中药组合为夜交藤→煅磁石,茯苓→茯神,牡蛎→龙骨,川芎→酸枣仁。通过聚类分析,得出4个聚类组,主要功效分别为交通心肾、重镇安神,养血调肝、宁心安神,祛痰利窍、养心安神,健脾和胃。结论:李佩芳主任医师认为失眠病位主要在心,与脾胃、肝、肾密切相关,临证常运用通调三焦法治疗失眠,以酸枣仁汤、甘麦大枣汤合安神定志丸为主方,并在此基础上确立了交通心肾、疏肝理脾、重镇安神的治疗原则。

Objective: To investigate the medication rule of Chief Physician Li Peifang in the treatment of insomnia based on data mining.Methods: Effective cases of insomnia treated by Chief Physician Li Peifang at the outpatient service from January 2019 to January 2021 and traditional Chinese medicine(TCM) prescriptions atinitial diagnosis were collected, and Excel was used to establish a database for the statistical analysis of frequency.Association rules of IBM SPSS Modeler 18.0 software were used to analyze commonly used drug combinations, and SPSS Statistics 23.0 software was used for the cluster analysis of TCM drugs with high frequency.Results: A total of 112 cases meeting the criteria were included, as well as 112 TCM prescriptions, which involved 151 TCM drugs.Among these drugs, 23 had a frequency of≥30 times, and the top 8 drugs in terms of frequency were tuber fleeceflower stem, Poria cocos, Concha Ostreae, Poria cum Radix Pini, dragon bone, calcined loadstone, Rhizoma Chuanxiong, and parched wild jujube seed.The functions of the frequently used drugs were mainly nourishing the heart and tranquilizing mind, tranquillizing with heavy prescription, activating blood and moving Qi, and strengthening the spleen and stomach.The analysis of prescription rules based on complex network and association rule obtained the most commonly used drug combinations of tuber fleeceflower stem-calcined loadstone, Poria cocos-Poria cum Radix Pini, Concha Ostreae-dragon bone, and Rhizoma Chuanxiong-wild jujube seed.The cluster analysis obtained 4 clusters with the following functions: coordinating the heart and kidney and tranquillizing with heavy prescription;nourishing the blood, regulating the liver, calming the heart, and tranquilizing the mind;expelling phlegm, disinhibiting the orifices, nourishing the heart, and tranquilizing the mind;strengthening the spleen and stomach.Conclusion: Chief Physician Li Peifang thinks that the main disease location of insomnia is the heart, which is closely associated with the spleen, stomach, liver, and kidney.Regulation of triple energizers is mainly used for the treatment of insomnia in clinical practice, and the main prescriptions are Suanzaoren decoction, Ganmai Dazao decoction, and Anshen Dingzhi pills.Coordinating the heart and kidney, soothing the liver and regulating the spleen, and tranquillizing with heavy prescription are established as the main treatment principles.