基于数据挖掘探讨李乾构治疗反流性食管炎用药规律

Discussion on the Medication Rules of Professor Li Qiangou in the Treatment of Reflux Esophagitis Based on Data Mining

目的利用数据挖掘方法探讨李乾构教授治疗反流性食管炎的用药规律。方法收集2019年1月-2021年9月首都医科大学附属北京中医医院李乾构教授门诊反流性食管炎患者152例,利用Excel2016建立数据库,通过古今医案云平台2.4.0进行药物频次、药物属性统计及关联规则分析、聚类分析及复杂网络分析。结果共纳入首诊处方152例,涉及中药116味,高频药物为陈皮、甘草、太子参、旋覆花、清半夏,药性以温、平、微寒为主,药味多苦、辛、甘,主要归脾、肺、胃、肝经。关联规则分析得到3个常用药对,聚类分析得到3类药物组合,复杂网络分析提示核心中药处方以四君子汤为基础加减。结论李乾构教授治疗反流性食管炎多从脾胃、肺、肝论治,善用辛开苦降之法恢复脾胃升降功能,针对脾虚气逆的基本病机,治疗以健脾益气、和胃降逆为主,兼顾理气、化痰、活血之法。

Objective To explore the medication rules of Professor Li Qiangou for the treatment of reflux esophagitis through data mining.Methods The patients with reflux esophagitis who were treated in the outpatient department of Professor Li Qiangou of Beijing Hospital of TCM of Capital Medical University from January 2019 to September 2021 were collected.Excel 2016 was used to establish the patient database.The medicine frequency statistics,medicine properties,association rule analysis,cluster analysis and complex network analysis were performed by using the ancient and modern medical records cloud platform 2.4.0.Results A total of 152 prescriptions were included,involving 116 kinds of Chinese materia medica.The high-frequency drugs were Citri Reticulatae Pericarpium,Glycyrrhizae Radix et Rhizoma,Pseudostellariae Radix,Inulae Flos,and Pinelliae Rhizoma.The medicinal properties were mainly warm,mild,and slightly cold.The medicinal tastes were mainly bitter,pungent,and sweet.The main meridian tropism were the spleen meridian,lung meridian,stomach meridian,and liver meridian.Three common medicinal pairs were obtained by association rule analysis,and three medicinal combinations were obtained by cluster analysis.Complex network analysis suggested that the core Chinese medicine prescriptions were modified based on Sijunzi Decoction.Conclusion Professor Li Qiangou treats reflux esophagitis mainly from the spleen and stomach,lung and liver meridians.He is good at restoring the ascending and descending function of the spleen and stomach by using the method of acmainid opening and bitter down.In view of the basic pathogenesis of spleen deficiency and qi counter-flowing,he puts forward the treatment principle of invigorating spleen and replenishing qi,harmonizing stomach descending,and taking into account the method of regulating qi,dissipating phlegm and activating blood.