基于数据挖掘探讨谭峰教授“三早”疗法治疗缺血性脑卒中的临证经验

Discussion the clinical experience of Professor Tan Feng’s“three early”therapy in the treatment of ischemic stroke based on data mining

目的基于数据挖掘技术探讨谭峰教授运用“三早”疗法治疗缺血性脑卒中的临证经验。方法收集2018年1月至2021年6月广州中医药大学附属佛山市中医院谭峰教授门诊及住院诊治的缺血性脑卒中患者服用的中药处方,运用中医传承辅助平台(V2.5)软件,采用频数分析、关联规则、复杂熵聚类分析等方法进行数据分析与挖掘。结果筛选出中药处方236首,共涉及中药127味,用药频次居于前5位的是白术、川芎、黄芪、半夏、当归,药物类别以调和气血药使用频率最高,药性以温、平为主,药味以甘、辛为主,归经以肝、脾、心经为主,关联规则分析得到常用中药组合18对,基于熵聚类药物核心组合挖掘出潜在新方5个。结论谭峰教授认为血瘀贯穿缺血性脑卒中病程始终,提出中医治疗缺血性脑卒中的“三早”疗法,临证强调活血化瘀药物应用,辅以益气化痰、解郁安神药物,针对久病者善用虫类药,可为临床提供参考。

Objective To explore Professor Tan Feng’s clinical experience of using“three early”therapy in the treatment of ischemic stroke based on data mining technology.Methods Chinese medicine prescriptions of ischemic stroke patients treated in the outpatients and inpatients of Professor Tan Feng in Foshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from January 2018 to June 2021 were collected.The traditional Chinese Medicine Inheritance Assistance Platform(V2.5)software was used for data analysis and mining by frequency analysis,association rules,complex entropy clustering analysis,and other methods.Results A total of 236Chinese medicine prescriptions were screened,involving 127 Chinese medicine ingredients.The top five drug use frequency were Atractylodis Macrocephalae Rhizoma,Chuanxiong Rhizoma,Astragali Radix,Pinelliae Rhizoma,and Angelicae Sinensis Radix.The most frequently used drugs were harmonizing qi and blood drugs.The drug properties were mainly warm and flat,the drug tastes were mainly sweet and pungent,and the channel tropisms were mainly liver,spleen,and heart channels.Eighteen pairs of common Chinese medicine combinations were obtained by association rule analysis,and five potential new prescriptions were mined based on entropy clustering.Conclusion Professor Tan Feng believes that blood stasis runs through the course of ischemic stroke,and puts forward the“three early”therapy of traditional Chinese medicine in the treatment of ischemic stroke.The clinical application of drugs promoting blood circulation for removing blood stasis is emphasized,supplemented by drugs supplementing qi and dissipating phlegm,resolving stagnation for tranquilization,and the use of insect drugs for patients with chronic illness,and it can provide reference for clinical practice.