基于数据挖掘的中医治疗胸痹的证治规律研究

Research on the Rule of TCM Treatment of Chest Obstruction Based on Data Mining

目的收集整理胸痹患者的诊疗信息,运用数据挖掘的方法探究胸痹的证治规律。方法对天津市南开区中医医院2018年1月1日-2020年12月31日收治的2008例胸痹患者进行研究,使用频数统计患者性别、年龄、证型、药物等情况,关联规则分析患者的症状、舌像、脉象与药物的相关性,复杂网络功能分析主要证型的核心用药及中药配伍规律。结果2008例患者中男837例,女1171例,年龄42~91岁;胸痹患者以心血瘀阻证(38.00%)、心气阴两虚证(26.49%)、心肾阳虚证(20.07%)和痰阻心脉证(15.44%)多见;心血瘀阻证的核心药物为桃仁、红花、当归、川芎、赤芍等;气阴两虚证的核心药物为党参、麦冬、五味子、当归、茯苓等;心肾阳虚证的核心药物为附子、党参、茯苓、白术、白芍等;痰阻心脉证的核心药物为瓜蒌、薤白、半夏、茯苓、桃仁等。结论胸痹患者主要证型的核心用药不同,主要的症状与治疗该证型主方的用药和对应病因病机的用药相关联。从各个证型用药情况来看,虽然主要表现症状相差不大,但是用药风格迥异。因此,不能忽视中医学整体观,割裂症状与舌象、脉象等的关系而进行辨证分型,遣方用药。

Objective To collect the diagnosis and treatment information of patients with thoracic obstruction,and to explore the rule of syndrome and treatment of thoracic obstruction by data mining.Methods A total of 2008 patients with thoracic obstruction admitted to Nankai District Hospital of Traditional Chinese Medicine from January 1,2018 to December 31,2020 were studied.Frequency statistics were used to analyze the gender,age,syndrome types and drugs of patients.Association rules were used to analyze the correlation between symptoms,tongue images,pulse conditions and drugs.Complex network function was used to analyze the core medication of main syndromes and the compatibility law of traditional Chinese medicine.Results Among the 2008 patients,there were 837 males and 1171 females,aged 42-91 years old;heart blood stasis syndrome(38.00%),heart Qi and Yin deficiency syndrome(26.49%),heart kidney Yang deficiency syndrome(20.07%)and phlegm obstructing heart pulse syndrome(15.44%)were common in patients with thoracic obstruction.The core drugs of heart blood stasis syndrome were Taoren,Honghua,Danggui,Chuanxiong,Chishao,etc.The core drugs of heart Qi and Yin deficiency syndrome were Dangshen,Maidong,Wuweizi,Danggui,Fuling,etc.The core drugs of heart kidney Yang deficiency syndrome were Fuzi,Dangshen,Fuling,Baizhu,Baishao,etc.The core drugs of phlegm obstructing heart pulse syndrome were Gualou,Xiebai,Banxia,Fuling,Taoren,etc.Conclusion The core medications of the main syndrome types of patients with thoracic obstruction are different,and the main symptoms are related to the medication of the main prescription of the syndrome type and the medication of the corresponding etiology and pathogenesis.From the perspective of drug use in each syndrome type,although the main symptoms are not significantly different,the medication styles are quite different.Therefore,the overall view of traditional Chinese medicine cannot be ignored,and the relationship between the symptoms of separation and the tongue and pulse conditions cannot be ignored for syndrome differentiation and treatment.