基于数据挖掘探讨国医大师辨治脾胃病的用药规律

Based on Data Mining to Explore the Medication Rules of Traditional Chinese Medicine Masters in the Treatment of Spleen and Stomach Diseases

目的:通过数据挖掘分析第一批、第二批国医大师治疗脾胃病的处方用药规律。方法:查阅《国医大师专科专病用方经验(第1辑)脾胃肝胆病分册》《国医大师专科专病用方经验(第2辑)脾胃肝胆病分册》中收录的国医大师治疗脾胃病的处方,采用古今医案云平台及SPSS Clementine 12.0软件进行关联规则分析,使用Apriori算法挖掘其中的配伍关系,应用SPSS Statistics 25统计软件进行聚类分析和因子分析。结果:共纳入22位国医大师治疗脾胃病的处方229首,涉及药物269味,累计频数为2552,其中频数≥20的药物共35味,排名前5位的药物依次为甘草、半夏、白芍、陈皮、黄连;药物功效分类排前3位的依次为燥湿化痰药、清热解毒药、降逆止呕药;用药以辛温、甘苦为主,多归脾、胃、肺经;对35味高频药物进行关联规则分析,共得到14条关联规则,其中党参-白术-甘草置信度最高;共提取14个公因子,因子累计贡献率为65.950%;对35味高频中药进行聚类分析,取类间距为9,聚为5类;将边权重设置为>20进行复杂网络分析,提取国医大师治疗脾胃病的核心组方为:陈皮、甘草、茯苓、砂仁、生姜、党参、半夏、白芍、白术。结论:国医大师诊治脾胃病强调以脾胃气虚为本、痰食气滞为标的基本病机,重视温补脾胃、散寒化湿、理气和中,以治本为主,兼顾治标,临床用药独特,组方灵活,疏理调补,相配得当。

Objective:To analyze the prescription and medication rules of the first and second batch of Chinese medicine masters in treating spleen and stomach diseases by means of data mining.Methods:Check the Chinese medicine master's experience in treating spleen and stomach diseases in Chinese Medicine Master's Specialty Prescription Experience(Volume 1)Spleen,Stomach,Liver and Gallbladder Diseases and Chinese Medicine Master's Specialty Prescription Experience(Second Series)Spleen,Stomach,Liver and Gallbladder Diseases.For prescriptions,Excel 2016 was used to establish a database,the ancient and modern medical record cloud platform and SPSS Clementine 12.0 software were used for association rule analysis,Apriori algorithm was used to mine the compatibility relationship,and SPSS Statistics 25 statistical software was used for cluster analysis and factor analysis.Results:A total of 229 prescriptions for spleen and stomach diseases by 22 Chinese medicine masters were included,involving 269 drugs,and the cumulative frequency of use was 2552.Among them,there were 35 drugs with a frequency of≥20 times.The top 5 drugs were Gancao(Glucyrrhizae radix et rhizoma),Banxia(Pinelliae rhizoma),Baishao(Paeoniae radix alba),Chenpi(Citri reticulatae pericarpium),Huanglian(Coptidis rhizoma).The top 3 drug efficacy classifications are in turn:damp-dampness and phlegm-removing drugs,heat-clearing and detoxifying drugs,anti-relieving and anti-vomiting drugs.Medication is mainly pungent,warm,sweet and bitter,and mostly returns to the spleen,stomach,and lung.After analyzing the association rules of 35 high-frequency drugs,a total of 14 association rules were obtained,and the confidence of Codonopsis-Atractylodes-Glycyrrhizae was the highest;a total of 14 common factors were extracted,and the cumulative factor contribution rate was 65.950%;cluster analysis was carried out on 35 high-frequency traditional Chinese medicines,and the class spacing was 9,and they were clustered into 5 classes;the edge weights were set Complex network analysis was performed for>20,and the core prescriptions of Chinese medicine masters for treating spleen and stomach diseases were extracted:Chenpi(Citri reticulatae pericarpium),Gancao(Glucyrrhizae radix et rhizoma),Fuling(Poria),Sharen(Amomi fructus),Shengjiang(Zingiberis rhizoma recens),Dangshen(Codonopsis radix),Banxia(Pinelliae rhizoma),Baishao(Paeoniae radix alba),Baizhu(Atractylodis macrocephalae rhizoma).Conclusion:In the diagnosis and treatment of spleen-stomach disease,Chinese medical masters emphasize the basic pathogenesis of spleen-stomach Qi deficiency and phlegm-food Qi stagnation as the target.The square is flexible,the adjustment is made,and the matching is appropriate.