基于数据挖掘的中医药治疗原发性胆汁性胆管炎用药规律研究

Study on the Medication Rules of Traditional Chinese Medicine for Treating Primary Biliary Cholangitis Based on Data Mining

目的基于数据挖掘方法探讨中医药治疗原发性胆汁性胆管炎(PBC)的用药规律和组方特点。方法检索中国知网(CNKI)、万方数据服务平台(Wanfang)、维普数据库(VIP)、中国生物医学文献数据库(SinoMed)所收录的建库至2021年10月中医药治疗PBC的随机对照临床研究文献,将筛选后获得的方药建立数据库,采用数据挖掘技术对药物进行频数分析、性味归经及功效分析、关联规则分析、聚类分析和因子分析。结果共纳入符合条件的文献79篇,涉及中药176味,累积药物使用频次1112次。用药频次较高的药物为茵陈、白术、丹参、茯苓、赤芍等;常用的药物类型为补虚药、清热药、活血化瘀药、利水渗湿药;药性以寒性、平性药为主;药味以苦味、甘味药为主;归经以入肝、脾、胃经药物为主;关联规则分析得出16组药对组合,聚类分析将高频药物分为7类,因子分析获得6个公因子。结论中医药治疗PBC的核心药物为茵陈、白术、丹参、茯苓、赤芍等,以补益肝脾肾为主,兼以清热、祛湿、活血等治法。临床可辨证参考选用“白术-茯苓”“茵陈-栀子”“女贞子-墨旱莲”等药对,“党参-白术-茯苓”“丹参-鳖甲-黄芪”“柴胡-白芍-甘草”等角药,以及二至丸、异功散、桃红四物汤、茵陈蒿汤、增液汤等经典方剂。

Objective To discuss the medication rules and prescription characteristics of traditional Chinese medicine(TCM)in the treatment of primary biliary cholangitis(PBC)based on the data mining method.Methods Randomized controlled clinical study on the TCM treatment of PBC were searched from CNKI,Wanfang,VIP and SinoMed from establishment until October 2021.We established the database of the screened prescriptions,and data mining technology was used to conduct frequency analysis,association rule analysis,cluster analysis,and factor analysis on the use,nature,taste,meridian,and efficacy of drugs.Results A total of 79 eligible literatures were included,involving 176 kinds of traditional Chinese medicine,and the cumulative frequency of drug usage was 1112 times.The drugs with higher frequency were Artemisiae scopariae herba,Atractylodis macrocephalae rhizoma,Salviae miltiorrhizae radix et rhizoma,Poria,and Paeoniae radix rubra,etc.The commonly used drugs were deficiencytonifying drugs,heat-clearing drugs,blood-activating and stasis-eliminating drugs,and water-drainage drugs.Natures of the drugs were mainly cold and mild.The flavors were mainly bitter and sweet.The channel tropisms with more frequencies were the liver,the spleen,and the stomach meridians.Through association rule analysis,16 groups of association drug pairs were obtained,7 core categories were classified by cluster analysis,and 6 common factors were obtained by factor analysis.Conclusion The core drugs of traditional Chinese medicine in the treatment of PBC are Artemisiae scopariae herba,Atractylodis macrocephalae rhizoma,Salviae miltiorrhizae radix et rhizoma,Poria,and Paeoniae radix rubra,etc.,mainly to tonify and nourrsh the liver,spleen and kidney,as well as clearing heat,removing dampness and promoting blood circulation.For clinical syndrome differentiation reference,it is recommended to select“Atractylodis macrocephalae rhizoma-Poria”,“Artemisiae scopariae herba-Gardeniae fructus”,“Ligustri lucidi fructus-Ecliptae herba”,and other drug pairs,such as“Codonopsis radix-Atractylodis macrocephalae rhizoma-Poria”,“Salviae miltiorrhizae radix et rhizoma-Trionycis carapax-Astragali radix”,“Bupleuri radix-Atractylodis macrocephalae rhizoma-Glycyrrhizae radix et rhizoma”and other triangle medicine,and Erzhi Pills,Yigong Powder,Tao Hong Siwu Decoction,Yinchenhao Decoction,Zengye Decoction and other classic formulas.