基于文献挖掘探析脑卒中后抑郁方药规律研究

Research on the rules of prescriptions and drugs for post-stroke depression based on literature mining

目的运用数据挖掘方法分析中医药治疗脑卒中后抑郁的病因病机、用药规律。方法收集中国知识资源总库(CNKI)、万方数据知识服务平台(Wanfang Data)、维普中文期刊服务平台(VIP)、中国生物医学文献数据库(CBM)自建库起至2021年7月中医药治疗脑卒中后抑郁的相关文献,以统一标准录入Microsoft Excel构建规范化数据库,通过SPSS 20.0、IBM SPSS Modeler 18.0软件进行数据挖掘,统计药物及其四气、五味、归经的频次,并分析研究用药规律。结果本研究共纳入306篇文献,使用中药方315次。共有154首方剂,常用方剂包括柴胡舒肝散、柴胡龙骨牡蛎汤、逍遥散、血府逐瘀汤、补阳还五汤、丹栀逍遥散、归脾汤、解郁通络汤等。共涉及181味中药,高频药物(频次≥30)共计33味,主要包括柴胡、甘草、川芎、郁金、当归、白芍、茯苓、石菖蒲、半夏、香附、陈皮等。药性以温性为主,药味以辛、苦、甘为多,归经以肝经、脾经、肺经为主,药物功效分析显示排名前三位为补虚药、活血化瘀药、理气药。关联规则分析获得二项关联规则22条、三项关联规则119条,聚类分析获得3个核心聚类群。结论脑卒中后抑郁与肝、脾、肺密切相关,正虚是其病因基础,主要病机是血瘀气郁、痰阻窍闭、正虚风动,以扶正祛邪、气血兼顾为指导原则,多采用活血化瘀行气、开窍化痰息风、清热安神补虚之法,为中医药治疗脑卒中后抑郁提供了参考方案。

Objective To analyze the etiology pathogenesis and medication rules of TCM treatment of post-stroke depression by using data mining.Methods The literatures on the treatment of post-stroke depression with TCM from CNKI,Wanfang Data,VIP and CBM database from the establishment of the database until July 2021 were collected,and a standardized database of prescriptions used by Microsoft Excel was built.SPSS20.0 and IBM SPSS Modeler 18.0 were used for data mining analysis,such as the frequency of drugs and their four qi,five flavors,and return to menstruation.Results A total of 306 literatures were included in this study,and herbal prescription were used 315 times.There are 154 prescriptions,commonly used prescriptions include ChaiHuShuGan San,ChaiHuLongGuMuLi Decoction,XiaoYao San,XueFuZhuYu Decoction,BuYangHuanWu Decoction,DanZhiXiaoYao San,GuiPi Decoction,JieYuTongLuo Decoction,etc.A total of 181 traditional Chinese medicines are involved,and a total of 33 high-frequency drugs(frequency≥30),including Bupleurum,Licorice,Chuanxiong,Turmeric,Angelica,White Peony,Poria,Shichangpu,Pinellia,Cyperus rotundus,Tangerine Peel,etc.The medicinal properties are mainly warm,and the medicinal taste is mostly pungent,bitter,and sweet.The main meridians are the liver meridian,spleen meridian,and lung meridian.Analysis of drug efficacy shows that the top three are tonic drugs,blood activating drugs,and qi regulating drugs.Association rules analysis obtained 22 binomial association rules,119 three association rules,and cluster analysis obtained 3 core clusters.Conclusion Post-stroke depression is closely related to the liver,spleen,and lungs.Deficiency is the basic etiology of post-stroke depression.The main pathogenesis is blood stasis and qi stagnation,phlegm obstructing orifice closure,deficiency of righteousness and wind movement.The guidelines are to strengthen the body and eliminate the evil,and give consideration to qi and blood.The methods of promoting blood circulation to remove blood stasis and promoting qi,resuscitating phlegm and dissipating wind,clearing away heat,soothing the nerves and replenishing deficiency are often used.This study provides references for the treatment of post-stroke depression by the theories of TCM.