基于古今医案云平台探讨中医药治疗幽门螺杆菌感染相关疾病用药规律

Analysis of Administration Rule of Chinese Medicine for Helicobactor Pylori Infection Related Diseases Based on Ancient and Modern Medical Case Cloud Platform

目的:探讨中医药治疗幽门螺杆菌(Hp)感染相关疾病的组方用药规律。方法:检索古今医案云平台医案库中有关中医药治疗Hp感染相关疾病的医案,建立标准化医案数据库,借助平台的数据挖掘技术对其药物的使用频次、药物功效、性味归经等进行统计分析。结果:共纳入医案64则,诊次164次,涉及处方42首,中药197味。高频药物有甘草、黄连、半夏、白术、茯苓等;性味以苦、甘、辛为主,主入脾、胃、肺经,功效类别以补虚药、清热药为主。关联规则提示半夏-甘草、白术-甘草、白芍-甘草为临床常用药对。聚类分析获得4个组合,有缓急止痛、温中助运、益气健脾、消食和胃之效。复杂网络分析提取出的核心处方为六君子汤加减。结论:中医药治疗Hp相关疾病的核心药物为甘草、黄连、半夏、白术,以“扶正、祛邪”为治疗大法,多采用补虚、清热、理气药,临床可用芍药甘草汤、六君子汤等方加减辨证治疗。

Objective:To explore the administration rule of Chinese medicine for Helicobacter pylori(Hp)infection related diseases.Methods:Medical records related to Chinese medicine treatment of Hp infection-related diseases were retrieved from the medical record database of Ancient and Modern Medical Case Cloud Platform;standardized medical record database was established,and statistical analysis was conducted on the frequency of herbs use,herbs effect,natures,flavors and channel entry of herbs with the help of data mining technology of the platform.Results:A total of 64 medical cases were included,164 consultation times,involving 42 prescriptions and 197 kinds of Chinese herbs.High frequency herbs included Radix et Rhizoma Glycyrrhizae,Rhizoma Coptidis,Rhizoma Pinelliae,Rhizoma Atractylodis Macrocephalae,Poria,etc;their natures and flavors were mainly bitter,sweet,acrid,and the channel entry of herbs was mainly the spleen,the stomach,the lung meridians;the effects of the herbs were mainly tonifying and heat-clearing.Association rules suggested that Rhizoma Pinelliae-Radix et Rhizoma Glycyrrhizae,Rhizoma Atractylodis Macrocephalae-Radix et Rhizoma Glycyrrhizae,and Radix Paeoniae Alba-Radix et Rhizoma Glycyrrhizae were common clinical herbal pairs.Four herbal combinations were obtained by cluster analysis,which had the effects of moderating the acute attack and relieving pain,warming the center and assisting transportation,boosting qi and fortifying the spleen,and promoting digestion and harmonizing the stomach.The core prescriptions extracted from complex network analysis was Liujunzi tang.Conclusion:The core herbs of Chinese medicine in treating Hp infection related diseases based on Ancient and Modern Medical Case Cloud Platform are Radix et Rhizoma Glycyrrhizae,Rhizoma Coptidis,Rhizoma Pinelliae and Rhizoma Atractylodis Macrocephalae.The main treatment methods are reinforcing healthy qi and dispelling pathogen,and the main herbs are deficiency supplementing herbs,heat-clearing herbs and qi-regulating herbs.In clinical practice,Shaoyao Gancao tang and Liujunzi tang can be modified to treat the diseases according to syndrome differentiation and treatment.