施维群教授诊治慢性乙型肝炎肝硬化用药经验的数据挖掘研究

Data mining study on professor Shi wei-qun’s medication experience in the diagnosis and treatment of chronic hepatitis B cirrhosis

目的:基于数据挖掘技术分析施维群教授治疗慢性乙型肝炎肝硬化患者的临床用药规律进行深入全面的分析,归纳总结其用药规律及组方特点,促进名老中医经验的传承与创新。方法:收集整理2016年1月至2017年12月杭州市余杭区中医院和浙江中医药大学附属第二医院施维群教授门诊就诊的88例慢性乙型肝炎肝硬化患者的264张中药处方,并将处方信息进行标准化预处理,录入中医传承辅助系统(V2.5),运用TCMISS中“统计报表”和“数据分析”模块,通过频次统计方法、关联规则挖掘方法,将所选病案数据客观化表现出来,并结合施教授相关学术思想及理论,总结其用药特点及规律。结果:对筛选出的264张处方进行分析,使用频次≥100次属于高频次药物,共有12味药,分别是白术、茯苓、甘草、白芍、枳壳、薏苡仁、黄芪、当归、白花蛇舌草、砂仁、牡丹皮、大腹皮等。运用关联规则挖掘方法,分别设置支持度为40%,置信度为0.8,得到常用药物组合共18条。结论:施维群教授对慢性乙型肝炎肝硬化的治疗独具特色,其“顾护脾胃”的思想贯穿于疾病治疗的始终,临床上多用益气健脾、行气利水、活血化瘀之品,其组方的核心药物为:白术、茯苓、甘草、白芍、枳壳、薏苡仁、黄芪、当归、白花蛇舌草。中医传承辅助系统用于名老中医经验的传承推广、临床医师经验的总结有非常重要的辅助作用,具有一定的科学价值和社会意义。

Objective:A thorough and comprehensive analysis of Professor Shi Wei-qun’s clinical medication rules in the treatment of patients with chronic hepatitis B cirrhosis was preformed by data mining to summarize the medication rules and prescription characteristics. Promote the inheritance and innovation of veteran Chinese medicine experience in the meantime.Methods:A total of 264 Chinese medicine prescriptions belong to 88 patients with hepatitis B and cirrhosis who were treated by professor Shi in the Yuhang Traditional Chinese Medicine Hospital and the Second Affiliated Hospital of Zhejiang Chinese Medicine University from January 2016 to December 2017 were collected. The prescription information was standardized pre-processed and entered into the Traditional Chinese Medicine inheritance auxiliary system(V2.5). Using the "statistical report" and "data analysis" modules of TCMISS, through the frequency statistics method and association rule mining method, the selected medical record data were objectified. Combined with Professor Shi’s academic thoughts and theories, the characteristics and rules of their medication were summarized. Results:The selected 264 prescriptions were analyzed, the frequency of use was ≥100, which belonged to high-frequency drugs. There were 12 kinds of drugs, namely Bai zhu, Fu lin, Gan cao, Bai sao, Zhi ke, Yi yi ren, Huang qi, Dang gui, Bai hua she she cao, Sha ren, Mu dan pi and Da fu pi. Using the association rule mining method, the support degree was set to 40%, the confidence was 0.8, and a total of 18 common drug combinations were obtained. Conclusion:Through the analysis and summary of the system of TCMISS, it can be seen that Professor Shi Weiqun has unique characteristics in the treatment of hepatitis B and cirrhosis. The idea of “care for the spleen and stomach” runs through the treatment of the disease. Tonifying Qi and spleen, activating qi to excrete water, and promoting blood circulation for removing blood stasis were used in clinical experience. The core drug combination of the group were Bai zhu, Fu lin, Gan cao, Bai sao, Zhi ke, Yi yi ren, Huang qi, Dang gui and Bai hua she she cao. TCMISS plays an important role in the inheritance and promotion of the experience of the famous Chinese medicine practitioners and the summary of the clinical experience of the clinicians. It has certain scientific and social significance.