基于数据挖掘探讨中医药治疗冠心病PCI术后再发心绞痛气虚血瘀证的用药规律

Based on Data Mining to Explore the Medication Rules of Traditional Chinese Medicine in the Treatment of Angina Pectoris after PCI with Coronary Heart Disease of Qi Deficiency and Blood Stasis Syndrome

目的采用数据挖掘分析中医药治疗冠心病经皮冠状动脉介入治疗(PCI)术后再发心绞痛气虚血瘀证的临床用药特点及遣药组方规律。方法系统检索中国知网(CNKI)、万方数据库(WanFang Data)、维普中文期刊数据库(VIP)、中国生物医学文献数据库(SinoMed)、PubMed数据库建库至2022年3月所有中医药治疗冠心病PCI术后再发心绞痛气虚血瘀证的相关文献。提取处方名称及药物组成,使用Excel 2019统计药物的使用频次,对其性、味、归经及功效类别进行频数分析;采用IBM SPSS Modeler 18.0和IBM SPSS Statistics 25.0对高频药物分别进行关联规则分析与系统聚类分析。结果纳入文献36篇,涉及处方34首,包含中药88味,总使用频次367次;使用频次较高的中药为黄芪(7.63%)、川芎(6.27%)、丹参(5.99%)等;药物功效以补虚药(29.16%)与活血化瘀药(27.79%)为主;药性以温、寒、平较多,药味以甘、苦、辛为主,药物以入肝经、脾经、心经居多。将使用频次≥5次的中药进行关联规则分析获得“黄芪-当归”“黄芪-当归-川芎”等常用药对,聚类分析获得4个聚类组合。结论冠心病PCI术后再发心绞痛气虚血瘀证为本虚标实之证,治疗以益气活血为主,辅以滋阴、行气、活络、涤痰等,挖掘出补阳还五汤、四君子汤、参松养心胶囊组方加减等,以期为后续临床实践提供参考。

Objective To analyze the prescription rules of traditional Chinese medicine for the treatment of angina pectoris after percutaneous coronary intervention(PCI)with Qi deficiency and blood stasis syndrome by data mining.Methods China National Knowledge Infrastructure(CNKI),WanFang Data Knowledge Service Platform(WanFang Data),VIP Chinese Periodical Database(VIP),China Biomedical Literature Database(SinoMed),and PubMed Database for all Chinese medicine treatments from the establishment of the database to March 2022 Relevant literature on angina pectoris after PCI with Qi deficiency and blood stasis syndrome.The prescription name and drug composition,were extracted and excel 2019 was used to count the frequency of drug use,and frequency analysis were performed medicine nature,taste,meridian and efficacy categories.IBM SPSS Modeler 18.0 and IBM SPSS Statistics 25.0 were used to conduct association rule analysis and systematic clustering analysis on high-frequency drugs respectively.Results Thirty-six literatures were included in the study,involving 34 prescriptions,including 88 traditional Chinese medicines,with a total use frequency of 367 times.The most popular traditional Chinese medicines were Astragalus(7.63%),Ligusticum Wallichii(6.27%)and Salvia(5.99%).The efficacy of medicines was mainly composed of tonic medicines(29.16%)and blood-activating and stasis-removing medicines(27.79%).The properties of the medicine were mostly warm,cold,and flat,the taste were mainly sweet,bitter,and acrid,and the majority of medicines enter the liver,spleen,and heart meridians.The association rules of traditional Chinese medicines with a frequency of use≥5 were analyzed to obtain that common drug pairs were,Astragalus-Angelica,Astragalus-Angelica-Ligusticum Wallichii,etc.Cluster analysis resulted showed there were 4 cluster combinations.Conclusion Angina pectoris after PCI with of Qi deficiency and blood stasis syndrome is a syndrome of deficiency and excess.The treatment is mainly to nourish Qi and activate blood,supplemented by nourishing Yin,activating Qi,activating collaterals,removing phlegm,etc.The modified Buyang Huanwu Decoction,Sijunzi Decoction,and Shensong Yangxin Capsules would provide reference for subsequent clinical practice.