基于数据挖掘中医药治疗原发性肝癌的用药规律研究

Medication rules of traditional Chinese medicine in treatment of primary liver cancer:a study based on data mining

目的分析现代文献医案中中医药治疗原发性肝癌的用药规律。方法以“肝癌”“中医药”“医案”为主题词,收集中国知网、万方、维普、中国生物医学文献数据库及PubMed现代医学文献数据库中收录的中医药治疗原发性肝癌的医案,采用数据挖掘法分析其用药规律。结果共纳入136篇文献,163份医案,涉及中药312味,累计频次5210次。发现患者群中男性多于女性,以中老年人为主;疑似肝癌常见的病名是肝积、臌胀、积聚;肝癌常见证型为肝郁脾虚、肝气郁结、脾胃虚弱、湿热蕴结、气滞血瘀;常见治法是益气法、行气法、活血法、解毒法、清热法。处方多为自拟方,中药频次分析显示治疗肝癌常见的药物是白术、茯苓、白花蛇舌草、鳖甲、甘草、白芍、半枝莲、黄芪、柴胡等。多层次子网络分析,根据肝癌不同证型、症状辨证/症用药。结论中医临证治疗肝癌以健脾益气类中药为主,佐以化痰散结、抗癌解毒、活血化瘀、清热祛湿、理气止痛类中药,祛邪始终不离扶正。

Objective To analyze the medication rules of traditional Chinese medicine(TCM)in treating primary liver cancer in modern literatures and medical records.Methods We collected the medical records of TCM in the treatment of primary liver cancer with the subject terms of“liver cancer”,“traditional Chinese medicine/TCM”and“medical records”in modern medical literature databases such as CNKI,WanFang,VIP,CBM and PubMed,and analyzed the medication rules by data mining.Results A total of 136 literatures and 163 medical records were included,involving 312 Chinese herbal medicines,with a cumulative frequency of 5210 times in this study.There were more males than females in the affected population,mainly middle-aged and elderly;the common names of suspected liver cancer were liver accumulation,swelling and accumulation;the common syndromes of liver cancer were liver depression and spleen deficiency,liver qi stagnation,spleen and stomach weakness,damp-heat accumulation,and qi stagnation and blood stasis;common treatment methods were qi-enriching method,qi-promoting method,blood-activating method,detoxification method,and heat-clearing method.The prescriptions were mostly self-made.The frequency analysis of TCM showed that the common drugs for the treatment of liver cancer were Atractylodes macrocephala,Poria cocos,Hedyotis diffusa,Turtle beetle,licorice,Radix Paeoniae Alba,Scutellaria barbata,Astragalus,Bupleurum,etc.Medication rules according to different syndrome types and symptoms of liver cancer were summarized by multi-level sub-network analysis.Conclusion TCM clinical treatment of liver cancer is mainly based on invigorating the spleen and replenishing qi,supplemented by Chinese herbal medicines for resolving phlegm and dispelling stagnation,anti-cancer and detoxification,promoting blood circulation and removing blood stasis,clearing heat and dampness,and regulating qi and relieving pain.The pathogen elimination is always accompanied by vital qi support.