基于数据挖掘探究阮岩治疗慢性鼻窦炎的用药规律

Exploring the medication pattern of professor Ruan Yan in the treatment of chronic sinusitis based on data mining

目的基于中医传承辅助平台系统分析广州中医药大学第一附属医院阮岩教授治疗慢性鼻窦炎的用药规律。方法通过收集和整理阮岩教授门诊治疗慢性鼻窦炎患者的有效病历,严格按照纳入与排除标准,遴选符合标准的医案,建立医案数据库,运用频数统计、关联规则分析、聚类分析对医案中的证型分布、药物频数、中药组合等进行统计分析,探讨阮岩教授治疗慢性鼻窦炎的用药特点及组方规律。结果共收集阮岩教授治疗慢性鼻窦炎医案159则,包含245个处方,共109味中药(除去甜叶菊)。其中159个医案中脾胃湿热证型占比最大;使用频次≥20的中药有24味;对高频中药进行关联规则分析得到关联药对13个,三味关联中药药组15个,四味关联中药药组4个,并通过聚类分析和因子分析得出7个治疗慢性鼻窦炎的潜在核心基础方及7个核心新处方。结论岭南大部分慢性鼻窦炎患者的证型与气候特点相一致,以脾胃湿热证型的患者居多。阮岩教授治疗慢性鼻窦炎有其独特的治法,认为虚实夹杂是其主要病机,擅于运用补脾益气、宣通鼻窍、清热化湿等主要治法,因地制宜,达到标本兼治。其中,苍耳子散是阮岩教授治疗慢性鼻窦炎最常用的基础方。

Objective To analyze the medication patterns of Professor Ruan Yan of the First Affiliated Hospital,Guangzhou University of Traditional Chinese Medicine,for the treatment of chronic sinusitis,based on the Traditional Chinese Medicine(TCM)inheritance aid platform system.Methods Valid medical records of patients with chronic rhinosinusitis from Professor Ruan Yan?s outpatient clinic were collected and collated.The medical cases that met the criteria were selected strictly according to the inclusion and exclusion criteria,and a medical case database was established.Subsequently,frequency statistics,association rule analysis,and cluster analysis were used to statistically analyze the distribution of evidence types,frequency of drugs,and combinations of Chinese medicines in the medical case repertoire.This was done to explore the characteristics of Professor Ruan Yan?s treatment of chronic rhinosinusitis and the rules of prescription grouping.Results We collected 159 medical records of patients treated for chronic sinusitis by Professor Ruan Yan,containing 245 prescriptions with 109 Chinese herbs(except Stevia rebaudiana).The statistical analysis showed that the largest proportion of all cases was the spleen and stomach damp-heat evidence type;24 herbs were used≥20 times.The association rule analysis of high-frequency herbs yielded 13 associated pairs,15 groups of three associated herbs,and four groups of four associated herbs.Additionally,seven potential core basic prescriptions and seven core new prescriptions for the treatment of chronic sinusitis were derived using cluster and factor analyses.Conclusion Most patients with chronic rhinosinusitis in Lingnan have evidence patterns consistent with climatic characteristics,with the majority of patients having the damp-heat evidence pattern of the spleen and stomach.Professor Ruan Yan considers deficiency and reality as the main pathogenesis based on his unique treatment method for chronic sinusitus.Additionally,Professor Ruan Yan is good at using the main treatment methods such as benefiting qi and strengthening the spleen,promoting nasal circulation,and clearing heat and dampness to achieve both the symptoms and the root cause of the disease according to local conditions.What?more,Xanthium Powder is the basic prescription of Professor Ruan Yan for treating chronic sinusitis.