郑玉玲教授治疗卵巢癌用药规律分析

Analysis of Professor ZHENG Yuling's Medication Rule for Ovarian Cancer

目的运用数据挖掘方法分析总结提炼郑玉玲教授治疗卵巢癌的思想。方法收集郑玉玲教授门诊治疗卵巢癌的处方,组建数据库,采用频数、聚类分析、关联规则及核心药对复杂网络分析等对方剂及高频中药进行分析。结果在契合纳入条件的46例医案中,频数最高的前5位方剂:五积散、当归芍药散、薯蓣丸、桃核承气汤、桂枝茯苓丸;将五积散主症标准化,归纳其治疗卵巢癌的症状特点。共涉及中药140味,累积次数803次,用药类别以温补脾肾,活血化瘀,利水祛湿为主。药性以温性居多,药味以甘味最多,药物归经以脾经、肺经、肝经居多。关联规则分析显示常用药对21条,系统聚类分析得到5类。复杂网络分析得到以“茯苓”“当归”为中心的2个模块群。结论郑玉玲教授认为卵巢癌病机属正虚邪实,治疗上以扶正祛邪为原则,尤其重视脾肾的调治;祛邪以健脾祛湿、行气利水、活血化瘀为主要治法,配合使用清利下焦湿热的药物。在攻邪时较少使用药性峻猛药物,多应用缓急、缓下的方法,以达到祛邪而不伤正的目的。在攻邪的同时多配合使用扶助正气的药物,很少使用纯粹祛邪方剂。

Objective To analyze and summarize Professor ZHENG Yuling's idea of treating ovarian cancer by data mining.Methods Collect the prescriptions of Professor ZHENG Yuling for ovarian cancer in the outpatient department,establish a database,and use frequency,cluster analysis,association rules and core drugs to analyze the prescription and high-frequency Chinese medicine such as complex network analysis.Results Among the 46 medical cases eligible for inclusion,the top 5 prescriptions with the highest frequency were Wuji Powder,Danggui Shaoyao Powder,Shuyu Pill,Taohe Chengqi Decoction,Guizhi Fuling Pill;The main symptoms of Wuji Powder were standardized,and the symptom characteristics of its treatment for ovarian cancer were summarized.A total of 140 traditional Chinese medicines were involved,with a cumulative number of 803 times.The drugs were mainly used to warm the spleen and kidney,promote blood circulation and remove blood stasis,and promote water and damp.Most of the drugs are warm,most of the drugs are sweet,and most of the drugs belong to spleen,lung and liver meridians.Association rule analysis showed that there were 21 drug pairs in common use,and 5 types were obtained by cluster analysis.The complex network analysis obtained two module groups centered on“Poria cocos”and“Angelica sinensis”.Conclusion Professor ZHENG Yuling believes that the pathogenesis of ovarian cancer belongs to the deficiency of vital energy and the excess of pathogenic factors;The main therapeutic methods for dispelling evils are invigorating the spleen and removing dampness,promoting Qi and water circulation,promoting blood circulation and removing blood stasis,and the drugs for clearing away dampness and heat in the lower energizer are used together.When attacking evils,it is less to use harsh drugs,and more to use the method of urgency and slowness,so as to achieve the goal of eliminating evils without harming the origin.At the same time of attacking evils,we should use more medicines to help the healthy Qi,and rarely use pure dispelling prescriptions.