基于数据挖掘分析慢性疲劳综合征中医证候特征及用药规律

Analysis on Syndromes and Medication Law of Chronic Fatigue Syndrome Based on Data Mining

目的 探讨慢性疲劳综合征的中医证候、证候要素、病位及用药规律。方法 检索知网、维普、万方及SinoMed中自建库至2020年的文献,从符合排除纳入标准的332篇文献的12 456例病例中提取证候要素及用药组成,利用EXCEL与中医传承辅助平台软件建立数据库,采用Aprior算法及熵层次聚类的数学算法进行总结整理。结果 共提取证候要素9个,主要为气虚、气滞、血虚;病位共5个,主要在脾、肝;共有证型42个,以肝郁脾虚多见;使用中药共计233种,使用频次最高的有补虚药、清热药及利水渗湿药,药性多为温性,归经多为脾、肝经。基于关联规则得到核心药物组合为黄芪、白术、当归、茯苓、柴胡、白芍、党参、炙甘草、陈皮,其治疗机制涉及抗神经元凋亡、抗氧化、提高免疫力、调节代谢产物、抑制炎症反应等。根据熵聚类分析得到6个新方,对于气虚、气滞、血虚、阴虚等证提供一定的用药参考。结论 慢性疲劳综合征的核心病机为气虚,在治疗上应以补虚为主,辅以理气、祛湿、活血。

Objective To explore the traditional Chinese medicine(TCM)syndrome, syndrome elements, disease location and medication law of chronic fatigue syndrome(CFS).Methods A systematic literature review of CNKI,Weipu, Wanfang and SinoMed from the establishment of the database to 2020 was conducted.Syndrome elements and drug composition were extracted from 12456 cases of 332 literatures that met the exclusion criteria.Excel and Chinese Medicine Inheritance auxiliary platform software were used to establish a database.Aprior algorithm and entropy hierarchical clustering algorithm were used to summarize and sort out the data.Results A total of 9 syndrome elements were extracted, mainly including Qi deficiency, Qi stagnation and blood deficiency.There were 5 locations, and it was mainly in spleen and liver.There were 42 syndrome types, most of which were liver depression and spleen deficiency and 233 kinds of traditional Chinese medicine were used.The most frequently used drugs were tonifying deficiency, clearing heat and promoting urination drugs.Most of the drugs are warm, and most of the meridians tropism were spleen and liver meridians.The core drug combinations obtained based on association rules were Huangqi(Astragali Radix),Baizhu(Atractylodis Macrocephalae Rhizoma),Danggui(Angelicae Sinensis Radix),Fuling(Poria),Chaihu(Bupleuri Radix),Baishao(Paeoniae Radix Alba),Dangshen(Codonopsis Radix),Zhigancao(Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle)and Chenpi(Citri Reticulatae Pericarpium).The therapeutic mechanism involves anti neuronal apoptosis, anti-oxidation, improving immunity, regulating metabolites, inhibiting inflammatory reaction, etc.According to the entropy clustering analysis, six new prescriptions were obtained, which provided certain medication reference for Qi deficiency, Qi stagnation, blood deficiency, Yin deficiency and other syndromes.Conclusion The core pathogenesis of CFS is Qi deficiency.The treatment should be mainly regulating Qi, eliminating dampness and promoting blood circulation for tonifying the deficiency.