真实世界中2576例慢性胃炎患者临床诊治规律分析

Analysis of Clinical Diagnosis and Treatment of 2576 Cases of Chronic Gastritis in Real World

目的基于真实世界2576例患者分析中医药治疗慢性胃炎的临床诊治用药规律,为临床指导用药提供思路。方法对张润顺主任医师的门诊病历处方所用中药进行数据挖掘,包括单味药物频次、药物功效和性味归经频次,并使用关联规则、聚类分析方法进行分析。结果2576例患者中男967例(37.5%),女1609例(62.5%),平均年龄为50.38岁。其中最常用的药物为甘草、陈皮、茯苓、黄连;使用中药中功效排名前5位分别是:补虚药、理气药、清热药、化痰药、活血化瘀药;使用药物药味排名前5位分别是:苦、辛、甘、酸、微苦;使用药物药性排名前5位分别是:温、微寒、平、寒、微温;使用药物归经排名前5位分别是:脾、肺、胃、肝、心。关联规则分析结果示支持度最高的药对是陈皮-柴胡(Support=0.665),置信度最高的药对是陈皮-枳壳(Confidence=0.893)。中药聚类分析结果共有4类。结论中医药治疗慢性胃炎的方法多以理气补虚、清热化湿、活血化瘀、辛开苦降为主,所用药物多为以辛温与苦寒相配伍为主的多种组合。

Objective To analyze the clinical diagnosis,treatment and medication law of traditional Chinese medicine in the treatment of chronic gastritis based on 2576 patients in the real world,so as to provide ideas for clinical medication.Methods The traditional Chinese medicine used in the outpatient medical record prescription of Chief Physician ZHANG Runshun was mined,including the frequency of single drug,drug efficacy,properties,tastes and meridian tropisms,then analyzed by association rules and cluster analysis.Results Among them,967 cases(37.5%) were males and 1609 cases(62.5%) were females,with an average age of 50.38 years.Among them,the most commonly used drugs are Licorice,Tangerine peel,Poria and Coptis chinensis;the top 5 in the use of traditional Chinese medicine are:tonic drugs,Smoothing Qi medicines,antipyretic drugs,phlegm medicines,blood-activating and stasis drugs;the top 5 tastes are:bitter,acrid,sweet,acid,and slightly bitter;the top 5 properties are:warm,slightly cold,even,cold,and micro-warm;the top 5 meridian tropisms are:spleen,lungs,stomach,liver,and heart.The results of association rule analysis showed that the drug pair with the highest support was Tangerine-Bupleurum(Support = 0.665),The drug pair with the highest confidence is Tangerine peel-Fructus aurantii(Confidence= 0.893).There are four kinds of cluster analysis results of drugs.Conclusion The overall means of traditional Chinese medicine in the treatment of chronic gastritis are mainly based on Smoothing Qi to supplement deficiency,clear heat and dampness,activate blood and dissolve stasis,and work hard to reduce pain,and the drugs used are mostly a variety of combinations based on the combination of hard temperature and bitter cold.