基于中医古籍挖掘冠心病气虚血瘀证的用药规律

Medication rule of coronary heart disease with Qi deficiency and blood stasis syndrome: A study based on data mining of Chinese medical classics

目的:基于中医古籍挖掘冠心病气虚血瘀证的用药规律。方法:在《中华医典》数据库及湖南中医药大学图书馆馆藏图书中搜集关于采用中药内服治疗冠心病气虚血瘀证的医案。运用Excel建立原始数据库,进行频次分析,采用SPSS Statistic 25.0和SPSS Modeler 18.0对高频药物进行关联分析和聚类分析。结果:共筛选出医籍71部,医案195则,方剂195首,药物206味,累计用药频次共2561次,排前5位的中药依次为丹参、黄芪、甘草、川芎、当归。排前5位的药物功效依次为补虚药、活血化瘀药、理气药、化痰止咳药、解表药。药性以温、寒、平为主,药味以甘、辛、苦为主,归经以心、肝、脾经为主。关联规则分析显示,丹参、黄芪、川芎、甘草为核心中药。关联强度排前3位的药对依次为川芎-丹参、丹参-黄芪、丹参-甘草。频次最高的2组药物组合为丹参-川芎、丹参-黄芪。聚类分析显示药物分类有4类。结论:治疗冠心病气虚血瘀证需谨守本虚标实之病机,尤为注重补虚药和活血药的使用,益气活血,标本兼治。

Objective: To investigate the medication rule of coronary heart disease with Qi deficiency and blood stasis syndrome based on data mining of Chinese medical classics.Methods: Traditional Chinese Medicine Classics Database and the library collection of Hunan University of Chinese Medicine were searched for medical records on the oral administration of traditional Chinese medicine(TCM) in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.Excel was used to establish the original database for frequency analysis, and SPSS Statistic 25.0 and SPSS Modeler 18.0 were used to perform the association analysis and cluster analysis of high-frequency drugs.Results: A total of 71 medical classics, 195 medical records, 195 prescriptions, and 206 drugs were obtained, with a cumulative drug frequency of 2561,and the top 5 TCM drugs in terms of frequency were Salvia miltiorrhiza, Astragalus membranaceus, Radix Glycyrrhizae, Rhizoma Chuanxiong, and Angelica sinensis.The top 5 drug functions were deficiency-tonifying drugs, blood-activating and stasis-resolving drugs, Qi-regulating drugs, phlegm-eliminating and cough-relieving drugs, and exterior syndrome-relieving drugs.Most drugs had a warm, cold or neutral nature and a sweet, pungent or bitter taste and mainly entered the heart, liver, and spleen meridians.The association rule analysis showed that Salvia miltiorrhiza, Astragalus membranaceus, Rhizoma Chuanxiong, and Radix Glycyrrhizae were core TCM drugs.The top 3 drug combinations in terms of association intensity were Rhizoma Chuanxiong-Salvia miltiorrhiza, Salvia miltiorrhiza-Astragalus membranaceus, and Salvia miltiorrhiza-Radix Glycyrrhizae, and the top 2 drug combinations in terms of frequency were Salvia miltiorrhiza-Rhizoma Chuanxiong and Salvia miltiorrhiza-Astragalus membranaceus.The cluster analysis showed that the drugs could be clustered into 4 types.Conclusion: In the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome, the pathogenesis of deficiency in origin and excess in superficiality should be considered cautiously, with a focus on the application of deficiency-tonifying drugs and blood-activating drugs.Qi-tonifying and blood-activating therapies should be used to treat both manifestation and root cause of disease.