基于数据挖掘平台的韩世荣名老中医治疗白癜风的用药规律研究

Research on the medication law of traditional Chinese medicine doctor han shirong in the treatment of vitiligo based on data mining platform

目的通过数据挖掘系统,归纳总结韩世荣名老中医治疗白癜风的理论思想及临证用药经验,寻找其中规律以期更好地指导临床。方法基于中医传承辅助平台V2.50软件,收集陕西省中医医院皮肤科门诊2020年6月至2021年6月经韩世荣名老中医诊治且诊断明确的白癜风患者门诊病案,对录入的处方进行药物频次统计、四气五味及归经统计、组方规律及关联规则分析、复杂系统熵聚类等数据挖掘,综合分析用药规律。结果经筛选,共纳入处方数819个,含括中药数122味。按频次排序,频次较高的药物有补骨脂、炒白术、茯苓、黄芪、炒薏苡仁等。药性以温、平为主,药味以甘、辛为主,归经上则以脾、肝、肾为主。常用高频次药对有“炒白术-补骨脂”“补骨脂-茯苓”“炒白术-茯苓”等。聚类分析得出新方9首,功效以益气健脾、清热祛湿、滋补肝肾为主。结论韩教授认为白癜风核心病机为内火所导致的气血失调,治疗重点在于“敛肌腠之热”,以“甘温除热”“引火归元”为法,用药多以白术、黄芪、党参等补中升阳,以附子、干姜、肉桂等助肾收敛元阳。施用茯苓、薏苡仁使邪从膀胱祛,强调补泻结合,祛邪不伤正的原则。

Objective To better guide the clinical practice,this paper summarizes Han Shirong’s theoretical ideas and clinical experience in the treatment of vitiligo through the data mining system and looks for the hidden rules.Methods Based on the traditional Chinese medicine inheritance platform system V2.50 software,the outpatient medical records of vitiligo patients diagnosed and treated by Han Shirong,a famous traditional Chinese medicine doctor,from June 2020 to June 2021 was collected.After data screening and processing,the records were entered into the software.The entered prescriptions were analyzed comprehensively by data mining,such as drug use frequency statistics,statistics of four nature of drugs,five flavours,and channel tropism,analysis of prescription rules and association rules,and complex system entropy cluster,etc.Results After screening,819 prescriptions were included,including 122 kinds of traditional Chinese medicine.In order of frequency,the drugs with high frequency were malaytea scurfpea fruit,fried largehead atractylodes rhizome,indian bread,milkvetch root,fried coix seed,ect.;the medicinal properties were mainly warm and flat,the medicinal tastes were mainly sweet and pungent,and the main ones were spleen,liver and kidney.The commonly used high-frequency drug pairs were“fried largehead atractylodes rhizome-malaytea scurfpea fruit”,“malaytea scurfpea fruit-indian bread”and“fried atractylodes-fried largehead atractylodes rhizome”.Cluster analysis obtained nine new prescriptions,the effect of which was mainly to tonify qi and spleen,clearing heat and dampness,and nourishing liver and kidney.Conclusion Professor Han believes that the core pathogenesis of vitiligo is the disorder of qi and blood caused by internal fire.The treatment focus is on reducing the potential heat between skin surface and muscle.Professor Han takes“Ganwen Chure”,“Yinhuo Guiyuan”as the methods.He uses largehead atractylodes rhizome,milkvetch root,tangshen and other drugs to invigorate and raise the Yang.He also uses prepared common monkshood branched root,zingiber and cassia bark to help the kidney astringe yuanyang.Applying indian bread and coix seed to remove the pathogenic factor from the bladder.It emphasize the combination of reinforcing and reducing.It also stress the principle of removing the pathogenic factor without harming the health.