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基于聚类分析及因子分析挖掘巢国俊临床验案探索“异病同治”的证药关系

Relation Analysis Between Chinese Herbs and Syndrome Type of Homotherapy for Heteropathy on Different Ophthalmic Diseases from Effective Clinical Cases based on Cluster and Factor Analysis
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摘要 目的:探索名中医巢国俊治疗不同眼科疾病同一肝肾阴虚证的“异病同证同治”组方用药关系。方法:运用现代信息技术和数据挖掘技术,整理2015—2022年就诊于巢国俊专家门诊的肝肾阴虚证不同眼病验案处方,分析药物出现频次及高频中药属性、功效,并进行关联规则、系统聚类分析、因子分析。结果:共纳入308张处方,3种常见眼科疾病,得到肝肾阴虚型常用20味高频中药。四气五味方面常用性寒味甘类药物,中药以入肝肾经为主,功效多为补益肝肾、清肝明目、益气健脾等。中药关联分析出20对常用药对组合,聚类分析分为2大组,因子分析进一步挖掘出2个新核心处方,处方1:茯苓、白术、地黄、枸杞子、夏枯草、桑叶、桑白皮;处方2:覆盆子、女贞子、楮实子、菟丝子、炙黄芪。结论:名中医巢国俊专家在临床治疗肝肾阴虚型不同眼底疾病以“肝肾同源”、“肝病传脾”为理论,注重补益肝肾、清热滋阴,兼顾健脾益气,体现了中医“异病同治”的特色。 Objective:To explore the relationship between famous Chinese medicine practitioner CHAO Guojun’s prescriptions and medicines of“Different Diseases,Same Syndromes,Same Treatment”in treating different ophthalmic diseases with the same syndrome of liver and kidney Yin deficiency.Methods:Using modern information technology and data mining technology,sort out the prescriptions of different eye diseases with liver-kidney yin deficiency syndrome in CHAO Guojun’s expert clinic from 2015 to 2022,analyze the frequency of drug occurrence and the properties and efficacy of high-frequency traditional Chinese medicine,and conduct Association rules,system cluster analy-sis,factor analysis.Results:A total of 308 prescriptions were included for 3 common ophthalmic diseases,and 20 highfrequency traditional Chinese medicines commonly used for liver and kidney Yin deficiency were obtained.In terms of four Qi and five flavors,commonly used cold and sweet medicines,traditional Chinese medicine mainly enters the liver and kidney meridian,and its effects are mostly tonifying the liver and kidney,clearing the liver and improving eyesight,nourishing Qi and invigorating the spleen,etc.The association analysis of traditional Chinese medicine found 20 pairs of commonly used medicine pairs.The cluster analysis was divided into 2 groups.The factor analysis further excavated 2 new core prescriptions.Baipi;Prescription 2:Raspberry,Ligustrum lucidum,Chushizi,Cuscuta,Sunburned Astragalus.Conclusion:CHAO Guojun,a well-known TCM expert,treats different fundus diseases of liver and kidney yin deficiency based on the theory of“liver and kidney are of the same origin”and“liver disease spreads to the spleen”as the theory,pays attention to nourishing the liver and kidney,clearing away heat and nourishing yin,and taking into account strengthening the spleen and replenishing Qi.It embodies the characteristics of“treating different diseases with the same treatment”in traditional Chinese medicine.
作者 史随随 周剑 高君 王雪瑶 祁宝玉 巢国俊 SHI Suisui;ZHOU Jian;GAO Jun;WANG Xxueyao;QI Baoyu;CHAO Guojun(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China;China Academy of Chinese Medical Scienses-Eye Hospital,Beijing 100040,China)
出处 《中医药临床杂志》 2023年第3期495-502,共8页 Clinical Journal of Traditional Chinese Medicine
基金 中国中医科学院“名医名家传承”项目(CM2014GD1031) 中国中医科学院科技创新工程(CI2021A02611) 国家中医药管理局国家中医临床研究基地业务建设科研专项课题项目(JDZX2015285) 北京市石景山区名医传承工作室师承项目(1021122)。
关键词 聚类分析 因子分析 眼科临床验案 异病同治 证药关系 Cluster analysis Factor analysis Ophthalmology clinical case Different diseases with the same treatment Syndrome-drug relationship
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