中医药治疗肺结节处方用药规律的数据挖掘研究

Data Mining on Chinese Medicinal Prescriptions for Pulmonary Nodules

目的:应用数据挖掘的方法研究中医药治疗肺结节的用药规律。方法:检索数据库中医药治疗肺结节的文献,构建肺结节方药数据库,利用SPSS 26.0、SPSS modeler 18.0软件,对肺结节处方进行性味归经、使用频次、关联规则、系统聚类、复杂网络等分析。结果:共纳入方剂122首,19大类中药,194味中药,中药使用总频次为1917次。药性以寒、温及平性为主,药味以苦、甘和辛味为主;归经以脾(胃)、肺(大肠)和肝(胆)经为主。中药使用类别以补虚药、清热药、化痰药、活血化瘀药及理气药为主。中药使用频次靠前的中药为甘草、浙贝母、黄芪、茯苓、当归、白术、半夏、牡蛎、夏枯草、川芎等。关联规则得到6组关联度较强的中药组合。聚类分析分为5组聚类中药组合。复杂网络分析显示以健脾益气、养阴、化痰散结、养血活血、行气类药物为主。结论:肺结节病机本虚标实,以肺脾气虚为本,以气滞、痰凝、血瘀有形结节为标,治宜肺脾同治、肝肺同治,临证应重视培土生金、气阴双补、苦降辛开、调气畅血等理论的应用,处方以四君子汤、二陈汤、沙参麦冬汤及柴胡疏肝散加减为核心,兼理气化痰、活血化瘀、软坚散结等法。

Objective:To reveal the medication rules of Chinese medicinal prescriptions in the treatment of pulmonary nodules based on data mining.Methods:The literature on the treatment of pulmonary nodules with Chinese medicinal prescriptions was retrieved for the building of a database of prescriptions for pulmonary nodules.SPSS 26.0 and SPSS modeler 18.0 were employed to analyze the natures,tastes,meridian tropism,frequency,association rules,systematic clustering,and complex networks of the medicines in the prescriptions.Results:A total of 122 prescriptions involving 194 Chinese medicines belonging to 19 major categories were included,and the total frequency of Chinese medicines used was 1917.The medicine were mainly cold,warm and plain,tasted bitter,sweet,and pungent,and had tropism to the spleen(stomach),lung(large intestine),and liver(gallbladder)meridians.The Chinese medicines commonly used were tonifying medicines,heat-clearing medicines,phlegm-resolving medicines,stasis-resolving medicines,and qi-moving medicines.The Chinese medicines with high frequency were Glycyrrhizae Radix et Rhizoma,Fritillariae Thunbergii Bulbus,Astragali Radix,Poria,Angelicae Sinensis Radix,Atractylodis Macrocephalae Rhizoma,Pinelliae Rhizoma,Ostreae Concha,Prunellae Spica,and Chuanxiong Rhizoma.Six Chinese medicine combinations with strong associations were predicted.The cluster analysis yielded 5 groups of Chinese medicine combinations.The complex network analysis showed that the medicines were mainly used to invigorate spleen,replenish qi,nourish yin,resolve phlegm,dissipate mass,nourish and activate blood,and move qi.Conclusion:Pulmonary nodules are rooted from the qi deficiency in lung and spleen and have the syndromes of qi stagnation,phlegm coagulation,and blood stasis.The treatment should involve both lung and spleen/liver and apply the theories of cultivating earth and generating gold,nourishing qi and yin,pungent dispersing and bitter descending,and regulating qi and blood.Sijunzi Decoction,Erchen Decoction,Shashen Maidong Decocton,and Chahu Shugan Powder can be modified according to the syndromes and the treatment methods such as regulating qi to resolve phlegm,activating blood to resolve stasis,and softening hardness and dissipating mass can be employed.