基于数据挖掘探讨黄力教授治疗不同证型原发性高血压的用药经验

Exploring Professor Huang Li’s experience in treating different types of essential hypertension based on data mining

目的分析黄力教授治疗原发性高血压的医案处方,总结黄力教授治疗原发性高血压的相关用药规律。方法收集中日友好医院2014年1月至2019年12月黄力教授所开的597张处方,进行频数分析、聚类分析及关联规则分析,观察其患者证型分布及核心药物组合。结果纳入分析的597张处方依据肝阳上亢证、气虚血瘀证、风痰上扰证、阴虚火旺证和瘀血阻滞证分别进行统计,其中肝阳上亢证患者365例(60.93%)、风痰上扰证患者79例(13.19%)、阴虚火旺证患者72例(12.02%)、气虚血瘀证患者47例(7.85%)、瘀血阻滞证患者34例(5.68%);聚类分析和关联规则分析得到肝阳上亢证核心药物组合为葛根-钩藤-川芎-天麻,风痰上扰证核心药物组合为炒白术-红景天-砂仁-柏子仁,阴虚火旺证核心药物组合为桑寄生-赤芍,气虚血瘀证核心药物组合为川芎-三七粉,瘀血阻滞证核心药物组合为红景天-红花-桃仁-生黄芪-三七粉。聚类分析显示,肝阳上亢证、气虚血瘀证、风痰上扰证、阴虚火旺证和瘀血阻滞证分别聚类为5、5、4、5、4类。结论黄力教授临床治疗原发性高血压常用平肝息风药、活血化瘀药、安神药,重视肝在高血压发病中的重要地位及瘀血等病理因素,并随症加减配伍。

Objective To analyze the medical case prescriptions of Professor Huang Li for the treatment of essential hypertension,and to summarize the relevant medication rules of Professor Huang Li for the treatment of essential hypertension.Methods The 597 prescriptions written by Professor Huang Li at China-Japan Friendship Hospital from January 2014 to December 2019 were collected,and frequency analysis,cluster analysis,and association rule analysis were performed to observe the distribution of their patient evidence types and core drug combinations.Results The 597 prescriptions included in the analysis were counted according to the evidence of liver-yang hyperactivity,qi deficiency and blood stasis,wind-phlegm upheaval,yin deficiency and fire stasis,and blood stasis,among which 365 patients(60.93%)with liver-yang hyperactivity syndrome,79 patients(13.19%)with wind-phlegm upheaval syndrome,72 patients(12.02%)with yin deficiency and fire stasis syndrome,47 patients(7.85%)with qi deficiency and blood stasis syndrome,34 patients(5.68%)with blood stasis syndrome.Cluster analysis and association rule analysis showed that the core Chinese medicine combination of liver-yang hyperactivity syndrome was Puerariae Lobatae Radix-Uncariae Ramulus cum Uncis-Chuanxiong Rhizoma-Gastrodiae Rhizoma.The core Chinese medicine combination of wind-phlegm syndrome was Atractylodis-Macrocephalae Rhizoma-Rhodiola rosea-Semen Platycladi.The core Chinese medicine combination of yin deficiency and fire was Taxilli Herba-Paeoniae Radix Rubra.The core Chinese medicine combination of qi deficiency and blood stasis syndrome was Chuanxiong Rhizoma-Notoginseng Radix.The core Chinese medicine combination of stasis block syndrome was Macrocephalae Rhizoma-Croci Stigma-Astragali Radix-Notoginseng Radix.Cluster analysis showed that the syndrome of liver-yang hyperactivity,qi deficiency and blood stasis,wind-phlegm upheaval,yin deficiency and fire stasis and blood stasis were clustered into 5,5,4,5,and 4 categories respectively.Conclusion Professor Huang Li’s clinical treatment of primary hypertension commonly used to pacify the liver and calming the wind,invigorating blood stasis and calming the mind,paying attention to the important role of the liver in the pathogenesis of hypertension and pathological factors such as blood stasis,and using targeted drug combinations.