基于数据挖掘的中医药防治新型冠状病毒感染儿童用药规律分析

Analysis of Medication Patterns in Traditional Chinese Medicine for the Prevention and Treatment of COVID-19 in Children Based on Data Mining

目的:采用数据挖掘方法分析中医药防治儿童新型冠状病毒感染的用药规律,为临床诊治儿童新冠病毒感染提供参考和推荐。方法:收集整理2023年1月10日之前国家及各省、自治区、直辖市卫生健康委员会、中医药管理局最新发布的新冠病毒感染中医药防治方案,建立标准化数据库。采用古今医案云平台(V2.3.5)的统计、关联、层次聚类分析等方法,对中医药治疗儿童新冠病毒感染的症状、证候、方药等进行分析。结果:本研究共纳入儿童治疗相关中医药防治方案28个。方案中得到儿童治疗中药处方共75首、儿童推荐治疗中成药109种。儿童群体新冠病毒感染常见症状为咳嗽、发热、咽痛、乏力、恶心,常见中医证候为疫毒闭肺证、寒湿郁肺证,常见中医治法为辛凉解表、芳香化湿。使用频次前5位的中药为甘草、苦杏仁、芦根、石膏、麻黄,中药药对高频组合为“金银花-甘草”、“石膏-苦杏仁”、“桔梗-芦根”等,使用药物五味以辛为主,四气以温为主,归经以归肺经为主。结论:儿童新冠病毒感染核心病机为“疫毒外侵”,病位在肺,病邪易累及脾胃,应结合儿童临床证候和生理病理特点辨证论治。

Objective:To provide basis for clinical prescriptions by exploration of distribution regularities of TCM for preventing and treating COVID-19 in children by data mining in the relevant literature.Methods:We collected the latest prevention and treatment protocols for COVID-19 by the National Health Commission and the Chinese Medicine Administration(CMA)of each province,autonomous region and municipality directly under the Central Government,and the Health Commissions of provincial capitals and prefecture-level cities before January 10,2023,and a standardized database was established for the prescriptions for prevention and treatment of COVID-19 in children.And 75 prescriptions were analyzed using statistical analysis,association analysis,cluster analysis and other methods integrated with the ancient and modern medical case cloud platform(V2.3.5).Results:This study included 28 prevention and treatment interventions and protocols for COVID-19,including 75 prescriptions and 109 types of Chinese patent medicine.High frequency clinical symptoms include cough,fever,pharyngeal pain,fatigue,nausea.The major TCM syndromes are pestilence-toxicity blocking the lung and Cold dampness stagnation lung syndrome,and the common TCM treatments are acrid-cold herbs relieving superficies and aromatic herbs eliminating dampness.The top 5 frequently used herbal medicines are licorice,bitter almond,rhizome,gypsum and ephedra,and the high frequency combinations of herbal medicines are"honeysuckle-licorice","gypsum-bitter almond","orris-rhizome".The five flavors of the drugs used are mainly pungent,the four natures are mainly warm,the main meridian was the lung.Conclusion:The core pathogenesis of COVID-19 infection in children is"external invasion of epidemic toxin",the disease is located in the lung,and the disease easily involves the spleen and stomach.The treatment should take into account clinical symptoms and physiology characteristics of children.