基于数据挖掘的王耀献教授治疗慢性肾炎经验研究

Professor Wang Yaoxian′s Experience in the Treatment of Chronic Nephritis Based on Data Mining

目的:总结王耀献教授治疗慢性肾小球肾炎的用药规律及学术经验。方法:选取2018年6月至2021年5月王耀献教授于东直门中医院门诊诊治的慢性肾炎病例共计452诊次,采用古今医案云平台工具,对数据规范化处理,进行统计、关联、聚类、复杂网络等数据分析。结果:本研究纳入处方452首,涉及药物218种,其常用药物可以分为4大类:1类,黄芪、党参、菟丝子、枸杞子、茯苓、炒白术;2类,防风、青风藤、蝉蜕;3类,海藻、牡蛎、鳖甲、土鳖虫;4类,黄蜀葵花、车前子、蒲公英。四气方面,寒性药、温性药、平性药应用最多,五味方面,甘味药、苦味药、辛味药应用最多。结论:王耀献教授依据慢性肾炎本虚标实的病机,创制了健脾补肾、祛风通络、消癥散结、清利湿热的治疗大法,以达到“通补兼施、邪祛正安”的目的,这体现了王耀献教授治疗慢性肾炎多样化、个体化的用药特点,以期为中医药治疗慢性肾炎提供思路与经验。

Objective:To summarize the medication rules and academic experience of Professor Wang Yaoxian in the treatment of chronic glomerulonephritis.Methods:From June 2018 to May 2021,452 cases of chronic nephritis treated by Professor Wang Yaoxian at the Outpatient Department,Dongzhimen Hospital of Beijing University of Chinese Medicine were selected.The data were standardized and analyzed using the Ancient and Modern Medical Record Cloud Platform,including statistical analysis,correlation analysis,cluster analysis,and complex network analysis.Results:A total of 452 prescriptions involving 218 drugs were included,which can be divided into four major categories.Category 1:Astragali Radix,Codonopsis Radix,Cuscutae Semen,Lycii Fructus,Poria,and fried Atractylodis Macrocephalae Rhizoma;Category 2:Saposhnikoviae Radix,Sinomenii Caulis,and Cicadae Periostracum;Category 3:Sargassum,Ostreae Concha,Trionycis Carapax,and Eupolyphaga Steleophaga;Category 4:Abelmoschi Corolla,Plantaginis Semen,and Taraxaci Herba.In terms of four qi properties,the cold,warm,and neutral drugs were mainly used,while in terms of the five flavors,sweet,bitter,and pungent drugs were mainly used.Conclusion:Based on the pathogenesis of chronic nephritis,i.e.,asthenia in origin and sthenia in superficiality,Professor Wang Yaoxian has developed a treatment method of tonifying the spleen and kidney,dispelling wind and dredging collaterals,breaking blood stasis and dispersing mass,and clearing dampness-heat to achieve the goal of“treating by both dredging and tonifying to expel evil”.This reflects the diversified and personalized medication characteristics of Professor Wang Yaoxian in the treatment of chronic nephritis and provides ideas and experience for the traditional Chinese medicine treatment of this disease.