基于数据挖掘刘国安教授治疗老年高血压临床经验研究

Data Mining-based Study on Professor Liu Guoan′s Clinical Experience in Treating Elderly Hypertension

目的:分析刘国安教授治疗老年高血压的用药规律和临床经验。方法:收集2020年10月1日至2021年10月1日刘国安教授诊治的58例老年高血压患者病案信息,描述性分析用药频数、性味等用药情况,对高频用药进行聚类分析、因子分析。结果:58首处方共涉及中药65味,频数≥20次的中药有10味,前3位依次为生地黄,甘草,山药、牛膝;药性多为平、寒;药味多为甘,其次苦和辛;药物归经多以肝、心、肾为主。高频药物因子分析得出4个公因子,主要涉及生龙骨、生牡蛎、柏子仁、牛膝、山药、白芍、甘草等7味中药。高频药物聚类分析得到6类:第1类为生龙骨、生牡蛎、生地黄,第2类为山药、白芍,第3类为牛膝、柏子仁;其余3类为单味药,分别是夜交藤、当归、甘草。结论:刘教授认为老年高血压多为肾阴亏虚,水不涵木,肝阳上亢,化火生风,痰瘀互结所致,用药以滋肾阴、平肝阳、疏肝风、清肝火、安心神为主,体现出寓通于补,通补兼施的治疗思想。

Objective:To analyze professor Liu Guoan's medication rule and clinical experience in the treatment of elderly hypertension.Methods:Medical record information of 58 elderly patients with hypertension diagnosed and treated by professor Liu were collected from October 1,2020 to October 1,2021,the frequency of medication,property and flavor of the medicine were analyzed using descriptive analysis,cluster analysis and factor analysis of high-frequency medication were carried out.Results:There were 65 herbs involved in 58 prescriptions,ten herbs with the frequency≥20 times,and the top three herbs were Shengdihuang(Rehmanniae radix),Gancao(Glycyrrhizae radix et rhizoma),Shanyao(Dioscoreae rhizoma)and Niuxi(Achyranthis bidentatae radix)successively;the natures of the medicine mostly were mild and cold;the flavors of the medicine were mostly sweet,followed by bitter and pungent;the meridian tropism was liver,heart and kidney mostly.Four common factors obtained by high frequency drug factor analysis mainly involved seven herbs,containing fossil fragments,Muli(Ostreae concha),Baiziren(Platycladi semen),Niuxi,Shanyao,Baishao(Paeoniae radix alba)and Gancao.Six kinds of herbs gained by cluster analysis of high-frequency herbs covered:the first kind:Shenglonggu,Muli,Shengdihuang(Rehmanniae radix),the second kind:Shanyao,Baishao,the third kind:Niuxi,Baiziren;the rest three kinds:single herb,Yejiaoteng(Tuber fleeceflower stem),Danggui and Gancao respectively.Conclusion:Professor Liu thinks that elderly hypertension is induced by depletion of kidney Yin,water failing to nourish wood,hyperactivity of liver Yang,transformation of fire and generation of wind,phlegm and stagnation intermingled,adopting nourishing kidney Yin,pacifying liver Yang,soothing liver wind,clearing liver fire and tranquilizing the mind as the main therapy,which embodies therapeutic thinking of purgation in tonifying,purgation and tonifying simultaneously.