基于真实世界的名老中医辨治肺癌的复杂网络分析

Complex Network Analysis of Diagnosis and Treatment of Lung Cancer by Illustrious Senior Traditional Chinese Medicine Practitioners Based on Real World

目的:运用复杂网络分析的方法总结国家级名老中医辨治肺癌的证治规律,为临床中医药治疗肺癌提供参考。方法:依托名医传承平台收集6位擅治肺癌的国家级名老中医医案,经名医传承平台导出医案数据至Excel软件,提取辨证分型及首诊中药处方数据,建立证型数据库及中药数据库,基于Gephi 0.9.2构建名老中医辨治肺癌的“证型-中药”复杂网络。结果:共收集有效医案1 056则,6位国家级名老中医辨治肺癌的主要共现证型为气阴两虚证,其次为痰瘀互结证及肺脾两虚证;核心用药为补虚药、化痰止咳平喘药、活血化瘀药及清热药等。结论:名老中医辨治肺癌以“正虚邪盛”为基本病机,以“气阴两虚、痰瘀互结、肺脾两虚”为核心病机,临证以益气养阴、祛痰活血为主要治法。

Objective:To summarize the syndrome and treatment patterns of lung cancer treated by national famous traditional Chinese medicine expert using complex network analysis method,and to provide reference for the clinical treatment of lung cancer with traditional Chinese medicine.Methods:Based on the FangNet platform,the medical records of 6 illustrious senior traditional Chinese medicine practitioners who were good at treating lung cancer were collected.The medical record data were exported to Excel software through the FangNet platform,and the data of syndrome differentiation and first diagnosis of traditional Chinese medicine prescriptions were extracted,and the syndrome type database and traditional Chinese medicine database were established.Based on Gephi 0.9.2,a complex network of"syndrome types-traditional Chinese medicine"for the treatment of lung cancer by illustrious senior traditional Chinese medicine practitioners was constructed.Results:A total of 1056 cases of effective medical records were collected.The main co-occurrence syndrome types of lung cancer differentiation and treatment among 6 national renowned traditional Chinese medicine practitioners were Qi Yin deficiency syndrome,followed by phlegm stasis syndrome and lung spleen deficiency syndrome.Core medications included tonifying deficiency,resolving phlegm,relieving cough,and asthma,promoting blood circulation and resolving blood stasis,and clearing heat.Conclusion:The differentiation and treatment of lung cancer by illustrious senior traditional Chinese medicine practitioners was based on the basic pathogenesis of"weakness of healthy Qi and strength of unhealthy Qi",with the core pathogenesis of"Qi Yin deficiency,phlegm and blood stasis,lung spleen deficiency",and the main treatment method for clinical symptoms was to replenish Qi and nourish Yin,dispel phlegm and promote blood circulation.