基于数据挖掘分析中医药治疗溃疡性结肠炎的用药规律

Medication rule of traditional Chinese meclicine in the treatment of ulcerative colitis:A study based on data mining

目的:基于数据挖掘技术分析中医药治疗脾虚湿热型溃疡性结肠炎(UC)的用药规律。方法:收集整理2017年6月1日至2022年6月1日在湖南中医药大学第一附属医院肛肠科门诊就诊的脾虚湿热型UC的病案资料,借助Microsoft Office Excel 2016、SPSS 26.0、SPSS Modeler 18软件对处方药物进行频次、关联规则及聚类分析。结果:共纳入处方159首,中药152味,用药频次总计2260次,其中高频药物共24味,排前10位的分别为黄连、党参、白术、蒲公英、陈皮、黄芪、当归、白芍、生地黄、木香。功效以清热、补虚为主,性味以寒、温、平性及甘、苦、辛味为主,多归脾、胃、肝、肺、大肠经。高频药物关联规则分析得到7对常用药对,其中党参-黄连支持度最高。聚类分析得到5组药物组合。结论:中医药治疗脾虚湿热型UC以脾胃为中心,注重调达肝经,畅通腑气。遣方用药以健脾清肠为大法,常以清热燥湿、益气健脾为主,注重气血皆调、通因通用,善用风药,体现出“虚实论治,标本兼顾,寒温并用,补泻兼施”的施治特点。

Objective:To investigate the medication rule in the traditional Chinese medicine(TCM) treatment of ulcerative colitis(UC) with spleen deficiency and damp-heat based on data mining.Methods:Medical records were collected from the patients with UC with syndrome of spleen deficiency and damp-heat who attended the outpatient service of Department of Coloproctology,The First Affiliated Hospital of Hunan University of Chinese Medicine,from June 1,2017 to June 1,2022,and Microsoft Office Excel 2016,SPSS 26.0,SPSS Modeler 18,and were used to perform the frequency,association rule,and cluster analyses of the drugs in prescriptions.Results:A total of 159 prescriptions were included,involving 152 TCM drugs,with a total frequency of 2260 times.There were 24 high-frequency drugs,and the top 10 drugs were Coptis chinensis,Codonopsis pilosula,Atractylodes macrocephala Koidz.,dandelion,tangerine peel,Astragalus membranaceus,Angelica sinensis,Radix Paeoniae Alba,Radix Rehmanniae,and Saussurea costus.The main functions were clearing heat and tonifying deficiency;most drugs were cold,warm,or neutral in nature and had a sweet,bitter,or pungent taste;most drugs entered the spleen,stomach,liver,lung,and large intestine meridians.The association rule analysis of high-frequency drugs obtained 7 commonly used drug combinations,among which Codonopsis pilosula-Coptis chinensis had the highest degree of support.The cluster analysis obtained 5 drug combinations.Conclusion:TCM treatment of UC with spleen deficiency and damp-heat focuses on the spleen and stomach and emphasizes the regulation of liver meridian and unobstructed Fu-Qi.As for prescription and medication,invigorating the spleen and clearing the intestine are the main treatment method,especially the heat-clearing and dampness-drying therapy and the Qi-tonifying and spleen-invigorating therapy,with a focus on the regulation of both Qi and blood and the treatment of discharging disease with purgatives,and wind-expelling drugs are often used,which reflects the treatment features of “treatment of deficiency and excess,addressing both the symptoms and root causes,use of both cold and warm drugs,and simultaneous application of tonifying and purging”.