徐力教授治疗亚实性肺结节的病案数据挖掘研究

A study on medical records of treating subsolid pulmonary nodule by Professor XU Li based on data mining

持续存在的亚实性肺结节被认为具有恶性潜能。徐力教授临床治疗了大量亚实性肺结节患者,临床疗效获得广泛认可。徐力教授认为亚实性肺结节病机的本质为本虚标实,本虚多为肺气阴两虚,日久可损及脾肾;标实在气机郁滞、痰瘀阻络、湿热瘀阻、癌毒内蕴等。病理因素包括气滞、痰湿、瘀血、癌毒。患者肝失调达,气机阻滞,痰湿凝聚不化,易发为纯磨玻璃结节;病久痰湿内阻所致郁而化热,津血焦灼成瘀,内生癌毒,瘀血与癌毒凝结为混杂性磨玻璃结节。本研究利用频次分析、聚类分析、复杂网络的数据挖掘方法发现核心处方。研究结果提示,徐力教授治疗亚实性肺结节的核心经验方为生黄芪、太子参、茯苓、生薏苡仁、白花蛇舌草、猫爪草、山慈菇、石见穿、醋莪术。该方有益气补肺、扶正固本、健脾渗湿、培土生金之功,亦有清热解毒抗肿瘤、化痰消散结、活血化瘀消肿之效。研究结果在中医药治疗亚实性肺结节中具有一定的指导价值。

Persistent subsolid pulmonary nodule is considered to have malignant potential.Professor XU Li has treated a large number of patients with subsolid pulmonary nodules,and the good clinical efficacy has been widely recognized by people.Professor XU Li believes that the pathogenesis essence of subsolid pulmonary nodule is deficient root and excessive superficial symptoms.The deficient root is mostly the deficiency of both Qi(气)and Yin(阴)of lung,which can damage the spleen and kidney over time;excessive superficial symptoms are Qi stagnation,phlegm and blood stasis,dampness and heat stasis,and cancer toxin accumulation.Pathological factors include Qi stagnation,phlegm dampness,blood stasis and cancer toxin.Patients with liver dysregulation,Qi stagnation,phlegm-dampness coagulation,are prone to pure ground-glass nodule.The stagnation of phlegm and dampness caused by the disease for a long time turned into heat,the blood was scorched into blood stasis,and cancer toxin was generated internally.The blood stasis and cancer toxin coagulated into mixd ground-glass nodule.In this study,the core prescriptions were found by the frequency analysis,cluster analysis,and complex network data mining method.The results suggested that Professor XU Li’s core empirical prescription in the treatment of subsolid pulmonary nodules contained Huangqi(Radix Astragali),Taizishen(Radix Pseudostellariae),Fuling(Poria),Yiyiren(Semen Coicis),Baihuasheshecao(Herba Hedyoti Diffusae),Maozhuacao(Radix Ranunculi Ternati),Shancigu(Pseudobulbus Cremastrae seupleiones),Shijianchuan(Herba Salviae Chinensis),and Ezhu(Rhizoma Curcumae).This prescription has the effects of replenishing Qi and lung,strengthening healthy energy,strengthening spleen to remove dampness and support lung,clearing heat,detoxification,antitumor,resolving phlegm,eliminating tumor,dispersing nodules,promoting blood circulation,removing blood stasis,and detumescence.The results of this study indicate a certain guiding value in the treatment of subsolid pulmonary nodule in TCM.