基于数据挖掘的严世芸治疗心悸(心律失常)方药规律研究

Study on Prescription Medication Laws of YAN Shiyun for Treatment of Palpitation(Arrhythmia)Based on Data Mining

目的运用数据挖掘方法探究严世芸教授辨治心悸(心律失常)的处方用药规律。方法纳入符合中西医诊断标准的心悸(心律失常)患者200例,609诊次,建立电子病案数据库,采用频次、频率分析、关联规则分析、复杂网络、聚类分析等数据挖掘方法,综合分析探寻严教授在心悸(心律失常)辨治中的处方特点、用药规律,总结处方思路,凝练学术思想。结果研究涉及经方24首,中药291味,高频药味包括桃仁、川芎、茯苓、黄芪、白术、白芍、桂枝、酸枣仁、附子、淫羊藿、猪苓等26味,多为益气温阳活血药,功效包括调气活血、温阳利水、清热养阴、安神镇静;关联分析得出9对高关联核心药对;聚类分析得出5个核心组方;方剂运用频次在前3位分别为强心饮、柴胡加龙骨牡蛎汤、血府逐瘀汤,组合形式以二方及以上联用居多。结论严教授治疗心悸(心律失常)多从益气活血温阳之法,遣方用药精要灵活,主次分明,邪正兼顾,圆机活法。

Objective To explore the prescription and medication laws of Professor YAN Shiyun for treatment of palpitation(arrhythmia)with data mining method.Methods Totally 200 palpitation(arrhythmia)cases,609 encounters,were selected as the clinical cases for the establishment of the electronic medical record database.Frequency statistics,association analysis,complex networks,clustering and other analysis methods were used to comprehensively analyze and explore the prescription characteristics and medication law of Professor YAN in the syndrome differentiation and treatment of palpitation(arrhythmia),and then the prescription ideas were summarized and the academic thoughts were refined.Results The study involved 24 classic prescriptions and 291 traditional Chinese drugs.The high-frequency medicines were Taoren(Persicae Semen),Chuanxiong(Chuanxiong Rhizoma),Fuling(Poria),Huangqi(Astragali Radix),Baizhu(Atractylodis Macrocephalae Rhizoma),Baishao(Paeoniae Radix Alba),Guizhi(Cinnamomi Ramulus),Suanzaoren(Ziziphi Spinosae Semen),Fuzi(Aconiti Lateralis Radix Praeparata),Yinyanghuo(Epimedii Folium),Zhuling(Polyporus),a total of 26 drugs.Most were replenishing Qi,warming Yang and activating blood circulation drugs,and the effects include regulating Qi and activating blood circulation,warming Yang and promoting diuresis,clearing heat and nourishing Yin and calming nerves.9 core durg pairs with high correlation were obtained by correlation analysis.5 core groups were obtained by cluster analysis.The top 3 of the high frequency prescriptions were Qiangxin Decoction(强心饮),Chaihu Jia Longgu Muli Decoction(柴胡加龙骨牡蛎汤)and Xuefu Zhuyu Decoction(血府逐瘀汤),and most of them were combined with two or more prescriptions.Conclusion Professor Yan treats palpitations(arrhythmias)mostly by supplementing Qi,promoting blood circulation,warming Yang and dispatching prescriptions that are flexible in essence,with clear priorities,balancing evil and vital Qi,and promoting the circulation of Qi and Yang.