基于数据挖掘的张允岭治疗帕金森病用药规律研究

Study on Zhang Yunling’s Medication Law in Treating Parkinson Disease Based on Data Mining

目的基于数据挖掘技术对张允岭教授治疗帕金森病(PD)的用药规律进行研究,为PD的临床治疗提供思路。方法收集张允岭教授治疗PD的门诊中药处方数据,运用古今医案云平台2.3.5对筛选出的中药处方进行药物频次统计、性味归经统计、方剂识别统计、病机要素统计、关联分析、聚类分析、复杂网络分析等。结果通过收集与筛选,共纳入中药处方278首,涉及中药169味,药物总频次为5238。使用频次前10位药物分别是龟甲、黄芪、白芍、山萸肉、白术、肉苁蓉、黄连、竹茹、枳实、川芎。药性以温性为主,其次为平性、微寒等;药味以甘味为主,其次为苦味、辛味等;归经以脾经为主,其次为肝经、肺经、肾经等。方剂识别对使用频次居前20位的高频中药进行统计分析,设定相似度>10%,可获得23首常用方剂。病机要素统计中居前10位者分别是阴虚、湿、精亏、痰、气滞、阳虚、风、血虚、气虚、瘀。药物关联中高频药物组合有“龟甲→白芍”“山萸肉→龟甲”“山萸肉→白芍”“肉苁蓉→龟甲”“白术→肉苁蓉”等。药物聚类分析将频次≥75的20味高频中药聚为6类。复杂网络分析筛选出治疗PD的核心组方为:龟甲、山萸肉、白芍、黄芪、肉苁蓉、白术、黄连。结论张允岭教授治疗PD注重补虚泻实,标本兼治,认为PD病机本虚标实,气血阴阳亏虚为本,痰湿瘀滞风动为标,病位多责之肝、脾、肾,常用滋阴养血、填精益髓、温阳益气、健脾益肾、息风止颤、化湿祛痰、活血化瘀、疏达气机之品,可为PD的临床治疗提供一定参考。

Objective To study the medication law of Professor Zhang Yunling in the treatment of Parkinson disease(PD)based on data mining technology;To provide ideas for the clinical treatment of PD.Methods Professor Zhang Yunling’s outpatient TCM prescription data for PD were collected,and the Ancient and Modern Medical Record Cloud Platform 2.3.5 was used to carry out data mining on the selected TCM prescriptions,including drug frequency statistics,property,taste and meridian statistics,prescription identification statistics,pathogenesis factor statistics,correlation analysis,clustering analysis,complex network analysis and so on.Results Through collection and screening,a total of 278 prescriptions were included,involving 169 kinds of Chinese materia medica,with a total frequency of 5238 times.The top 10 herbal medicines were Carapax et Plastrum Testudinis,Astragali Radix,Paeoniae Radix alba,Corni Fructus,Atractylodis Macrocephalae Rhizoma,Cistanches Herba,Coptidis Rhizoma,Bambusae Caulis in Taenia,Aurantii Immaturus Fructus and Chuanxiong Rhizoma.It was mainly warm in property,followed by mild and slightly cold;it was mainly sweet in taste,followed by bitter and pungent;it was mainly the spleen meridian,followed by the liver,lung and kidney meridians.The top 20 types of high-frequency Chinese materia medica were statistically analyzed,and 23 classical commonly used prescriptions were obtained by setting the similarity to be more than 10%.The top 10 pathogenic factors were yin deficiency,dampness,essence deficiency,phlegm,qi stagnation,yang deficiency,wind,blood deficiency,qi deficiency and stasis.High-frequency combinations in herbal medicines association included“Carapax et Plastrum Testudinis→Paeoniae Radix alba”,“Corni Fructus→Carapax et Plastrum Testudinis”,“Corni Fructus→Paeoniae Radix alba”,“Cistanches Herba→Carapax et Plastrum Testudinis”and“Atractylodis Macrocephalae Rhizoma→Cistanches Herba”.Clustering analysis clustered 20 kinds of high-frequency Chinese materia medica used more than 75 times into 6 categories.Complex network analysis screened out the core prescriptions for the treatment of PD:Carapax et Plastrum Testudinis,Corni Fructus,Paeoniae Radix alba,Astragali Radix,Cistanches Herba,Atractylodis Macrocephalae Rhizoma,and Coptidis Rhizoma.Conclusion Professor Zhang Yunling focuses on reinforcing deficiency and reducing excess in the treatment of PD and treats both the symptoms and root causes of PD,and holds that the pathogenesis of PD is deficiency in origin and excess in superficiality,setting deficiency of qi,blood,yin and yang as the root cause,phlegm,dampness,stasis and wind as the superficiality,and liver,spleen and kidney as the disease locations,which often uses the medicines,such as nourishing yin and blood,replenishing essence and marrow,warming yang and replenishing qi,strengthening spleen and kidney,calming wind and stopping tremor,eliminating dampness and phlegm,activating blood and resolving stasis,regulating qi movement,which can provide some reference for the clinical treatment of PD.