基于数据挖掘的张允岭治疗眩晕用药规律研究

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

目的基于数据挖掘技术对张允岭教授治疗眩晕的用药规律进行研究,为眩晕的临床治疗提供思路。方法收集张允岭教授治疗眩晕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、药物功效统计、关联分析、聚类分析、复杂网络分析等。结果通过收集与筛选,共纳入符合标准的中药处方496首,涉及中药184味,药物总频次为8532。药物使用频次前10位为白术、法半夏、川芎、黄芪、天麻、竹茹、豆蔻、远志、石菖蒲、白芍。药性以温为主,其次为平、微寒等,药味以甘为主,其次为辛、苦等,归经以肺经为主,其次为脾经、肝经、胃经、心经、肾经等。药物功效以燥湿化痰、平抑肝阳、祛风止痛、清心除烦、燥湿利水、健脾益气等使用频次较高。对使用频次前20位的高频中药进行方剂识别,可获得相似度≥10%的35首经典处方。药物关联分析得到法半夏-白术,川芎-白术,天麻-法半夏等。药物聚类可将使用频次≥100次的28味高频中药聚成6类。复杂网络分析筛选出核心组方为白术、法半夏、川芎、天麻、竹茹、黄芪、远志、石菖蒲。结论张允岭教授治疗眩晕注重补虚泻实,标本兼治,认为眩晕病机本虚标实,气血亏虚、清窍失养为本,痰湿瘀滞、浊邪阻窍为标,病位与五脏相关,牵涉胃腑,常用益气养血滋阴、健脾疏肝补肾、祛痰化湿活血、清心除烦息风、化浊开窍宁神、升清降浊祛邪之品,可为眩晕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 vertigo based on data mining technology;To provide ideas for the clinical treatment of vertigo.Methods TCM prescriptions data of Professor Zhang Yunling’s outpatient for the treatment of vertigo 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 herbal medicine frequency statistics,property taste and meridian statistics,prescription identification statistics,herbal medicine efficacy statistics,correlation analysis,clustering analysis,complex network analysis and so on.Results Through collection and screening,496 prescriptions meeting criteria were included,involving 184 kinds of Chinese materia medica,with a total frequency of 8532 times.The top 10 herbal medicines were Atractylodis Macrocephalae Rhizoma,Pinelliae Rhizoma Praeparatum,Chuanxiong Rhizoma,Astragali Radix,Gastrodiae Rhizoma,Bambusae Caulis in Taenia,Amomi Rotundus Fructus,Polygalae Radix,Acori Tatarinowii Rhizoma and Paeoniae Alba Radix.It was mainly warm in nature,followed by mild and slightly cold,sweet in taste,followed by pungent and bitter,and lung meridian in meridian tropism,followed by spleen,liver,stomach,heart and kidney meridians.In the statistics of drug efficacy,the efficacy of eliminating dampness and resolving phlegm,suppressing liver-yang,expelling wind and relieving pain,clearing heart and relieving restlessness,eliminating dampness and promoting diuresis,strengthening spleen and replenishing qi was used more frequently.Prescription identification counted the top 20 high-frequency herbal medicines,and 35 classical famous prescriptions could be obtained by setting the similarity≥10%.The herbal medicines association included Pinelliae Rhizoma Praeparatum-Atractylodis Macrocephalae Rhizoma,Chuanxiong Rhizoma-Atractylodis Macrocephalae Rhizoma,Gastrodiae Rhizoma-Pinelliae Rhizoma.28 kinds of high frequency herbal medicines which were used more than 100 times could be clustered into 6 categories.Complex network analysis screened out the core formula:Atractylodis Macrocephalae Rhizoma,Pinelliae Rhizoma Praeparatum,Chuanxiong Rhizoma,Gastrodiae Rhizoma,Bambusae Caulis in Taenia,Astragali Radix,Polygalae Radix and Acori Tatarinowii Rhizoma.Conclusion In the treatment of vertigo,Professor Zhang Yunling pays attention to reinforcing deficiency and reducing excess,and treats both the symptoms and root causes,and holds that the pathogenesis of vertigo is deficiency in origin and excess in superficiality,deficiency of qi and blood,malnourishment of clear orifices,stagnation of phlegm and dampness,and obstruction of orifices by turbid pathogens,and the location of the disease is related to the five viscera and involves the stomach,which often uses medicines of supplementing qi,nourishing blood,nourishing yin,strengthening the spleen,soothing the liver and tonifying the kidney,eliminating phlegm,resolving dampness and activating blood circulation,clearing away heartfire,relieving restlessness and calming the wind,resolving turbidity,inducing resuscitation and calming the mind,ascending the clear and descending the turbid to eliminate pathogenic factors,which can provide a reference for the clinical treatment of vertigo.