基于K-均值聚类老年病中药干预的群集功效与组方特点

Cluster Efficacy and the Characteristics of Formulations of Herbal Interventions for Senile Diseases Based on K-means Clustering

目的:采用数据挖掘技术对中医辨治老年病的临床医案数据进行解构,从中研究中药运用与组方规律。方法:基于K-均值(K-means)聚类的挖掘方法,对目标医案数据库进行药物、方剂两个维度的挖掘分析与临床解构。结果:本次研究涉及医案166人次,383诊次,临床症状292种,药物358种。K-means聚类运算挖掘后,药物K-means聚类39类,方剂K-means聚类20类。结论:名老中医辨治老年病用药主要脏腑为肝、肾,配伍注重多脏合治,对气滞、血虚、阴虚复合辨证,兼顾补肾、平肝、健脾的扶正药物与清热、利湿、散结祛邪之品组合运用,方剂结构多为复法小方,以四君子汤、天麻钩藤饮为核心基础加减化裁,常复合偏于补肾的六味地黄丸、知柏地黄丸,偏于补肝的独活寄生汤,偏于安神的酸枣仁汤。

Objective:To analyze the data of clinical medical cases of differentiating and treating senile disease by TCM using data mining,thereby studying the laws of herbal application and formulation.Methods:Clinical deconstruction and excavation analysis of the targeted clinical medical databases were carried out from medicine and prescriptions based on the digging methods of K-means clustering.Results:The study involves 166 persons in medical cases,and 383 times of consultations,292 clinical symptoms and 358 medicines.39 sorts of drug K-means clustering and 20 kinds of prescription K-means clustering were found after mining with K-means clustering algorithm.Conclusion:The main viscera are liver and kidney when famous veteran TCM doctors differentiate senile diseases,the compatibility of medicines focuses on the combined treatment of the viscera.They differentiate Qi stagnation,blood deficiency and Yin deficiency together,considering the combined application of the medicines of enhancing healthy Qi such as tonifying kidney,soothing liver and invigorating spleen,with the ones of clearing heat,resolving dampness,removing nodules and eliminating the evil factors,the prescriptions frequently refer to modified Sijunzi decoction and Tianma Gouteng drink as the core,combined with Liuwei Dihuang pills and Zhibo Dihuang pills which could tonify the kidney,Duhuo Jisheng Tang which could tonify the liver and Suanzaoren Tang which could calm the spirit,and these are small compounds.