基于数据挖掘分析中医药治疗肝豆状核变性湿热内蕴证的用药规律

Analysis of the Medication Rules of Traditional Chinese Medicine in the Treatment of Hepatolenticular Degeneration with Damp-heat Intrinsic Syndrome Based on Data Mining

目的:运用数据挖掘技术探讨肝豆状核变性(HLD)湿热内蕴证中药组方用药规律,为优化临床治疗方案提供参考。方法:收集2014年1月—2020年1月于安徽中医药大学第一附属医院脑病中心住院治疗的HLD湿热内蕴证病人3156例的临床资料,并获得相应的中药处方用药信息,运用频数统计、关联规则分析、聚类分析、因子分析总结HLD湿热内蕴证处方的用药规律。结果:最终纳入符合纳入与排除标准的病人3156例,年龄3~67岁,其中,10~39岁为HLD湿热内蕴证病人的主要集中人群;涉及中药391味,总药用频次为38699次,用药频率≥50%的中药依次为大黄、黄连、半枝莲、萆薢、黄芩和穿心莲。药物性味分布以寒、平性为主,苦、甘居多,多归于肝、脾、肺、胃经。中药类别以清热药、利水渗湿药、活血化瘀药、补虚药和泻下药为主。关联规则分析大黄-黄连、黄连-半枝莲-大黄、穿心莲-半枝莲-黄连-大黄、穿心莲-黄芩-半枝莲-黄连-大黄为支持度最高的药对、药组和药方。聚类分析共获得6类药物组合。因子分析共提取6个公因子。结论:清热解毒、通腑利尿为治疗HLD湿热内蕴证的基本方法,补益气血、活血养髓法体现了标本兼顾、既病防变之整体辨治思想。

Objective:To explore the regularity of traditional Chinese medicine(TCM)prescription for the damp-heat syndrome of hepatolenticular degeneration(HLD).Methods:A total of 3156 patients with HLD damp-heat internal syndrome were collected,and the corresponding information of the prescription of TCM was obtained.Frequency statistics,association rule analysis,cluster analysis,and factor analysis were used to summarize the prescription rules of HLD with intrinsic damp-heat syndrome.Results:A total of 3156 HLD patients were screened,with an age distribution ranging from 3 to 67 years old.The patients aged 10 to 39 years old were the main population of HLD patients with damp-heat syndrome.Involving 391 flavors of TCM,the total medicinal frequency was 38699 times.The herbs with frequency≥50%were rhubarb,coptis,bark lotus,yam rhizome,skullcap,and andrographis.Drug flavor distribution were mainly cold and flat,bitter and sweet,and most of them attributed to liver,spleen,lung,stomach meridians.The main categories of Chinese medicine were heat-clearing medicines,diuretics and dampness-removing medicines,blood-activating and stasis-removing medicines,deficiency-tonifying medicines and laxative medicines.Rhubarb-coptis,coptis-banzhilian-rhubarb,andrographis-banzhilian-coptis-rhubarb,andrographis-scutellaria baicalensis-scutellaria barbata-coptis chinensis-rhubarb were the popular drug pair,drug group and prescription.A total of 6 categories were obtained by cluster analysis,and 6 common factors were extracted by factor analysis.Conclusion:Clearing away heat and detoxifying,unblocking the fu-organs and diuresis are the basic methods for the treatment of HLD with damp-heat intrinsic syndrome.The methods of nourishing Qi and blood,promoting blood and nourishing marrow reflect the overall diagnosis and treatment thought.