基于数据挖掘的赵瑞华治疗子宫腺肌病痛经用药规律研究

Study on Medication Laws of ZHAO Ruihua for Treatment of Adenomyosis Dysmenorrhea Based on Data Mining

[目的]挖掘赵瑞华教授治疗子宫腺肌病痛经的经验。[方法]筛选2016年1月至2021年6月就诊于中国中医科学院广安门医院赵瑞华教授门诊,且治疗有效的子宫腺肌病痛经患者的处方数据,应用频次分析、关联规则分析、聚类分析等数据挖掘方法,对符合纳入标准的处方数据进行挖掘,包括一般资料、中药频次、性味功效、药物组合、核心处方等内容。[结果]共纳入子宫腺肌病痛经患者122例,802个诊次处方,患者平均年龄(38.30±0.51)岁。患者痛经平均病程(78.15±8.42)月,明显高于患者诊断子宫腺肌病的平均病程(32.55±3.23)月,差异有统计学意义(P<0.01)。使用频率大于50%的药物有茯苓、桂枝、鸡内金、白芍、薏苡仁、炒白术、三七粉、生甘草、党参、胡芦巴、生姜、丹参、姜黄和醋柴胡。温性药、平性药,辛、甘、苦味药物使用频次较高,药物归经主要涉及到脾经、肝经、肺经、胃经和肾经。常用的药物组合为桂枝-白芍、鸡内金-薏苡仁、茯苓-炒白术等。药物聚类分析显示,高频使用的中药主要聚为3类,结合数据挖掘及专家访谈结果,最终总结出赵瑞华教授治疗子宫腺肌病痛经的核心处方。[结论]赵瑞华教授治疗子宫腺肌病痛经组方精简、用药平和,处方用药充分体现了其重视阳气、重视脾胃、疏肝理气、活血化瘀的学术思想,临床疗效显著,可供参考。

[Objective]To explore Professor ZHAO Ruihua's experience in the treatment of adenomyosis dysmenorrhea.[Methods]The prescriptions data of adenomyosis dysmenorrhea patients treated effectively in the outpatient clinic of Professor ZHAO in Guang'anmen Hospital,China Academy of Chinese Medical Sciences from January 2016 to June 2021 were screened.Data mining methods such as frequency analysis,association rule analysis and cluster analysis were used to mine the prescriptions data that met the inclusion criteria.It included general information,Chinese drug frequency,drug properties,drug combination,core prescriptions and so on.[Results]A total of 122 patients with adenomyosis dysmenorrhea and 802 prescriptions were included,with an average age of(38.30±0.51)years.The mean course of dysmenorrhea was(78.15±8.42)months,and that of adenomyosis was(32.55±3.23)months,the difference was statistically significant(P0.01).The drugs with a frequency of more than 50%were Poria Cocos,Cmnamomi Mmulus,Galli Gigerii Endothelium Corneum,Paeoniae Radix Alba,Coicis Semen,Atractmlodis Macrocephalae Rhizoma,Notoginseng Radix et Rhizoma,Glycyrrhiza uralensis,Codonopsis Radix,Trigonella Foenum Graecum,Zingiberis Rhizoma Recens,Salvia Miltiorrhiza,Curcumae Longae Rhizoma and Bupleuri Radix.The drugs with warm and flat nature and pungent,sweet and bitter drugs were used more frequently.The channel tropism of drugs mainly involved spleen channel,liver channel,lung channel,stomach channel and kidney channel.The commonly used drug combinations were Cmnamomi Mmulus-Paeoniae Radix Alba,Galli Gigerii Endothelium Corneum-Coicis Semen,Poria CocosAtractmlodis Macrocephalae Rhizoma,etc.Drug cluster analysis showed that the frequently used Chinese drugs were mainly clustered into3 categories.Combined with data mining and expert interview results,Professor ZHAO's core prescription for treating adenomyosis dysmenorrhea was finally summarized.[Conclusion]Professor ZHAO Ruihua's prescription for the treatment of adenomyosis dyspenorrhea is simple and gentle,which fully reflects her academic thoughts of paying attention to Yang Qi,spleen and stomach,soothing the liver and regulating Qi,promoting blood circulation and removing stasis,and has significant clinical efficacy for reference.