基于数据挖掘探讨刘德清治疗脾胃湿热证型慢性非萎缩性胃炎临床用药规律

Clinical medication rule of LIU Deqing in treating chronic non-atrophic gastritis with dampness-heat syndrome of spleen and stomach based on data mining

目的:探讨脾胃湿热证型慢性非萎缩性胃炎的用药规律,总结药物相关作用机制。方法:基于医院信息系统,收集2021年10月―2022年3月名老中医刘德清治疗慢性非萎缩性胃炎的所有门诊处方,使用Excel 2019将符合纳入标准的处方进行归纳整理,通过SPSS 26.0及SPSS Modeler 18.0平台分析名老中医用药的关联规则及核心药物组合,由此总结临床用药规律,并通过检索中国知网、万方数据库相关文献对药物作用机制进行探讨。结果:共收集有效处方331首,涉及药味110味,根据药物性味归经进行分类,得出中药以补虚药为主,其次为清热药、理气药、活血药。总结得出使用频次超过90次的高频中药共14味,为甘草、陈皮、黄连、茯苓、川芎、白术、半夏、黄芩、白芍、佛手等。对使用频次超过50次的中药共20味进行中药聚类分析,共得到6个聚类群组,分析得出名老中医用方由经典方黄连温胆汤、二陈汤、芍药甘草汤等化裁。通过构建分类值共线频率进行复杂网络分析,得出常用药对10对。对高频用药进行文献检索,得出这些药物通过抗炎、镇痛、调节胃肠道运动、保护胃黏膜等作用机制发挥治疗作用。结论:通过数据挖掘的方式对名老中医临床常用方药进行整理,由此总结出其用药规律,为中医药治疗脾胃湿热证型慢性非萎缩性胃炎提供了临床经验与参考。

Objective:To explore the drug administration rules of chronic non-atrophic gastritis with dampness-heat syndrome of spleen and stomach,and summarize the drug related mechanism.Methods:Based on the hospital information system,all outpatient prescriptions for the treatment of chronic non-atrophic gastritis by LIU Deqing,a veteran TCM doctor,from October 2021 to March 2022 were collected.Excel 2019 was used to summarize and sort out the prescriptions that met the inclusion criteria.SPSS 26.0 and SPSS Modeler 18.0 platforms were used.The association rules and core drug combinations of famous veteran TCM doctor were analyzed,and the clinical drug use rules were summarized,and the mechanism of drug action was also explored by searching the relevant literature in CNKI and Wanfang databases.Results:A total of 331 valid prescriptions were collected,involving a total of 110 medicinals.According to the classification of medicinal flavours and properties,it was concluded that TCM medicine was mainly used to tonify deficiency,which was followed by heat-clearing,Qi(气)-regulating and blood-activating medicinals.It was concluded that there were 14 kinds of high frequency TCM medicines used more than 90 times,which were Gancao(Licorice),Chenpi(Dried tangerine),Huanglian(Coptis),Fuling(Poria),Chuanxiong(Ligusticum chuanxiong),Baizhu(Atractylodes rhizome),Banxia(Pinellia ternata),Huangqin(Radix Scutellariae Sinensis),Baishao(Radix Paeoniae Alba)and Foshou(Fructus Foetida),etc..The cluster analysis of 20 TCM medicines which were used more than 50 times was carried out,and a total of 6 cluster groups were obtained.The analysis showed that the famous veteran TCM doctor’s prescriptions were mainly Huanglian Wendan decoction(黄连温胆汤),Erchen decoction(二陈汤)and Shaoyao Gancao decoction(芍药甘草汤).Through the complex network analysis of collinear frequency of classification values,10 pairs of common drugs were obtained.Literature search of high-frequency drugs showed that these drugs exerted therapeutic effects through pharmacological mechanisms such as antispasmodic and analgesic,anti-inflammatory,regulation of gastrointestinal motility,and protection of gastric mucosa.Conclusion:By means of data mining,the common clinical prescriptions of famous veteran TCM doctor are sorted out,and the medication rules are summarized to provide clinical experience and reference for the treatment of chronic non-atrophic gastritis with spleen and stomach damp-heat syndrome.