基于数据挖掘的聂惠民治疗小儿咳嗽用药规律研究

Multi-dimensional Analysis on Medication Law of Nie Huimin in Treating Pediatric Cough

目的 分析聂惠民教授治疗小儿咳嗽的用药规律。方法 收集筛选聂惠民教授1998年8月-2005年12月治疗小儿咳嗽临床病案,经过数据清洗、标准化处理后建立医案数据库,运用古今医案云平台V2.3.7、R-Studio3.6.2、Mul-Charts1.8等软件进行中药统计分析、聚类分析、核心方药分析,对高频药物进行流年变化分析,并将其规律进行可视化展示;进行兼症-中药分析,获得治疗兼症的中药。结果 共纳入处方618首,涉及药物113味,中药性味以微寒、平、寒及苦、甘、辛为主,归经以肺经、胃经、心经、脾经、肝经、肾经为主,使用频次较高的药物为柴胡、川贝母、甘草、桔梗、牡蛎、黄芩、白芍、炙甘草、龙骨等,聚类分析显示出5个药物群组,其中药物群组2与核心方药分析出的药物一致,以小柴胡汤、芍药甘草汤、桔梗汤为基础加减;流年变化分析显示,炒六神曲、炒麦芽、炒山楂比例总体有增加,提示更加重视调理脾胃;兼症-中药分析显示兼症以肺脾胃系症状为主,治疗仍以调肺脾胃为主。结论 聂惠民教授以小柴胡汤为基础治疗小儿咳嗽,以和解少阳、调畅气机、理肺化痰为基本治法,同时重视调理脾胃。

Objective To analyze the medication law of Professor Nie Huimin in the treatment of pediatric cough.Methods Medical cases of pediatric cough treatment from Professor Nie Huimin from Aug.1998 to Dec.2005 were collected,and a standardized medical case database was established after data cleaning and standardization treatment.The Ancient and Modern Medical Record Cloud Platform V2.3.7,R-Studio 3.6.2,and Mul-Charts 1.8 were used to carry out statistical analysis,clustering analysis,correlation analysis and the timeflow analysis was conducted of high-freguency herbs,and visualized;analysis on accompanied symptom-Chinese materia medica was conducted,and Chinese materia medica for treating symptomatic conditions was obtained.Results A total of 618 prescriptions were included,involving 113 kinds of Chinese materia medica.The properties and tastes were mainly mild bitter,mild,cold,bitter,sweet,and pungent.The meridians were mainly lung,stomach,heart,spleen,liver,and kidney meridians.The high-frequency herbs were Bupleuri Radix,Fritillariae Cirrhosae Bulbus,Glycyrrhizae Radix et Rhizoma,Platycodonis Radix,Ostreae Concha,Scutellariae Radix,Paeoniae Radix alba,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,and Os Draconis.Clustering analysis showed 5 drug groups,among which drug group 2 was consistent with the drugs analyzed by the core prescription,represented by modified Xiaochaihu Decoction,Shaoyao Gancao Decoction,and Jiegeng Decoction.Time-flow analysis showed that the proportion of fried Liushenqu,fried Hordei Fructus Germminatus,fried Crataegi Fructusoverall increased,indicating a greater emphasis on regulating the spleen and stomach.Analysis on accompanied symptom-Chinese materia medica showed that symptoms of the lung,spleen,and stomach system are the main symptoms,and treatment still focused on regulating the lungs,spleen,and stomach.Conclusion Professor Nie Huimin treats pediatric cough on the basis of Xiaochaihu Decoction,and takes the principle of reconciling Shaoyang,adjusting the qi movement and adjusting lung and eliminating phlegm.At the same time,attention is paid to the conditioning of the spleen and stomach.