基于医案数据挖掘探讨地黄饮子临床应用规律

Discussion on the Clinical Application Rules of Dihuang Yinzi(地黄饮子)Based on Data Mining of Medical Records

目的分析临床运用地黄饮子的证候规律与用药特点。方法以PubMed、Embase、Cochrane Library、CNKI、VIP、万方数据库、古今医案云平台为检索数据库,获取并挖掘地黄饮子临床医案数据。结果共筛选到233例医案,以中风病为多见,肾精亏虚证为主要证候,症状以头晕和言语不利多见,舌脉象以舌红、苔薄白、脉细为主。主要药物为山茱萸、石菖蒲、远志、麦冬、肉苁蓉、巴戟天、熟地黄、五味子、茯苓、石斛;加味中药以平性、温性、寒性多见,甘味、辛味、苦味为主,归肝、脾、肾经最多,功效以清热凉血、强筋骨、生津为主。药物关联规则分析得到核心药对石菖蒲-远志。主要药物聚类分析得到3个聚类药组,复杂网络分析得到9种核心药物。结论通过分析地黄饮子的临床应用规律,明确了临床运用地黄饮子辨治疾病的典型症状、关键证候、核心药物及其加减等,可为临床医师合理应用地黄饮子提供方证对应和加减用药参考依据。

Objective The syndromes and medication characteristics of clinical use of Dihuang Yinzi(地黄饮子)were analyzed.Methods Using PubMed,Embase,Cochrane Library,CNKI,VIP,WanFang Database,Ancient and Modern Medical Record Cloud Platform as search databases,the clinical medical record data of Dihuang Yinzi were obtained and excavated.Results A total of 233 medical cases were screened,with stroke as the most common type,kidney essence deficiency syndrome is the main syndrome,the symptoms are dizziness and unfavorable speech,and the tongue pulse is mainly red tongue,thin white coating,and fine pulse;The main medicines are Shanzhuyu(Cornifructus),Shichangpu(Acori Tatarinowii Rhizoma),Yuanzhi(Polygalae Radix),Maidong(Ophiopogonis Radix),Roucongrong(Cistanches Herba),Bajitian(Morindae Officinalis Radix),Shudihuang(Rehmanniae Radix Praeparata),Wuweizi(Schisandrae Chinensis Fructus),Fuling(Poria),Shihu(Dendrobii Caulis);Add traditional Chinese medicine is mostly flat,warm,and cold,with sweet,pungent,and bitter taste as the main taste.It belongs to the liver,spleen,and kidney meridians most.Its effects are mainly to clear heat and cool blood,strengthen muscles and bones,and promote fluid production.Drug association rule analysis obtained the core drug pair Shudihuang(Rehmanniae Radix Praeparata)-Yuanzhi(Polygalae Radix).The main drug cluster analysis obtained 3 cluster drug groups,and complex network analysis obtained 9 core drugs.Conclusion By analyzing the clinical application rules of Dihuang Yinzi for the prevention and treatment of nervous system diseases,the typical symptoms,key syndromes,core drugs and their addition and subtraction,etc.of clinical application of Dihuang Yinzi for diseases are clarified,which can be used for clinicians to rationally apply Dihuang Yinzi provides prescription and syndrome correspondence and reference basis for addition and subtraction of medication.