基于数据挖掘探析张明雪教授治疗冠心病合并2型糖尿病用药规律研究

Research on Medication Rule of ZHANG Mingxue Treating Coronary Heart Disease Combined with Type 2 Diabetes Based on Data Mining

目的运用数据挖掘技术探索张明雪教授治疗冠心病合并2型糖尿病处方用药规律。方法收集张明雪教授2019年9月6日—2021年9月6日期间诊治冠心病合并2型糖尿病患者的病案,筛选并记录中药处方。利用中医传承辅助平台(V2.5)软件,采用频数分析、关联规则分析及聚类分析等统计方法,挖掘其中用药规律。结果筛选处方共285首,涉及中药146味,多寒性之品,多归肺、脾、心经,药味以甘、苦、辛为主。常用药物为补益药、理气化痰药、化瘀止血药、健脾利湿药、清热凉血药、收敛药、升阳举陷药、安神药等。演化得到核心组合药物群共14个,新处方7个。结论张明雪教授治疗冠心病合并2型糖尿病高频药物为半夏瓜蒌薤白汤合复元活血汤化裁:薤白、瓜蒌、半夏、黄芪、西洋参、茯苓、桃仁、当归、天花粉、柴胡、大蓟、小蓟、鸡内金、赤芍、升麻、桔梗、水牛角、龙骨。治疗以益气养阴为核心,辅以化痰宣痹、清热利湿、敛涩止遗、升阳举陷之法。

Objective This study aimed to analyze the medication rules of Professor ZHANG Mingxue treating coronary heart disease with type 2 diabetes based on the traditional Chinese medicine inheritance support platform software(V2.5).Methods It collected the professor's medical records of coronary heart disease with type 2 diabetes from September 6,2019 to September 6,2021,then screened and recorded the prescriptions.Using the traditional Chinese medicine inheritance support platform software(V2.5),the statistical methods such as frequency analysis,association rule analysis and cluster analysis were used to explore the medication rules.Results A total of 285 prescriptions were screened,involving 146 traditional Chinese drugs,most of them were cold drugs,mostly attributed to the lung,spleen and heart meridians,and the medicinal taste was mainly sweet,bitter and spicy.The commonly used drugs were tonic drugs,regulating Qi for eliminating phlegm drugs,dissolving blood stasis and stopping bleed-ing drugs,invigorating spleen to eliminating dampness drugs,heat-clearing drugs,astringents,invigorating Yang and lifting drugs,tranquilizing the mind drugs,etc.There were 14 core groups and 7 new prescriptions.Conclusion Professor ZHANG Mingx-ue's high frequency drugs are Shenqi Gualou Xiebai Banxia and Fuyuan Huoxue Decoction(半夏瓜蒌薤白汤合复元活血汤):Xiebai(Allii Macrostemonis Bulbus),Gualou(Trichosanthis Fructus),Banxia(Pinelliae Rhizoma),Huangqi(Astragali Radix),Xiyangshen(Panacis Quinquefolii Radix),Fuling(Poria),Taoren(Persicae Semen),Danggui(Angelicae Sinensis Radix),Tian-huafen(Trichosanthis Radix),Chaihu(Bupleuri Radix),Daji(Cirsii Japonici Herba),Xiaoji(Cirsii Herba),Jineijin(Galli Gigerii Endothelium Corneum),Chishao(Paeoniae Radix Rubra),Shengma(Cimicifugae Rhizoma),Jiegeng(Platycodonis Radix),Shuiniujiao(Bubali Cornu)and Longgu(fossil fragments).The treatment is based on the core of supplementing Qi and nourishing Yin,with eliminating phlegm and dredging meridians blockage,clearing heat and promoting diuresis,arresting enursis and invigor-ating Yang and lifting.