基于数据挖掘杨晓晖教授治疗2型糖尿病用药规律分析

Analysis of Medication Law for Type 2 Diabetes Mellitus Treatment by Professor YANG Xiaohui Based on Data Mining

目的 基于中医传承计算平台,对杨晓晖教授治疗2型糖尿病患者的用药规律进行分析。方法 收集整理了杨晓晖教授2019—2022年门诊诊治的2型糖尿病患者医案,按照纳入、排除标准进行筛选及数据标准化,使用中医传承计算平台V3.0中频次分析、关联规则分析、聚类分析等功能进行数据挖掘。结果 研究共纳入173例患者,553个门诊医案,使用频率最高的前10味中药分别为黄连、赤芍、柴胡、蝉蜕、百合、牛膝、蒲黄、女贞子、知母、佛手。常用药以清热类、补虚类、解表类、活血化瘀类、化痰止咳平喘类药物为主。药性以寒性居多,药味以苦味为主,归经主入肝经,其次为肺经及脾经。关联规则分析结果显示,“黄连-赤芍”“赤芍-柴胡”“黄连-蝉蜕”等为高频药物组合模式,聚类分析得到3组核心处方,结合杨晓晖教授临床经验,认为核心药串为“黄连、赤芍、柴胡”。结论 杨晓晖教授治疗2型糖尿病重视气血在发病中的重要作用。用药多入肝、脾、肺三经,意在通调气机,补益脏腑虚损;寒温并用,以取清热不伤正、补虚不助邪之效。治疗紧抓“阴虚燥热”的基本病机,气血同调,补益脏腑虚损,兼顾气郁、痰湿、瘀血等实邪的祛除。

Objective Based on the Traditional Chinese Medicine Inheritance Computer System,this study analyzes the medication law of Professor YANG Xiaohui in treating patients with type 2 diabetes mellitus.Methods This study collected and organized medical records of type 2 diabetes mellitus patients treated by Professor YANG Xiaohui in outpatient clinics from 2019 to 2022.The data was screened and standardized according to inclusion and exclusion criteria,and data mining was performed using the Traditional Chinese Medicine Inheritance Computer System V3.0,including frequency analysis,association rule analysis,and cluster analysis.Results This study included a total of 173 patients and 553 outpatient medical cases.The top 10 most frequently used Chinese herbal medicines were Huanglian(Coptidis Rhizoma),Chishao(Paeoniae Radix Rubra),Chaihu(Bupleuri Radix),Chantui(Cicadae Periostracum),Baihe(Lilii Bulbus),Niuxi(Achyranthis Bidentatae Radix),Puhuang(Typhae Pollen),Nuzhenzi(Ligustri Lucidi Fructus),Zhimu(Anemarrhenae Rhizoma),and Foshou(Citri Sarcodactylis Fructus).Commonly used drugs mainly included those for clearing heat,tonifying deficiency,relieving exterior syndromes,promoting blood circulation and removing blood stasis,as well as resolving phlegm,relieving cough,and easing asthma.The majority of the drugs were cold in nature and bitter in taste.The meridian of the medicine is mainly the liver meridian,followed by the lung and spleen meridians.Association rule analysis revealed that“Huanglian(Coptidis Rhizoma)-Chishao(Paeoniae Radix Rubra)”“Chishao(Paeoniae Radix Rubra)-Chaihu(Bupleuri Radix)”and“Huanglian(Coptidis Rhizoma)-Chantui(Cicadae Periostracum)”were frequent drug combination patterns.Cluster analysis identified three core prescriptions,and in combination with Professor YANG Xiaohui's clinical experience,the core compatibly grouped drugs were Huanglian(Coptidis Rhizoma),Chishao(Paeoniae Radix Rubra),and Chaihu(Bupleuri Radix).Conclusion Professor YANG Xiaohui emphasizes the important role of Qi and blood in the pathogenesis of type 2 diabetes mellitus.His medication approach focuses on the liver,spleen,and lung meridians to regulate Qi circulation and tonify visceral deficiency.The use of both cold and warm herbs aims to clear heat without damaging the body's vital Qi,and to supplement deficiencies without assisting pathogenic factors.The treatment strategy targets the fundamental pathogenesis of“endogenous heat due to Yin deficiency”,while harmonizing Qi and blood,tonifying visceral deficiency and addressing excessive Qi stagnation,phlegm-dampness,and blood stasis.