基于数据挖掘探讨中医药治疗急性肾损伤的组方用药规律

Exploration of the prescription and medication rules of traditional Chinese medicine in treating acute kidney injury based on data mining

目的采用数据挖掘分析中医药口服治疗急性肾损伤的用药特点及组方规律。方法检索中国知网(CNKI)、万方数据知识服务平台(Wanfang)、维普中文期刊(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of Science数据库自建库至2022年11月所有中医药口服治疗急性肾损伤的临床研究文献。筛选文献并提取资料后,应用Microsoft Excel、古今医案云平台对方剂进行频数统计、关联规则分析、层次聚类分析及复杂网络分析。结果共纳入方剂69首,涉及中药161味,共计使用频次714次。急性肾损伤的病因以脓毒症为主,中医证候以气阴两虚型、湿热阻滞型及毒热内盛证为主,中药使用频次≥10共计21味,包括大黄、甘草、茯苓、黄芪、白术等;药味以甘为主,药性以寒为主,药物归经以脾经、肝经及肺经为主,药物功效以清热解毒、清热泻火、逐瘀通经为主。关联规则分析得到“茯苓-大黄”“白术-黄芪”“丹参-大黄”等常用药对。层次聚类分析得到3个常用药物组成。复杂网络分析得到1组潜在治疗急性肾损伤的中药药物组成。结论数据挖掘揭示了急性肾损伤病机是本虚标实,用药规律是补气阴,兼祛外邪,挖掘出了常用药对及药物组合,为临床用药提供新的参考。

Objective To analyze the medication characteristics and prescription rules of traditional Chinese medicine oral treatment for acute kidney injury using data mining.Methods All clinical research literature on the oral treatment of acute kidney injury with traditional Chinese medicine were retrieved on CNKI,Wanfang,VIP,CBM,PubMed,and Web of Science databases,with the retrieval duration from their establishment to November 2022.After screening literature and extracting data,Microsoft Excel and the Ancient and Modern Consilia Cloud Platform were used for frequency statistics,association rule analysis,hierarchical clustering analysis,and complex network analysis of the prescription.Results A total of 69 prescriptions were included,involving 161 traditional Chinese medicines,with a total frequency of use of 714 times.The main cause of acute kidney injury was sepsis,and the traditional Chinese medicine syndrome was characterized by the deficiency of both qi and yin,damp-heat stagnation,and internal toxin-heat exuberance.The frequency of use of traditional Chinese medicine was≥10,with a total of 21 traditional Chinese medicines,including rhubarb,licorice,poria cocos,astragalus membranaceus,and atractylodes macrocephala;The medicinal taste was mainly sweet,and the medicinal properties were mainly cold.The main meridians of medicine were the spleen,liver,and lung meridians.The medicinal effects were mainly clearing heat and detoxifying,clearing heat,and purging fire,removing blood stasis,and clearing meridians.The commonly used drug pairs such as"poria cocos-rhubarb""atractylodes macrocephala-astragalus"and"salvia miltiorrhiza-rhubarb"were obtained by the association rule analysis.Three commonly used drug compositions were obtained through hierarchical clustering analysis.A group of potential traditional Chinese medicine components for the treatment of acute kidney injury was obtained by the complex network analysis.Conclusion Data mining reveals that the pathogenesis of acute kidney injury is based on deficiency of vitality and excess in superficiality,and the medication rule is to replenish qi and yin,while also eliminating external pathogens.It has also discovered commonly used drug pairs and drug combinations,providing new references for clinical medication.