基于数据挖掘的刘兰林教授运用温病学三焦理论辨治慢性难治性湿疹的用药规律

A Data Mining-based Study of Professor LIU Lanlin's Medication Pattern in the Treatment of Chronic Refractory Eczema Using the Theory of Triple Burner in TherapeuticsIdentification

目的:运用数据挖掘技术研究刘兰林教授辨治慢性湿疹的用药规律。方法:收集整理刘兰林教授治疗慢性湿疹的105张门诊处方单,借助Microsoft Excel 2010、SPSS Statistics 22.0、SPSS Modeler 18.0计算机软件建立数据库并进行频数及聚类分析。结果:所收集的处方涉及中药147味,18类,使用频数≥20次的常用药物有牡丹皮、蝉蜕、白鲜皮等,清热药、利水渗湿药位居前2位,药性上寒温搭配,药味以甘、苦、辛为主,归经多入肝、胃、脾、肺经。聚类分析出牡丹皮、大青叶、生地黄、淡竹叶、水牛角、玄参、首乌藤,蝉蜕、防风、僵蚕、徐长卿等7种组合。结论:刘兰林教授以温病学三焦理论为指导,将慢性湿疹病机核心责之于湿热内蕴,外发肌肤,治疗遵循三焦辨治原则,治以清热祛湿,调畅气机,分消上中下三焦湿热之邪,酌情配以凉血散瘀,祛风通络之品,用药喜寒温搭配,甘苦合化及苦辛相伍,擅以犀角地黄汤、升降散、五苓散、四妙散等经典名方加减。

Objective To study the medication pattern of Professor LIU Lanlin's treatment of chronic eczema by using data mining technology.Methods 105 outpatient prescription lists of Professor LIU for the treatment of chronic eczema were collected and collated,and the database was established and analyzed by frequencyandclustering with the help of Microsoft Excel 2010,SPSS Statistics 22.0 and SPSS Modeler 18.0 computer software.Results The collected prescriptions involved 147 flavors and 18 categories of Chinese medicine,and the commonly used drugs with a frequency of≥20 times included peony bark,cicada molasses,and white fresh peel,etc.Heat-clearing drugs and water-releasing and damp-permeating drugs were in the top 2 positions,with a combination of cold and warm properties and a taste of sweet,bitter,and pungent,and their meridians were mostly in the liver,stomach,spleen,and lung meridians.The clustering analysis revealed seven combinations of Moutan Cortex,Folium Isatidis,Rehmanniae Radix,Lophatheri Herba,Buffalo Horns,Scrophulariae Radix,Polygni Multiflori Caulis,Cicadae Periostracum,Saposhnikoviae Radix,Bombyx Batryticatus and Cynanchi Paniculati Radix Et Rhizoma.Conclusion Professor LIU is guided by the Three Jiao theory of therapeutics and blames dampness and heat within the chronic eczema pathogenesis for the external development of the skin.His treatment follows the principles of the Three Jiao discriminatory treatment,which is based on clearing heat and dispelling dampness,regulating the Qi flow,dispersing dampness and heat in the upper,middle and lower jiao,dispersing blood stasis,dispelling wind and clearing the ligaments as appropriate,combining cold and warm,combining sweet and bitter,and combining bitter and pungent.She specializes in the addition and subtraction of classical formulas such as Rhizoma Rhizoma Dihuang Tang,Shengli San,Wu Ling San,and Si Miao San.