基于数据挖掘探讨国医大师韦贵康治疗腰椎间盘突出症的用药规律

Data Mining-based Exploration into the Medication Rules of TCM National Master Wei Guikang in the Treatment of Lumbar Disc Herniation

目的:基于数据挖掘对国医大师韦贵康治疗腰椎间盘突出症(lumbar disc herniation,LDH)的用药规律进行归纳、总结与探讨。方法:收集从2017年1月9日至2020年1月9日在广西中医药大学附属瑞康医院就诊于韦贵康教授门诊而且具有确切临床疗效的316例LDH患者的首诊处方,建立处方数据库。采用SPSS 20.0软件对处方中出现的药物进行频次统计分析;用SPSS Modeler 14.1软件对处方中出现的高频药物进行关联规则分析。结果:韦贵康教授治疗LDH频数较高的前15味中药为三七、甘草、两面针、白芍、丹参、细辛、龙骨、降香、千斤拔、茯苓、熟地黄、山萸肉、牡丹皮、泽泻、山药;并且挖掘出46组核心药物组合,支持度均大于50%,且置信度为100%,衍化得出2个核心处方:六味地黄汤和痛安汤加味。结论:国医大师韦贵康治疗LDH的临证用药主要以活血化瘀药为主,其中活血、补肾、扶正药物使用频次最多,体现了韦贵康教授诊疗LDH的整体观和“补肾通督,化瘀扶正”的学术思想。

Objective:To summarize,generalize and explore the medication rules of Wei Guikang,TCM national master,in the treatment of lumbar disc herniation(LDH)based on data mining.Methods:The first prescriptions of 316 LDH patients with definite clinical efficacy who visited Professor Wei Guikang's clinic at Ruikang Hospital affiliated to Guangxi University of Traditional Chinese Medicine from January 9,2017 to January 9,2020 were collected to establish prescription database.Frequency statistics of drugs appearing in prescriptions were analyzed using SPSS Statistics 20.0 software as well as association rule of high frequency drugs appearing in prescriptions using SPSS Modeler 14.1 analysis software.Results:The top 15 Chinese medicines with high frequency in the treatment of LDH by Prof.Wei Guikang were Sanqi(notoginseng radix et rhizoma),Gancao(Glycyrrhizae radix et rhizoma),Liangmianzhen(Zanthoxyli radix),Baishao(Paeoniae radix alba),Danshen(Salvia miltiorrhizae radix et rhizoma),Xixin(asari radix et rhizoma),fossil fragments,Jiangxiang(Dalbergiae odoriferae lignum),Qianjinba(Flemingia prostrata Roxb.f.ex Roxb.),Fuling(Poria),Shudihuang(Rehmanniae Radix Praeparata),Shanzhuyu(Corni fructus),Mudanpi(Moutan cortex),Zexie(Alismatis rhizoma),and Chinese yam;and 46 groups of core drug combinations were mined,with the support level of all of them being greater than 50%,and with confidence level of 100%,and derivation yielded two core prescriptions:Six-flavored Dihuang Tang and modified Tong'an Tang.Conclusion:The medications used by TCM national master Wei Guikang in the treatment of LDH mainly focus on activating blood circulation and removing blood stasis,among which the medications for activating blood circulation,tonifying the kidney,and enhancing healthy Qi were used most frequently,which reflects the holistic view of the diagnosis and treatment of LDH by Prof.Wei Guikang,and his academic thinking of"tonifying the kidney and unobstructing the governor meridian,and removing blood stasis and enhancing healthy Qi".