基于数据挖掘分析胡欣主任中医维持治疗乳腺癌的用药规律

An analysis of medication law of Director HU Xin in the TCM maintenance treatment of breast cancer based on data mining

目的:总结胡欣主任中医维持治疗乳腺癌的用药规律。方法:收集并筛选2019年1月―2021年12月胡欣主任中医维持治疗乳腺癌患者的门诊处方102首,录入中医传承计算平台系统(V3.0),运用频数统计、关联规则等方法进行统计和分析。结果:(1)药物频次分析:102首处方共涉及中药133味。用药频次≥40的药物有18味,使用频次居前10位的药物依次是山药、槲寄生、夏枯草、党参、浙贝母、山慈菇、薏苡仁、红景天、甘草、茯苓。(2)药物性味归经:平性药物使用频数最多,达724次,占比42.12%;五味以甘、苦为主,占比分别为45.12%和30.76%;归经多归肺、脾二经,其次为胃、肝、心、肾经。(3)组方规律分析:药物组合67个,包含中药13味,组合频次从高到低依次是山药和槲寄生、山药和薏苡仁、山药和山慈菇、山药和夏枯草、夏枯草和浙贝母等;30条药物关联规则,关联度较高的组合分别为薏苡仁、红景天-山药;槲寄生、薏苡仁-山药;夏枯草、薏苡仁-山药;竹茹-山药;浙贝母、薏苡仁-山药等。结论:胡欣主任中医维持治疗乳腺癌强调其“本虚标实”的病机,临床采用“补脾养胃益肺以固护其本,清热化痰散结以兼顾其标”的治疗思路,对临床上中药维持治疗乳腺癌具有参考意义。

Objective:To summarize the medication law of Director HU Xin in the treatment of breast cancer by TCM maintenance.Methods:A total of 102 outpatient prescriptions of Director HU Xin in the treatment of breast cancer by TCM maintenance from January 2019 to December 2021 were collected and screened.Then they were input into TCM inheritance computing platform(V3.0),and frequency statistics,association rules and other methods were used to carry out statistics and analysis.Results:(1)Herb frequency analysis:The 102 prescriptions involved 133 Chinese medicinal materials.There were 18 Chinese medicinal materials flavors of herbs with a frequency of 40 times or more.The top 10 herbs used frequently were Shanyao(Yam),Hujisheng(Mistletoe),Xiakucao(Prunella Vulgaris),Dangshen(Codonopsis pilosula),Zhebeimu(Fritillaria thunbergia),Shancigu(Mountain arrowhead),Yiyiren(Coix seed),Hongjingtian(Rhodiola),Gancao(Licorice)and Fuling(Poria).(2)Medicinal properties,flavors,and meridians:Mild drugs had the highest frequency of use,reaching 724 times,accounting for 42.12%.The main flavors were sweet and bitter,accounting for 45.12%and 30.76%,respectively.The active ingredients of Chinese medicinal materials mainly flow into the lung and spleen meridians,followed by the stomach,liver,heart,and kidney meridians.(3)Analysis of prescription rules:There were 67 medicine combinations,including 13 Chinese medicinal.The frequency of medicine combinations from high to low was as follows:Shanyao-Hujisheng,ShanyaoYiyiren,Shanyao-Shancigu,Shanyao-Xiakucao,Xiakucao-Zhebeimu,etc.There were 30 medicine association rules,and the combinations with higher correlation were Yiyiren-Hongjingtian-Shanyao,Hujisheng-Yiyiren-Shanyao,Xiakucao-Yiyiren-Shanyao,Zhuru(Caulis Bambusae in Taenia)-Shanyao,Zhebeimu-Yiyiren-Shanyao,etc.Conclusion:Director HU Xin emphasizes the pathogenesis of“deficiency in origin and excess in superficiality”in the breast cancer by TCM maintenance treatment,and clinically adopts the treatment idea of“supplementing the spleen,nourishing the stomach and supplementing the lung to target the root causes,and clearing heat,resolving phlegm and dispersing knot to relieve the symptoms”.It has reference significance for clinical maintenance treatment of breast cancer in TCM.