基于隐结构结合关联规则辨证分析卵巢功能早衰的方药规律

Medication Rule in Treating Premature Ovarian Failure with Syndrome Differentiation Based on Latent Structure and Association Rule

目的:基于隐结构结合关联规则辨证分析卵巢功能早衰的用药规律,以期为临床辨证及用药提供依据。方法:检索中国知网数据库、万方数据库、中国医学生物文献数据库、维普中文科技期刊数据库建库至2023年6月中收录的中医药治疗卵巢功能早衰的相关文献;提取纳入文献相关信息建立数据库,以隐结构分析和量化卵巢功能早衰证候要素、证型、治法分布规律,并运用关联规则网络可视化呈现核心药物及主要证型的症-药关系。结果:纳入文献292篇,计343条记录,获得出现频率≥5%的症状65个、中药59味。阳虚是卵巢功能早衰的首要证候要素,其次是阴虚、痰湿、血瘀、气郁;归纳总结出卵巢功能早衰5个常见证型,分别为肾虚肝郁证、脾肾阳虚证、肝肾阴虚证、肾虚血瘀证、心肾不交证,以肾虚肝郁证为主;中药功效类别以补虚药为主,熟地黄、当归、菟丝子、淫羊藿、山药、枸杞子、山茱萸为核心中药,与其组成的配伍关联亦最强;常用方剂为柴胡疏肝散、归肾丸、参苓白术散、右归丸、当归六黄汤、左归丸、桃红四物汤、天王补心丹等。结论:隐结构与关联规则结合的数据挖掘方法系统梳理、分析卵巢功能早衰的证素特征、辨证规律和用药特点等,得出卵巢功能早衰患者多以肾虚为本,兼以肝郁、脾虚、肝阴虚、血瘀、心肾不交等,治疗应根据病机的不同有所侧重,在补肾益精的基础上佐以疏肝理气、益气健脾、养血滋阴、活血化瘀、宁心安神等辨证论治,标本兼治。

Objective:To analyze the drug use rule of premature ovarian failure with syndrome differentiation based on latent structure and association rule,in order to provide evidence for clinical syndrome differentiation and drug use.Methods:Literature related to the treatment of premature ovarian failure with traditional Chinese medicine was retrieved from CNKI database,Wanfang Database,Chinese Medical Biology Literature Database and Vip Chinese Science and technology journal database from the establishment of the database to mid-June 2023.The relevant information of the included literature was extracted to establish a database,and the distribution law of syndrome elements,syndrome types and treatment methods of premature ovarian failure was analyzed and quantified by hidden structure,and the syndrome-drug relationship of core drugs and major syndrome types was visualized by association rule network.Results:A total of 343 records were included in 292 literatures,and 65 symptoms and 59 TCM flavors with frequency≥5%were obtained.Yang deficiency is the primary syndromic factor of premature ovarian failure,followed by Yin deficiency,Phlegm and Dampness,blood stasis and Qi depression.Five common types of premature ovarian failure were summarized,which were Kidney deficiency and Liver depression syndrome,Spleen and Kidney Yang deficiency syndrome,Liver and Kidney Yin deficiency syndrome,Kidney deficiency and blood stasis syndrome,Heart-Kidney disjunction syndrome,with Kidney deficiency and Liver depression syndrome being the most common one.The main efficacy categories of Chinese medicine were deficiency tonic medicine,with Shudihuang(Rehmanniae Radix Praeparata),Danggui(Angelicae Sinensis Radix),Tusizi(Cuscutae Semen),Yinyanghuo(Epimedii Folium),Shanyao(Dioscoreae Rhizoma),Gouqizi(Lycii Fructus),Shanzhuyu(Corni Fructus)being the core Chinese medicinals in use,and the compatibility of them in formulas was most used.The commonly used prescriptions are Chaihu Shugan Powder,Guishen Pill,Shenling Baizhu Powder,Yougui Pill,Danggui Liuhuang Decoction,Zuogui Pill,Taohong Siwu Decoction,Tianwang Buxin Pill and so on.Conclusion:The data mining method combined with latent structure and association rule analysis systematically sorted out and analyzed the characteristics of syndrome elements,syndrome differentiation rules and medication characteristics of premature ovarian failure.It was concluded that most patients with premature ovarian failure were based on Kidney deficiency,and on Liver depression,Spleen deficiency,Liver Yin deficiency,blood stasis,Heart-Kidney disharmony,etc.The treatment should be carried out according to the different pathogenesis.Based on tonifying Kidney and Essence,the treatment should be carried out with syndrome differentiation,such as soothing Liver and regulating Qi,invigorating Qi and strengthening Spleen,nourishing blood and tonifying Yin,promoting blood circulation and removing blood stasis as well as calming heart and easing mind.