基于专家意见及数据挖掘分析继发性痛经中成药用药规律

Medication Regularity of Chinese Patent Drug for Secondary Dysmenorrhea Based on Expert Opinion and Data Mining

目的:基于专家意见,通过数据挖掘的方式,分析疗效确切的中成药治疗继发性痛经的用药规律。方法:筛选2017版医保目录、2015版《中华人民共和国药典》中治疗痛经的药物,合并同一方剂不同剂型中成药,运用德尔菲法,对妇科专家以问卷调查的形式筛选出最常用、最推荐的治疗继发性痛经的中成药,并通过中医传承辅助平台探究治疗继发性痛经的中成药处方的用药规律、核心组合及关联规则,基于无监督的熵层次聚类推演出新方。结果:共筛选出中成药处方25个,涉及中药75味,常用药物为延胡索、当归、香附、川芎、白芍、丹参、五灵脂、红花、肉桂、熟地黄;主要归肝、脾经;通过关联规则得出常用药对以延胡索、当归、川芎相互组合为主;进一步聚类分析得到潜在核心组合8个,新处方4首。结论:临床常用治疗继发性痛经中成药处方用药以活血化瘀药为主,兼补血、温阳、益气,标本兼治,聚类分析得出的潜在药物组合和新方具有一定理论价值及代表性,可为临床探索及实验研究提供参考。

Objective:Based on expert opinion and data mining,to analyze the medication regularity of Chinese patent medicines with precise efficacy in the treatment of secondary dysmenorrhea.Methods:The medicines for treating dysmenorrhea in the 2017 version of the medical insurance catalog and the 2015 version of the Pharmacopoeia of the People's Republic of China were screened,combining different forms of Chinese patent drugs of the same prescription,the Delphi method was used to screen out the most commonly used and recommended Chinese patent drugs for the treatment of secondary dysmenorrhea in the form of questionnaires,TCMISS was used to explore the medication laws,core combinations,and association rules of the Chinese patent drugs prescribed for treating secondary dysmenorrhea,to deduce a new formula based on unsupervised entropic hierarchical clustering.Results:A total of 25 prescriptions for Chinese patent drugs were screened,involving 75 herbs,and the commonly used medicines were Yanhusuo(Corydalis rhizoma),Danggui(Angelicae sinensis radix),Xiangfu(Cyperi rhizoma),Chuanxiong(Chuanxiong rhizoma),Baishao(Paeoniae radix alba),Danshen(Salviae Miltiorrhizae radix rhizoma),Wulingzhi,safflower(Flos Carthami),Rougui(Cinnamomi cortex),and Shudihuang(Rehmanniae radix praeparata);they were mainly attributed to the liver and the spleen meridians;the commonly used drug combinations were the mutual combinations of Yanhusuo,Danggui and Chuanxiong as concluded from the association rules;and the further clustering analysis yielded eight potential core combinations and four new prescriptions.Conclusion:The Chinese patent drugs commonly used in clinical treatment of secondary dysmenorrhea are mainly used to promote blood circulation and eliminate blood stasis,meanwhile and tonify blood,warm yang,and benefit Qi,so as to treat both the symptoms and the root cause,and the potential combinations of medicines and new formulas derived from the cluster analysis have certain theoretical value and representativeness,which can provide references for clinical explorations and experimental researches.