岐黄学者张学智培土畅中法治疗幽门螺杆菌根除后化生性慢性萎缩性胃炎的处方用药规律

ZHANG Xuezhi's medication pattern for treating metaplasia chronic atrophic gastritis post-HP eradication adheres to the traditional Chinese medicine principles of spleen nourishment and middle burner regulation

目的:运用数据挖掘探究张学智教授培土畅中法治疗幽门螺杆菌(HP)根除后化生性慢性萎缩性胃炎(MCAG)的用药规律。方法:收集2022年9月—2023年9月张学智教授治疗HP根除后MCAG处方,运用R4.3.2、SPSS Modeler 18.0和Cytospace 3.10.1对处方进行分析。结果:共收集150首处方,中药共162味,频次共3289次,频数排名前20药物功效以补虚、理气为主。药性以寒、温、平为主,药味以甘、苦、辛为主,归经以肝经、肺经、脾经、胃经为主。关联规则得到“黄芪、瓦楞子-柴胡”、“陈皮-黄芪”、“黄连-黄芪”等药对,聚类分析呈现2个类别。得到核心处方:黄芪、茯苓、白术、三七、陈皮、法半夏、香附、丹参、甘草,同时运用中药权重方法计算加权相似度>0.5共计99首,合计占66%的处方。结论:张教授认为HP根除后MCAG属本虚标实,应以培土补虚为本,寒热并用,攻补兼施,注重调理气机、燥化痰湿、活血化瘀。

Objective This study aims to investigate the medication patterns employed by Professor ZHANG Xuezhi in the treatment of Metaplasia Chronic Atrophic Gastritis following the eradication of Helicobacter pylori(HP)using data mining techniques.Methods Prescriptions from Professor ZHANG Xuezhi for Metaplasia CAG after HP eradication between September 2022 and September 2023 were collected.The analysis was conducted using R 4.3.2,SPSS Modeler 18.0,and Cytospace 3.10.1.Results A total of 150 prescriptions were collected,comprising 162 different Chinese herbs with a total frequency of 3289 occurrences.The top 20 drugs by frequency primarily targeted tonifying deficiencies and regulating qi.The predominant nature of the drugs was cold,warm,and neutral,while the predominant tastes were sweet,bitter,and pungent.The associated meridians included the liver,lung,spleen,and stomach.Association rules revealed pairs of drugs such as"Astragalus,Valeriana-Bupleurum","Tangerine Peel-Astragalus",and"Coptis-Astragalus".Cluster analysis revealed two distinct categories.The core prescription included Astragalus,Poria,Atractylodes,Notoginseng,Tangerine Peel,Pinellia,Cyperus,Salvia,and Licorice.Using a traditional Chinese medicine weight method,99 prescriptions with a weighted similarity greater than 0.5 were identified,collectively constituting 66%of the prescriptions.Conclusion Professor ZHANG suggests that post-HP eradication,Metaplasia chronic atrophic gastritis is characterized by deficiency with excess symptoms.The treatment approach should focus on tonifying deficiencies,combining cold and warm properties,and emphasizing the regulation of qi,elimination of dampness,and promotion of blood circulation to resolve stasis.