基于数据挖掘名老中医食管癌医案探讨虫类药物作用机制的研究进展

review on the mechanism of action of insect drugs on esophageal cancer in famous veteran traditional Chinese medicine practioner’s medical records based on data mining

目的:通过数据挖掘分析名老中医诊治食管癌医案,发掘其中虫类药物的运用规律并对其作用机制进行探讨。方法:①以国家中医药管理局公布的第一批至第三批国医大师和第一批至第六批全国老中医药专家学术经验继承工作指导老师名单为依据,在河南中医药大学图书馆馆藏书目检索系统输入名老中医姓名,检索其著作、经验集,从中寻找其诊治食管癌的医案。②以名老中医姓名、“食管癌”“中医”“医案”“临床经验”为检索词,分别检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库自建库至今公开发表的食管癌诊治医案,提取医案详细信息,包括诊断、处方药物、虫类药物、证型,运用中医传承辅助平台对处方药物的四气五味、归经、用药频次、虫类药物频次、证型分布进行分析。结果:共纳入331个处方、344味药物,使用频次居前10位的分别为茯苓、黄芪、陈皮、白术、甘草、威灵仙、麦冬、白花蛇舌草、党参、砂仁。证候频次居前10位的依次为痰瘀互结、气阴两虚、痰气交阻、瘀毒互结、胃气上逆证、脾气虚证、脾肾两虚证、脾胃虚弱、气滞血瘀、痰湿内停。其中所涉虫类药物频次居前10位的分别为:壁虎、蜈蚣、全蝎、僵蚕、蜂房、穿山甲、土鳖虫、蟾皮、水蛭、乌梢蛇。

Objective:To explore the application law of insect drugs and their mechanism of action in the diagnosis and treatment of esophageal cancers through the data mining analysis of the medical record of famous veteran traditional Chinese medicine practioner.Methods:①Based on the list of the first to third batch of masters of traditional Chinese medicine and the first to sixth batch of national veteran traditional Chinese medicine experts academic experience inheritance work instructors announced by the State Administration of Traditional Chinese Medicine,the names of famous veteran traditional Chinese medicine practitioners were entered into the library collection bibliographic search system of Henan University of Chinese Medicine,and their works and experience collections were searched,and their medical cases for diagnosis and treatment of esophageal cancer were searched.②With the names of veteran traditional Chinese medicine practitioners,“esophageal cancer”,“traditional Chinese medicine”,“medical records”and“clinical experience”,as search terms,the medical records for the diagnosis and treatment of esophageal cancer published in CNKI,Wanfang Data Knowledge Service Platform and VIP Chinese Science and Technology Journal database from the establishment of the database to the present were respectively searched.The detailed information of medical records,including diagnosis,prescription drugs,insect drugs,and syndrome type,was extracted,and the four properties and five tastes of prescription drugs,channel attribution,frequency of medication,frequency of insect drugs,and syndrome type distribution of prescription drugs were analyzed using the TCM inheritance auxiliary platform.Results:A total of 331 prescriptions and 344 flavors were included,and the top 10 drugs were Fuling(Poria),Huangqi(Radix Astragali),Chenpi(Pericarpium Citri Reticulatae),Baizhu(Rhizoma Atractylodis Macrocephalae),Gancao(Radix Glycyrrhizae),Weilingxian(Radix et Rhizoma Clematidis),Maidong(Radix Ophiopogonis),Baihuasheshecao(Herba Hedyoti Diffusae),Dangshen(Radix Codonopsis),Sharen(Fructus Amomi).The top 10 syndromes were interlocking of phlegm and blood stasis,deficiency of Qi(气)and Yin(阴),interlocking of phlegm and Qi,interlocking of blood stasis and toxin,inversion of stomach Qi,deficiency of spleen,weakness of the spleen and stomach,stagnation of Qi and blood stasis,internal stagnation of phlegm and dampness.Among them,the top 10 insect drugs involved were Bihu(G.Swinhoanis),Wugong(Scolopendra),Quanxie(Scorpio),Jiangcan(Bombyx Batryticatus),Fengfang(Nidus Vespae),Chuanshanjia(Squama Manis),Tubiechong(Eupolyphaga Seu Steleophaga),Chanpi(Corium Bufonis),Shuizhi(Hirudo),Wushaoshe(Zaocys).