基于数据挖掘探析巩跃生教授治疗溃疡性结肠炎用药规律

Analysis of Medication Rules of Professor Gong Yuesheng in the Treatment of Ulcerative Colitis Based on Data Mining

目的:基于数据挖掘方法,研究巩跃生教授治疗溃疡性结肠炎(UC)的组方用药规律,指导临床运用。方法:收集巩跃生教授2018年1月-2023年1月在郑州市大肠肛门病医院治疗溃疡性结肠炎的患者病例,根据纳排标准筛选符合规范医案,进行药物频次、药效、中药性味归经统计,运用R语言进行关联规则及聚类分析,获得核心组方。结果:口服处方中,用药频次排名前5位是白术、茯苓、党参、甘草、木香;外用处方中,用药频次排名前5位是白及、黄连、黄柏、白术、甘草。口服及外用处方均以寒性药、苦味药居首,以脾、胃及肝经为主,以清热药及补虚药频率较高,且口服治疗多配伍健脾理气药,外用则多配伍凉血止血药。延胡索+木香、茯苓+枳壳+香附分别是2阶3阶口服药物关联规则中支持度最高的组合,口服核心药物组合为茯苓、木香、枳壳、延胡索、柴胡、香附、川楝子,以疏肝健脾、行气止痛为主;白头翁+黄连、白头翁+秦皮+黄连分别是2阶、3阶外用药物关联规则中支持度最高组合,外用核心药物组合为白头翁、秦皮、黄连、黄柏,以清热解毒、凉血止痢为主。结论:巩跃生教授治疗UC采用口服及外用药物相结合方式,注重肝脾同治,兼顾清热利湿、调和气血。体现其重视脏腑传变、辨证论治、调和阴阳、标本兼治的学术思想。

Objective:Based on the method of data mining,this paper studied the rule of Professor Gong Yuesheng's prescription medication in the treatment of ulcerative colitis(UC),and guided the clinical application.Methods:Patients with ulcerative colitis treated by Professor Gong Yuesheng in Zhengzhou Anorectal Hospital from January 2018 to January 2023 were collected.The medical records meeting the standard were screened according to the exclusion criteria,and the drug frequency,efficacy,and medicinal property,flavors and channel tropism of Chinese medicine were statistically analyzed.Using R language to conduct association rules and cluster analysis,the core combination is obtained.Results:The top 5 drugs of oral prescription frequency are Atractylodis Macrocephalae Rhizoma,Poria,Codonopsis Radix,Glycyrrhizae Radix et Rhizoma,Aucklandiae Radix.The top 5 of external prescriptions in the frequency of drugs are Bletilla Rhizoma,Coptidis Rhizoma,Phellodendri Chinensis Cortex,Atractylodis Macrocephalae Rhizoma,Glycyrrhizae Radix et Rhizoma.In oral and external prescriptions,cold drugs and bitter drugs topped the list,and spleen,stomach and liver channels were the main ones.All of them paid attention to the use of heat-clearing drugs and vacuity-tonifying drugs.In addition,oral treatment was mostly combined with spleen-strengthening and Qi-regulating drugs,while external treatment was mostly combined with cooling and hemostasis drugs.Corydalis Rhizoma-Aucklandiae Radix,Poria-Aurantii Fructus-Cyperi Rhizoma are the most supported combinations in the 2-order and 3-order oral drug association rules,respectively.The core drug combinations for oral are Poria,Aucklandiae Radix,Aurantii Fructus,Corydalis Rhizoma,Bupleuri Radix,Cyperi Rhizoma and Toosendan Fructus,which mainly focused on soothing the liver and strengthening the spleen,promoting qi and relieving pain.Pulsatillae Radix-Coptidis Rhizoma,Pulsatillae Radix-Fraxini Cortex-Coptidis Rhizoma are 2-order and 3-order for external treatment medicine association rules in support of the highest combination.The core drug combination for external treatment are Pulsatillae Radix,Fraxini Cortex,Coptidis Rhizoma and Phellodendri Chinensis Cortex,mainly to clear heat and detoxify,cool blood and stop dysentery.Conclusion:Professor Gong Yuesheng treats UC by combining oral and external drugs,focusing on the relaxation of spleen,stomach and liver channels,clearing heat and diuresis,and regulating qi and blood.It embodies the academic thought of attaching importance to the transmission of internal organs,treating syndrome differentiation,reconciling Yin and Yang,treating both symptoms and root causes.