基于数据挖掘分析《中华医典5.0》对中风病气虚证的用药特点及处方配伍规律

Medication characteristics and compatibility rules of Chinese Medical Code 5.0 against qi deficiency syndrome of stroke based on data mining

目的基于《中华医典5.0》探讨中风病气虚证的用药特点和处方配伍规律。方法收集《中华医典5.0》中治疗中风病气虚证的古代及近代处方,通过Microsoft Office Excel 2013软件建立规范化数据库,并利用SPSS Statistics 25和SPSS Modeler 18.0软件对数据库中处方进行频数、关联规则、聚类分析等数据挖掘方法的研究。结果本研究共得到频率>15%的中药16味,使用频次前5位的中药分别是:甘草70次、人参64次、白术50次、当归43次、茯苓41次。药性多为温、寒、平之品,药味以甘、辛、苦为主,主要归脾、肺、心经。药类频次前6位的中药类别为:补虚药、解表药、理气药、化痰止咳平喘药、温里药及活血化瘀药。关联分析得到强关联配对方式50种(置信度>0.8、支持度>0.1),支持度前5位的药对为白术—茯苓、甘草—陈皮、茯苓—半夏、人参—半夏、甘草—半夏。聚类分析得到聚类组5类,复杂网络分析得到中风病气虚证的核心处方,共包含26味中药:人参、半夏、天麻、川芎、当归、木香、桔梗、熟地黄、独活、甘草、生姜、白术、白芍、白芷、竹沥、细辛、羌活、肉桂、茯苓、防风、附子、陈皮、麻黄、黄芩、黄芪、乌药,为六君子汤、四物汤、九味羌活汤合方。结论《中华医典5.0》中记载治疗中风病气虚证的处方呈现以益气养血、祛风解表、理气祛痰为主的处方规律,治疗以补气为核心,兼以祛风、化痰、祛湿之品。需要注意的是,气虚证贯穿中风病发病始终,在中风病气虚证的治疗中,调补后天之气是治疗的关键,运用毒性药物或可成为治疗中风病气虚证的新思路。

Objective To explore the medication characteristics and compatibility rules in the qi deficiency syndrome of stroke from Chinese Medical Code 5.0.Methods The ancient and modern prescriptions for qi deficiency syndrome of stroke in Chinese Medical Code 5.0 were collected.A standardized data base was established with Microsoft Office Excel 2013 software.Data mining methods,such as frequency,association rules,factors and cluster analysis were studied by SPSS Statistics 25 and SPSS Modeler 18.0 software.Results 16 kinds of Chinese medicines with frequencies over 15%were obtained in this study,the top five herbs were liquorice(70 times),ginseng(64 times),white atractylodes rhizome(50 times),Chinese angelica(43 times)and Poria cocos(41 times).Most drugs were warm,cold or neutral in nature and had a sweet,pungent or bitter taste,and the drugs mainly belong to spleen channel,lung channel and heart channel.The top six types of Chinese medicine were tonifying deficiency drugs,diaphoretic,qi-regulating drug,resolving phlegm,relieving cough,relieving asthma drugs and warming-interior drugs.50 kinds of strong correlation matching methods were obtained by correlation analysis(confidence>0.8,support>0.1).The top 5 drug pairs were Atractylodes-Poria cocos,Licorice-Dried orange peel,Poria cocos-Pinellia,Ginseng-Pinellia,Licorice-Pinellia.Cluster analysis showed that five groups were clustered.Complex network analysis showed that the core prescription consisted of 26 kinds of Chinese herbs:ginseng,pinellia,Gastrodia,Chuanxiong,Angelica,radix aucklandiae,platycodon,cooked Rehmannia,Duhuo,licorice,ginger,Baizhu,Paeoniae,radix angelicae,bamboo juice,asarum,Qianghuo,cinnamon,Poria,Parsnips,aconite,Tangerine peel,ephedra,Scutellaria,Astragalus,Lindera aggregata,which is thecombined prescription of Liujunzi Decoction,Siwu Decoction and Jiuwei Qianghuo Decoction.Conclusion The prescriptions recorded in Chinese Medical Code for the treatment of qi deficiency syndrome of stroke present a rule of prescriptions based on reinforcing qi and nourishing blood,regulating qi and eliminating phlegm and dispelling wind and eliminating dampness,which is tonifying qi as the core,combined with the use of wind-dispelling phlegm-removing and dampness-dispelling medicine.It should be noted that qi deficiency syndrome runs through the onset of stroke.In the treatment of qi deficiency syndrome of stroke,regulating acquired qi is the key to treatment.The use of toxic traditional Chinese medicine may become a new idea for the treatment of qi deficiency syndrome of stroke.