基于数据挖掘探讨周继红治疗肺结节术后用药规律

Discussion on Medication Rules of ZHoU Jihong Treating Pulmonary Nodules After Surgery Based on Data Mining

目的:探讨周继红主任运用中医药治疗肺结节术后患者的用药特点及组方规律。方法:收集342例肺结节术后治疗处方,构建方药数据库。应用SPSS Modeler 18.0、SPSS Statistics 24.0对处方进行药物频次统计、关联规则分析及系统聚类。结果:共纳入方剂372首,涉及中药194味,使用频次在150次以上(使用频率≥40%)的药物共有11味,具体为炙甘草、茯苓、麸炒白术、当归、黄芪、桔梗、法半夏、陈皮、麦冬、白芍、生地黄。在高频药物中归脾胃经的药物数量最多,达22味(73.3%);其次为归肺与大肠经的药物,有18味(60.0%);归肾经的药物最少,只有4味(13.3%)。关联规则分析(支持度≥10%,置信度≥85%,最大前项数1)得到关联规则71条,炙甘草与茯苓、麸炒白术与黄芪、茯苓与法半夏、炙甘草与当归等组合均为治疗肺结节术后常用药物组合。聚类分析得到7个组合,第1组以理气化痰类药物为主,包括竹茹、麸炒枳实、大枣等;第2组以活血祛瘀类药物为主,包括酒川芎、燀桃仁;第3组仅有1味炙甘草,以祛痰止咳、调和诸药为主要功效;第4组仅有1味茯神,以宁心安神为主要功效;第5组以益气固表类药物为主,包括麸炒白术、黄芪、防风;第6组以健脾养胃、清热散结、健脾利湿类药物为主,包括炒鸡内金、炒麦芽、太子参等;第7组以滋养肺肾、止咳化痰类药物为主,包括百合、玄参、浙贝母等。结论:治疗肺结节术后患者以滋肾补肺、益气固表、行气化痰、活血补血为基本原则,从脾胃论治肺系疾病是其用药特点之一。

Objective:To discuss the medication characteristics and prescription rules of Director ZHOU Jihong treating patients who received surgery of pulmonary nodules with traditional Chinese medicines.Methods:Prescriptions of 342 patients receiving surgery of pulmonary nodules were collected to establish a database.SPSS Modeler 18.0 and SPSS Statistics 24.0 were used to perform frequency statistics for Chinese medicines used in the prescriptions,association rule analysis and hierarchical cluster.Results:A total of 372 prescriptions were included,involving 194 Chinese medicines.A total of 11 were used more than 150 times(use frequency≥40%),including Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Poria,Atractylodis Macrocephalae Rhizoma Stir-fried with Bran,Angelicae Sinensis Radix,Astragali Radix,Platycodonis Radix,Pinelliae Praeparatum Rhizoma,Citri Reticulatae Pericarpium,Ophiopogonis Radix,Paeoniae Alba Radix and Rehmanniae Radix.Among the highly-used Chinese medicines,those for channel entries to the spleen and stomach accounted for the most,up to 22(77.3%);followed by 18(60.0%)for channel entries to the lung and large intestine;those for channel entries to the kidney were the least,with only 4(13.3%).The association rule analysis(support≥10%,confidence level≥85%,maximum number of antecedent 1)suggested 71 association rules,and the combinations of Glycyrrhizae Radix et Rhizoma Praeparata cum Melle and Poria,Atractylodis Macrocephalae Rhizoma Stir-fried with Bran and Astragali Radix,Poria and Pinelliae Praeparatum Rhizoma,Glycyrrhizae Radix et Rhizoma and Angelicae Sinensis Radix were all commonly used for the treatment of pulmonary nodules after surgery.The cluster analysis presented seven combinations,and the first group was mainly for regulating qi and dissolving phlegm,including Bambusae Caulis in Taenia,Atractylodis Macrocephalae Rhizoma Stir-fried with Auranti Fructus Immaturus and Jujubae Fructus;the second group was mainly for activating blood and dispelling stasis,including Chuanxiong Rhizoma processed by yellow wine and blazing Persicae Semen;the third group had only Glycyrrhizae Radix et Rhizoma Praeparata cum Melle with main effect of dispelling phlegm and suppressing cough,and harmonizing each Chinese medicine;the fourth group had only Sclerotium Poriae Pararadicis,mainly for calming the mind and tranquilizing;the fifth group was mainly for boosting qi and securing the exterior,including Atractylodis Macrocephalae Rhizoma Stir-fried with Bran,Astragali Radix and Saposhnikoviae Radix;the sixth group was mainly for fortifying the spleen and nourishing the stomach,clearing heat and dissipating binds,and fortifying the spleen and draining dampness,including Gigeriae Galli Endothelium Corneum Preparata,Hordei Fructus Germinatus and Pseudostellariae Radix;the seventh group was mainly for nourishing the lung and kidney,and suppressing cough and dissolving phlegm,including Lili Bulbus,Scrophulariae Radix and Fritillariae Thunbergi Bulbus.Conclusion:The basic treatment principles of patients undergoing surgery of pulmonary nodules should be nourishing the kidney and tonifying the lung,boosting qi and securing the exterior,moving qi and resolving phlegm,activating and tonifying blood,and one of the medication characteristics is treating lung diseases from the spleen and stomach.