基于数据挖掘分析国医大师郑新治疗慢性肾脏病的用药规律

Medication rule of National Chinese Medicine Master Zheng Xin in treatment of chronic kidney disease:A study based on data mining

目的:基于中医传承辅助平台分析国医大师郑新治疗慢性肾脏病(Ⅰ~Ⅲ期)中药方剂的用药规律。方法:收集2000—2010年国医大师郑新治疗慢性肾脏病门诊医案115个,采用中医传承辅助平台的数据挖掘方法分析其中医证型、中药使用频次、药物性味归经、关联规则、核心组合及演化新方。结果:纳入医案115个,内服方剂182首,共139味药物,涉及证型28个。高频药物为石韦、白茅根、生地黄、蝉蜕、太子参、牡丹皮、鱼腥草、牛蒡子、玄参、山药等,药物四气以寒、平、温为主,五味以辛、苦、甘为主,多入肺、肝、肾经,关联规则显示白茅根和石韦置信度较高,基于熵聚类的方剂组合规律得到14组核心组合,7首新方。结论:国医大师郑新治疗慢性肾脏病多涉及肺、脾、肾三脏,治疗以补益肺脾肾为主,辅以利咽活血之法。

Objective:To investigate the medication rule of traditional Chinese medicine(TCM)prescriptions used by National Chinese Medicine Master Zheng Xin for the treatment of chronic kidney disease(stageⅠ-Ⅲ)based on Traditional Chinese Medicine Inheritance Support System.Methods:A total of 115 medical records were collected from the cases of chronic kidney disease treated by National Chinese Medicine Master Zheng Xin at the outpatient service from 2000 to 2010,and the method of data mining in Traditional Chinese Medicine Inheritance Support System was used for the analysis of TCM syndrome types,frequency of use of TCM drugs,drug nature/taste/meridian entry,association rule,core combinations,and new prescriptions.Results:A total of 115 medical records were included,involving 182 prescriptions for oral administration,139 drugs,and 28 TCM syndrome types.High-frequency drugs included Pyrrosiae Folium,Imperatae Rhizoma,Radix Rehmanniae,cicada slough,Radix Pseudostellariae,Cortex Moutan Radicis,Houttuynia cordata,Fructus Arctii,Radix Scrophulariae,and Dioscorea opposite.The drugs mainly had a cold,neutral or warm nature and a pungent,bitter or sweet taste,and they mainly entered the lung,liver,and kidney meridians.The association rule analysis showed that Imperatae Rhizoma and Pyrrosiae Folium had a relatively high degree of confidence,and the prescription rule analysis based on entropy clustering obtained 14 core drug combinations and 7 new prescriptions.Conclusion:The treatment of chronic kidney disease by National Chinese Medicine Master Zheng Xin mainly involves the lungs,the spleen,and the kidneys,with tonifying the lungs,the spleen,and the kidneys as the main treatment method,assisted by the method of relieving sore throat and activating blood.