张士卿教授治疗小儿多动症的用药规律

Professor Zhang Shiqing's Medication Rules of Treating Children with ADHD

目的:基于数据挖掘技术分析全国名中医张士卿教授治疗小儿多动症(attention deficit hyperactivity disorder,ADHD)的用药规律。方法:收集2020年11月至2021年4月张士卿在甘肃中医药大学附属医院门诊治疗ADHD的处方。采用Excel 2016建立中药数据库并进行中药频次、四气五味及归经频次统计,对频次≥20次的中药四气五味及归经进行可视化分析;采用IBM SPSS Modeler 18.0软件中的Apriori算法对频次≥20次的中药进行关联规则分析;应用SPSS 25.0软件进行聚类分析和因子分析。结果:共筛选出89份处方,149味中药,其中使用频次≥20次的药物有33味,以赤芍、牡蛎、蝉蜕、白芍、龙骨、炙甘草、黄芩、法半夏、钩藤、党参出现频次较高;药物分类以疏风清热药、熄风止痉药多见;四气以寒、温为主,五味以辛、苦、甘居多,归经以肝、肺和胃经多见。关联规则分析显示置信度、支持度均最高的为龙骨→牡蛎。聚类分析共得到7类组合;因子分析共提取初始特征值>1的11个公因子。结论:全国名中医张士卿教授治疗ADHD以柴胡加龙骨牡蛎汤加减,以清离定巽法为主,随证配伍疏风清热药、熄风止痉药、补血药、清热化痰药等药物。

Objective:To analyze national famous doctor of TCM and professor Zhang Shiqing's medication rules of treating children with attention deficit hyperactivity disorder(ADHD)based on data mining technology.Methods:Professor Zhang Shiqing's prescriptions of treating ADHD were collected from November,2020 to April,2021 in the outpatient clinic of Affiliated Hospital of Gansu University of Chinese Medicine.Excel 2016 was adopted to establish the database of herbs,meanwhile to count the frequency of herbs,four natures and five flavors,and meridian tropism,and to perform visual analysis of four natures and five flavors,and meridian tropism of the herbs with the frequency≥20 times;Apriori algorithm of IBM SPSS Modeler 18.0 software was adopted to analyze the association rules of the herbs with the frequency≥20 times;SPSS 25.0 software was applied to carry out cluster analysis and factor analysis.Results:The study has selected 89 prescriptions and 149 herbs,among them,there were 33 herbs with the frequency≥20 times,and the herbs appeared in higher frequency containing:Chishao(Paeoniae radix Rubra),Muli(Ostreae concha),Chantui(Cicadae periostracum),Baishao(Paeoniae radix alba),fossil fragments,Zhigancao(Glycyrrhizae radix et rhizoma praeparata cum melle),Huangqin(Scutellariae radix),Fabanxia(Pinelliae Rhizoma Praeparatum),Gouteng(Uncariae ramulus cum Uncis)and Dangshen(Codonopsis radix);the drugs of dispelling wind and clearing heat,and the ones of relieving convulsion and spasm were commonly seen,of warm and cold mainly in four natures,mostly pungent,bitter and sweet,mainly entering the meridians of liver,lung and stomach.Association rule analysis showed that the drug combinations with the highest confidence and support were fossil fragments and oysters.Cluster analysis yielded seven combinations;factor analysis extracted 11 common factors with initial eigenvalues>1.Conclusion:National famous doctor of TCM and professor Zhang Shiqing treats ADHD with modified Chaihu plus Longgu Muli Tang(the decoction of bupleuri radix plus fossil fragments and oysters),mainly applying the method of clearing heat,nourishing Yin and calming wind,combining with the drugs of dispelling wind and clearing heat,calming wind and relieving spasm,enriching the blood,clearing heat and resolving phlegm.