基于数据挖掘的朴炳奎治疗大肠癌术后用药规律研究

Study on the Medication Law of Postoperative Treatment of Colorectal Cancer by Piao Bingkui Based on Data Mining

目的研究全国名中医朴炳奎教授治疗大肠癌术后患者用药规律。方法收集朴炳奎教授在中国中医科学院广安门医院和北京颐庆堂中医诊所2002年1月1日-2022年2月28日大肠癌术后患者的门诊电子和纸质医案资料,运用R4.2.1对大肠癌术后患者处方进行高频药物、药物类型、中药性能、药物阴阳五行和用药剂量,以及多味药关联性用药的规律研究。结果共纳入大肠癌术后患者642例,涉及2226诊次处方、180味中药、总频次为39988。高频药物为黄芪、麸炒枳壳、山药等,药物功效多为补虚药、消食药等;中药药性多用温、平,药味以甘、辛、苦为多,主归脾经、胃经,常用升浮药,药物基本无毒;补阳药使用频率高,五行常用属土药;药物剂量多为10、15、20 g。多味药关联性复杂网络分析和聚类分析得出朴炳奎教授治疗大肠癌术后基础方为黄芪、麸炒枳壳、山药、盐益智仁、陈皮、土茯苓、太子参、麸炒白术。结论朴炳奎教授治疗大肠癌术后重在扶正培本,顾护脾胃,兼顾清热解毒、祛湿化痰、导滞散瘀,辨证施治,补中益气,调畅气机,从而达到“治中焦如衡”,以平为期。

Objective To study the medication law of postoperative treatment of colorectal cancer by national TCM doctor Professor Piao Bingkui.Methods Professor Piao Bingkui’s electronic medical records and paper medical records of colorectal cancer postoperative patients at Guang'anmen Hospital,China Academy of Chinese Medical Sciences and Beijing Yiqingtang Chinese Medicine Clinic were collected and organized from their outpatients from January 1st,2002 to February 28th,2022.R4.2.1 was used to study the prescriptions,including high-frequency drugs,drug types,properties of Chinese materia medica,yin yang and five elements and dosage of drugs,as well as the law of multi-drug association in postoperative patients with colorectal cancer.Results Totally 642 colorectal postoperative cancer patients were included,involving 2226 prescriptions,180 kinds of Chinese materia medica,and a total frequency of 39988 times.The high-frequency drugs were Astragali Radix,fried Aurantii Fructus with wheat bran,Dioscoreae Rhizoma,etc.The main drugs in terms of efficacy were tonics for tonifying deficiency,disinfectants,etc.;the main properties were warm and neutral,the main tastes were sweet,pungent and bitter,and the main meridians were spleen meridians and stomach meridians.Ascending medicines were often used,and the drug were basically non-toxic.The frequency of using yang tonifying medicine was high,and the five elements were commonly used as local medicines;the dosage was mostly 10,15 and 20 g.The complex network analysis and clustering analysis of the association between multiple drugs found that Professor Piao Bingkui’s basic prescription for treating colorectal cancer included Astragali Radix,fried Aurantii Fructus with wheat bran,Dioscoreae Rhizoma,salt Alpiniae Oxyphyllae Fructus,Citri Reticulatae Pericarpium,Smilacis Glabrae Rhizoma,Pseudostellariae Radix,and fried Atractylodis Macrocephalae Rhizoma with wheat bran.Conclusion In the treatment of colorectal cancer,Professor Piao Bingkui focuses on reinforcing the healthy qi,nourishing spleen and stomach function,combined with detoxication method and clearing heat,expelling phlegm and dampness,guiding stagnation and dispelling stasis methods,making syndrome differentiation as well as tonifying and benefiting qi,regulating qi movement,so as to realize the“treating middle-energizer as balance”and achieve mild level when treating colorectal cancer.