基于复杂网络分析方法探索中医药治疗急性脑梗死的专家医案和经验方处方用药规律

Medication patterns in the medical records and empirical prescriptions in the treatment of acute ischemic stroke using a complex network analysis method

目的 基于复杂网络分析方法探索中医药治疗急性脑梗死的专家医案和经验方处方用药规律。方法 检索中国知网(CNKI)数据库、万方数据(Wan fang Data)知识服务平台、维普(VIP)数据库,建立本研究所需急性脑梗死处方数据库。采用分析软件提取数据,Python统计分析,并应用社会网络分析软件Cytoscape进行复杂网络分析。结果 筛选出符合纳入标准医案和经验方文献报告70篇,包括138首处方,311味中药,累计用药频次1 561次。共涉及解表药、清热药、补虚药、活血化瘀药、平肝熄风药、理气药等19类,其中,活血化瘀药出现频次最多,为312次。共涉及8个证候,共计96次,气虚血瘀证、痰热腑实证最多见,为21次(21.87%)。使用频次≥50的中药共5味,出现频次较高的前3味中药依次分别为:桃仁(61次,占3.80%)、牛膝(57次,占3.65%)、红花(56次,占3.58%)。复杂网络分析得出核心基本方组成为黄芪、赤芍、川芎、红花、桃仁、丹参、水蛭、胆南星、茯苓、地龙、天麻、石菖蒲、大黄。结论 国医大师和脑病专家治疗急性脑梗死的关键在于扶正,通过扶助正气达到祛邪的目的。

Objective This study aims to explore the medication patterns in the treatment of acute ischemic stroke by analyzing the medical records and empirical prescriptions from traditional Chinese medicine(TCM) experts using a complex network analysis method.Methods Databases including the CNKI,Wanfang Data,and VIP were searched to compile a database of prescriptions for acute ischemic stroke.Data were extracted and analyzed using Python for statistical analysis,and Cytoscape was used for complex network analysis.Results A total of 70 articles reporting expert medical cases and empirical prescriptions were selected,which included 138 prescriptions and 311 types of TCM herbal ingredients,with a cumulative usage frequency of 1561 times.The study identified 19 categories of drugs used in these treatments,including herbs for relieving exterior,heat-clearing,tonifying deficiency,blood-activating and stasis-removing,liver-calming and wind-extinguishing,and qi-regulating.The most frequently used were herbs for activating blood circulation and removing blood stasis,which appeared 312 times.The analysis also identified eight syndromes,totaling 96 occurrences,with qi deficiency and blood stasis syndrome and phlegm heat and bowel excess syndrome being the most common,each appearing 21 times(21.87%).Five herbs were used with a frequency of 50 or more,with the top three being Taoren(Semen Persicae,61 times,3.80%),Niuxi(Radix Achyranthis Bidentatae,57 times,3.65%),and Honghua(Safflower,56 times,3.58%).Complex network analysis revealed that the core formulae consist of Huangqi(Radix Astragali),Chishao(Radix Paeoniae Rubra),Chuanxiong(Rhizoma Chuanxiong),Honghua,Taoren,Danshen(Radix et Rhizoma Salviae Miltiorrhizae),Shuizhi(Hirudo),Dannanxing(Arisaema cum Bile),Fuling(Poria),Dilong(Pheretima),Tianma(Rhizoma Gastrodiae),Shichangpu(Rhizoma Acori Tatarinowii),and Dahuang(Radix et Rhizoma Rhei).Conclusion The study concludes that the key to treating acute ischemic stroke according to National TCM Masters and encephalopathy experts is to focus on strengthening qi to eliminate pathogenic factors.