基于数据挖掘的中药治疗慢性萎缩性胃炎用药规律研究

Study on medication law of treatment for chronic atrophic gastritis based on data mining methods

目的通过数据挖掘方法探讨慢性萎缩性胃炎(CAG)用药规律。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(重庆维普)建库至2023年12月31日发表于中文及科技核心期刊的CAG临证经验类文献,提取证型、治法、方药信息进行频次分析、聚类分析、关联规则分析、复杂网络分析。结果共纳入文献313篇,涉及经验方581首,涉及中医病名5种,以“胃脘痛”最多,其次为“痞满”;高频证型包括脾胃气虚证、胃络瘀阻证、胃阴虚证、脾胃湿热证、肝胃气滞证;应用的主要治法有活血化瘀、健脾益气、理气和胃、疏肝理气等;处方药味数主要在10~15味;共用中药321味,频次排名前5位中药依次为白术、茯苓、白芍、陈皮、黄连;用药药性以温、平为主,药味以苦、甘、辛居多,归经主要为脾、胃、肺、肝经。高频用药聚类分析主要划分为6类,中药关联规则分析、中药复杂网络分别显示5种高频证型的核心配伍、处方,呈现以香砂六君汤、柴胡疏肝散、半夏泻心汤、沙参麦冬汤等辨证论治经典方与改善胃黏膜病变的经验配伍相结合的模式。结论益气活血解毒为中医治疗CAG特色治法,体现整体辨证论治与改善局部黏膜病变并行的“点面结合”用药策略。

Objective To explore the medication law for treating chronic atrophic gastritis(CAG)through data mining methods.Methods Literature on experiences in treating CAG was retrieved from CNKI,Wanfang data,and VIP from the establishment of the databases to December 31,2023.The information on syndromes,treatment methods,and prescriptions was extracted for frequency statistics,clustering analysis,complex networks analysis were performed.Results A total of 313 articles were included in the study,involving 581 experienced prescriptions,involving 5 kinds of TCM disease names,with"epigastric pain"as the most,followed by"fullness";high-frequency syndromes included spleen-stomach qi deficiency syndrome,stomach collateral stasis syndrome,stomach yin deficiency syndrome,spleen-stomach damp-heat syndrome,liver-stomach qi stagnation syndrome;the main treatment methods used were promoting blood circulation and removing blood stasis,invigorating spleen and replenishing qi,regulating qi and harmonizing stomach,soothing liver and regulating qi,etc.The number of prescription drugs was mainly in 10-15 kinds of Chinese materia medica;a total of 321 kinds of Chinese materia medica were shared,and the top five Chinese medicines ranked by frequency were Atractylodis Macrocephalae Rhizoma,Poria,Paeoniae Radix Alba,Citri Reticulatae Pericarpium,Coptidis Rhizoma.The medicinal properties were mainly warm and neutral,and the tastes were mostly bitter,sweet and pungent.The meridians were mainly spleen,stomach,lung and liver meridians.The clustering analysis of high-frequency medication was mainly divided into 6 categories.The association rule analysis of Chinese materia medica and the complex network of Chinese materia medica showed the core compatibility and prescription of 5 high-frequency syndromes,respectively,showing the combination of Xiangsha Liujun Decoction,Chaihu Shugan Powder,Banxia Xiexin Decoction,Shashen Maidong Decoction and other classical prescriptions for syndrome differentiation and treatment combined with the experience of improving gastric mucosal lesions.Conclusion Tonifying qi,removing blood stasis and detoxifying are the feature methods to treat CAG,embodying a"point surface combination"medication strategy that combines holistic diagnosis and syndrome differentiation and treatment with improvement of local mucosal lesions.