基于数据挖掘的国医大师晁恩祥教授治疗AECOPD的用药规律探究

Data Mining Analysis on Professor Chao Enxiang’s Medication Rules in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:利用中医传承辅助平台对国医大师晁恩祥教授治疗慢性阻塞性肺疾病急性加重期(AECOPD)的门诊处方进行数据挖掘,根据统计结果进行归纳分析,总结其用药规律,为临床组方用药提供参考。方法:根据AECOPD的临床表现及诊断要点,筛选出国医大师晁恩祥教授门诊治疗AECOPD相关的中药处方,运用中医传承辅助系统V2.50进行用药规律分析。结果:共纳入方剂636首,涉及中药168味,挖掘出高频药物为黄芪、桂枝、橘红、枳实、白芍、砂仁、姜半夏、紫苏子、五味子、山萸肉、干姜、仙鹤草、白术、山药和黄精等补益气血、健脾和胃及对症降气止咳化痰类药物,辨证治疗以“补气血、顾脾胃”为核心思维。结论:归纳用药规律可发现,“气血亏虚,尤其是肺脾肾之气不足”的病机贯穿AECOPD的病程始末。依据AECOPD“本虚标实”的病理性质,在用药时可根据具体病情给予“补气血”“护脾胃”和“降气化痰”等治疗的组合,进行整体调护,促进疾病尽早转变为稳定期。

OBJECTIVE:To mine the data of outpatient prescriptions of Professor Chao Enxiang in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)by using the traditional Chinese medicine inheritance assistance platform,analyze the statistical results,and summarize the medication rules,so as to provide reference for clinical prescription medication.METHODS:According to clinical manifestations and diagnostic criteria of AECOPD,traditional Chinese medicine prescription for the outpatient treatment of AECOPD by Professor Chao Enxiang was screened,and the medication rules were analyzed by traditional Chinese medicine inheritance auxiliary system V2.50.RESULTS:A total of 636 prescriptions were enrolled,including 168 kinds of traditional Chinese medicine.The high frequency drugs were Hedysarum multijugum maxim,Cinnamomi ramulus,Citri exocarpium rubrum,Aurantii fructus immaturus,Paeoniae radix alba,Amomum aurantiacum,Pinelliae rhizoma praeparatumcum zingibere et alumine,Perillae fructus,Schisandrae sphenantherae fructus,Fructus cornus,Zingiberis rhizoma,Agrimonia eupatoria,Atractylodes macrocephala koidz,Dioscoreae rhizoma and Polygonati rhizoma,and other drugs that tonifying Qi and blood,strengthening spleen and stomach and relieving cough and phlegm.The core thinking of syndrome differentiation treatment was“tonifying Qi and blood,taking care of spleen and stomach”.CONCLUSIONS:Through summarizing the pattern of medication,it can be found that“deficiency of Qi and blood,especially the Qi of the lung,spleen and kidney”runs through the entire process of AECOPD.According to the pathological nature of AECOPD,the combination of“tonifying Qi and blood”“taking care of spleen and stomach”“reducing Qi and eliminating phlegm”can be given according to the specific condition during medication,so as to promote the disease into a stable period as early as possible.