基于数据挖掘分析徐经世治疗脾胃肝胆病的组方用药规律

Analysis of prescription and medication rules in Xu Jingshi’s treatment of spleen,stomach,liver,and gallbladder diseases based on data mining

目的基于数据挖掘技术对国医大师徐经世临证治疗脾胃肝胆病的组方遣药规律进行探讨。方法检索徐经世对于脾胃肝胆病治疗的相关医案并收集处方,利用WPS OFFICE软件建立处方数据库,对其使用过的中药开展频次、性味归经及功效分类等剖析,通过Cytoscape 3.7.2、IBM SPSS Modeler 18.0 Apriori和SPSS Statistics 22.0软件展开核心处方中药筛选、关联规则分析、聚类分析和因子分析。结果共收录117首处方,使用中药共计143味,总使用频次达1394次,频次排名前5的药物分别是竹茹、陈皮、枳壳、绿萼梅、半夏;所用中药寒温并用,四气五味以甘寒为主,苦辛温为辅,归经以入胃经为主,多为补虚药、理气药、化痰止咳平喘药。关联规则分析得到高支持度用药组合“竹茹-半夏-枳壳”,高置信度组合“白术-黄芪”,并通过复杂网络得到竹茹、枳壳、半夏、陈皮、白术、绿萼梅之间关联性最强;聚类分析得到10类药物组合;因子分析得到11个公因子。结论脾胃肝胆病的病机以胆胃不和、肝郁脾虚为主,主要表现为脾虚失运、胃失和降、肝失疏泄、胆腑失利、气机失调、气血失和等,对其治疗主要以利胆和胃,平衡升降为法,辅以理气化痰、清热健脾等,常用黄连温胆汤、苍白二陈汤、补中益气汤、参苓白术散等方。

Objective To explore the prescription and medication rules used by Xu Jingshi,a master of traditional Chinese medicine,in the treatment of spleen,stomach,liver,and gallbladder diseases based on data mining techniques.Methods Relevant medical records of Xu Jingshi’s treatment of spleen,stomach,liver,and gallbladder diseases were searched and prescriptions collected.A prescription database was established using WPS OFFICE software.The used traditional Chinese medicine were analyzed in terms of frequency,nature,flavor,and meridian affiliation,and efficacy classification.Core prescription herbs were screened,followed by association rule analysis,cluster analysis,and factor analysis were conducted using Cytoscape 3.7.2,IBM SPSS Modeler 18.0 Apriori,and SPSS Statistics 22.0 software.Results A total of 117 prescriptions were collected,involving 143 traditional Chinese medicine with a total usage frequency of 1394 times.The top five herbs in frequency were bamboo shavings,pericarpium citri reticulatae,Fructus Aurantii,Green-Calyx Plum Blossom,and Pinellia ternata.The traditional Chinese medicines used in this study employed both cold and warm properties,with the four properties and five flavors dominated by sweet and cold,supplemented by bitter,pungent,and warm.Most of these herbs primarily entered the Stomach meridian and were mainly used for tonifying deficiency,regulating qi,resolving phlegm,stopping cough,and alleviating asthma.Association rule analysis revealed a high-support combination of“bamboo shavings-Pinellia ternata-Fructus Aurantii”and a high-confidence combination of“Rhizoma Atractylodis Macrocephalae-radix astragali”.The complex network analysis identified the strongest correlation among bamboo shavings,Fructus Aurantii,Pinellia ternata,pericarpium citri reticulatae,Rhizoma Atractylodis Macrocephalae and Green-Calyx Plum Blossom.Cluster analysis identified 10 combinations of herbs,and factor analysis extracted 11 common factors.Conclusion The pathogenesis diseases of spleen,stomach,liver,and gallbladder is mainly characterized by disharmony between the gallbladder and stomach and liver depression with spleen deficiency.The main manifestations include impaired spleen transportation,impaired stomach descent,impaired liver dispersion,gallbladder dysfunction,qi circulation disorder,qi-blood disharmony.The treatment approach focuses on promoting bile flow and harmonizing the stomach,regulating the ascending and descending qi,supplemented by regulating qi and resolving phlegm,clearing heat,and strengthening the spleen.Commonly used prescriptions include Huanglian Wendan decoction,Cangbai Erchen decoction,Buzhong Yiqi decoction,Shenling Baizhu Powder.