基于多元数据挖掘探讨国医大师干祖望治疗鼻炎的用药规律

Exploration on the Medication Law of National TCM Master Gan Zuwang in Treating Rhinitis Based on Multivariate Data Mining

目的使用多元技术分析挖掘国医大师干祖望治疗鼻炎的用药规律。方法选取1984年4月-2001年2月干祖望教授于江苏省中医院诊治鼻炎的临床医案,采用频次统计、共现次数、关联规则、剂量分析、聚类分析等多角度揭示药物之间的潜在关系,结合热力图、谱系图、复杂网络等可视化结果进行直观展现。结果纳入医案数据1080例,涉及处方1044首,中药281味。高频药物有辛夷、白术、白芷等;药味以甘、苦、辛为主,药性主要为寒、温,多归肺经和肝经。药物功效分类排名前3位为解表药、清热药、补虚药。低频药物中出现以食代药,自加荸荠、海蜇、海带等。此外,防风-黄芪-白术、苍耳子-薄荷-辛夷-白芷等为核心药对,石菖蒲与白芷的用药剂量较为离散,茯苓用药剂量低于药典标准值。通过综合分析最终获得四类方剂,玉屏风散与脱敏汤治疗过敏性鼻炎,苍耳子散与鼻渊合剂治疗鼻窦炎,升清流气饮治疗耳鸣,四君子汤、参苓白术散、异功散、补中益气汤等用于健脾益气。结论本研究深入挖掘药物之间的潜在关联,全面探索干祖望教授治疗鼻炎的用药经验,弥补了单一研究的高频局限性与数据偏差性。

Objective To analyze the medication law of national TCM master Gan Zuwang in the treatment of rhinitis using multivariate techniques.Methods The clinical cases of Professor Gan Zuwang’s treatment of rhinitis from Jiangsu Province Hospital of Chinese Medicine from April 1984 to February 2001 were selected.Frequency statistics,co-occurrence frequency,association rules,dosage analysis and clustering analysis were used to reveal potential relationships between drugs from multiple perspectives,which were combined with the visual results of heat map,spectrogram,complex network,etc.,for intuitive presentation.Results Totally 1080 medical cases were included,involving 1044 prescriptions and 281 kinds of Chinese materia medica.The high-frequency drugs included Magnoliae Flos,Atractylodis Macrocephalae Rhizoma,Angelicae Dahuricae Radix,etc.;the tastes were mainly sweet,bitter and pungent,and their properties were mainly cold and warm,and most of them were classified into the lung meridian and the liver meridian.The top three drug efficacy classifications were antidepressants,purgatives and deficiency tonics.And substitute food for medicine,adding water chestnuts,jellyfish,kelp appeared in low-frequency drugs.In addition,Saposheikovize Radix-Astragali Radix-Atractylodis Macrocephalae Rhizoma,Xanthii Fructus-Menthae Haplocalycis Herba-Magnoliae Flos-Angelicae Dahuricae Radix were the core pairs,the dosage of Acori Tatarinowii Rhizoma and Angelicae Dahuricae Radix was more discrete,and the dosage of Poria was lower than the latest standardized value.Four types of formulas were finally obtained through comprehensive analyses:Yupingfeng Powder and Tuomin Decoction were used for the treatment of allergic rhinitis,Cangerzi Powder and Biyuan Mixture were used for the treatment of nasosinusitis,Shengqing Liuqi Decoction was used for the treatment of tinnitus,and Sijunzi Decoction,Senling Baizhu Powder,Yigong Powder and Buzhong Yiqi Decoction were used to strengthen spleen and tonify qi.Conclusion This study delves into the potential association between drugs and comprehensively explores Professor Gan Zuwang’s medication experience in the treatment of rhinitis,which compensates for the highfrequency limitation and data bias of a single study.