基于数据挖掘探讨高智教授治疗慢性肾脏病的用药规律

Study on Medication Rules of Gao Zhi in the Treatment of Chronic Kidney Disease Based on Data Mining

目的:利用数据挖掘探讨高智教授治疗慢性肾脏病的用药规律,总结其组方经验,以供临床参考。方法:从2017年7月~2022年8月于武汉市中医医院肾病科高智教授门诊就诊的慢性肾脏病患者中筛选出109例,病案共计1179份(包括同一患者初、复诊),利用Excel建立基础数据库统进行药物频次统计,IBM SPSS Modeler 18.0进行关联规则分析,SPSS Statistics 25进行聚类分析。结果:共计使用中药195味,总用药频次24,301次,高频药物20味;药物性味以温、平、寒和甘、苦、辛为主,主要归肝、脾、肾、心、肺经;关联规则分析得出4对药组;聚类分析得出3组核心药物。结论:高智教授认为慢性肾脏病属本虚标实,因虚致实,因实更虚,强调瘀阻肾络是本病发展的关键,临床多选用补益脾肾,益气养血,活血化瘀,利湿泻浊等治法。

Objective: To explore the medication rules of Professor Gao Zhi in the treatment of chronic kidney disease and summarize his prescription experience for clinical reference. Methods: From July 2017 to August 2022,109 chronic kidney disease patients were selected from the outpatientts of Professor Gao Zhi, Department of Nephrology, Wuhan Hospital of traditional Chinese medicine, a total of 1179 medical records (including the initial and follow-up of the same patient), using Excel to establish a basic database for drug frequency statistics, IBM SPSS Modeler 18.0 for association rule analysis, SPSS Statistics 25 for cluster analysis. Results: A total of 195 herbs were used, with a total frequency of 24,301, and 20 high-frequency drugs;the medicinal flavor was mainly warm, calm, cold, and sweet, bitter, pungent, which mainly belonged to the liver, spleen, kidney, heart and lung meridians. Through association rule analysis, 4 pairs of drug groups were obtained, and 3 cluster prescriptions were obtained by cluster analysis. Conclusion: Professor Gao Zhi believed that the chronic kidney disease belongs to deficiency Ben and excessive Biao, excessive Biao resulted from deficiency Ben, excessive Biao leads to Ben worse. He emphasized that the stasis of the kidney is the key to the development of the disease, and the clinical treatment methods such as tonifying the spleen and kidney, invigorating qi and nourishing blood, activating blood stasis and removing dampness and removing turbidities are often used.