基于数据挖掘分析高智教授治疗老年性夜尿症的用药规律

Medication Rules of Professor Gao Zhi in the Treatment of Senile Nocturia Based on Data Mining

目的:通过数据挖掘技术探索高智教授治疗老年性夜尿症的用药规律。方法:收集并整理高智教授2019年01月01日~2022年12月31日在湖北中医药大学附属武汉市中医院门诊治疗老年性夜尿症症的病例,使用Microsoft Excel2019、SPSS Statistics25.0、SPSS Modeler18.0等软件建立高智教授治疗老年性夜尿症中药数据库,对药物的使用频次、四性五味、功效分类进行统计分析,以及进行聚类分析、关联规则分析。结果:共纳入中药处方156首,涉及中药202味,其中高频药物有30味,排名靠前的药物有牛膝、芡实、牡蛎、龙骨、茯苓、白芍、皂角刺、莲子、牡丹皮、沙苑子等。药物四气以平性为主,其次为温、微寒。五味以甘味为主,其次为苦味、辛味和酸味。归经以肝、肾经为主,其次为脾经。功效分类以利尿通淋药、强筋骨药、补肝肾药最为常见。关联规则分析得到22种关联强度高的药物组合,支持度及置信度均较高的药对为龙骨–牡蛎、沙苑子–芡实。聚类分析得到5种药物组合。结论:高智教授认为老年性夜尿症核心病机为肝肾不足、肾失固涩,处方以金锁固精丸及六味地黄丸为基础方加减化裁而来,用药以甘补为主,并配伍酸收、苦利之品,同时辩证使用活血化瘀、补脾渗湿的药物,对临床实践具有一定的指导意义。

Objective: To explore the medication rule of Professor Gao Zhi in the treatment of senile nocturia through data mining technology. Methods: Collected and sorted out the cases of senile nocturia treated by Professor Gao Zhi in the outpatient department of Wuhan Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Chinese Medicine from January 1, 2019 to December 31, 2022. Microsoft Excel2019, SPSS Statistics25.0, SPSS Modeler18.0 and other software were used to establish the traditional Chinese medicine database of Professor Gao Zhi for the treatment of senile nocturia, and the classification of drug use frequency, four nature of drugs, five flavours and efficacy were analyzed statistically, as well as cluster analysis and association analysis. Results: A total of 156 TCM prescriptions were included, involving 202 kinds of TCM, of which 30 were high-frequency drugs, and the top drugs were achyranthes, euryale, oyster, keel, poria cocos, white peony, spina gleditsiae, lotus seed, moutan bark and milkvega seed. Four natures of drugs were mainly flat, followed by warm and slightly cold. The five flavours are mainly sweet, followed by bitter, hot and sour. Liver and kidney channels were the main channels, followed by spleen channels. The most common types of efficacy are diuretic and drenching drugs, muscle strengthening and bone strengthening drugs, and liver and kidney tonifying drugs. Twenty-two drug combinations with high association strength were obtained by association rule analysis, and the drug pairs with high support and confidence were keel—oyster and milkvetch seed—euryale seed. Five drug combinations were obtained by cluster analysis. Conclusion: The core pathogenesis of Professor Gao Zhi’s treatment of senile nocturia is insufficiency of liver and kidney, loss of the kidney’s ability to induce astringency. The prescription is based on Jinsuo Gujing pills and Liuwei Dihuang Pills. The main drug is sweet tonic, and the combination of sour convergence and bitter downward, and the dialectical use of drugs to promote blood circulation for removing blood stasis, invigorating spleen and eliminating dampness, which has certain guiding significance for clinical practice.