陈洪教授治疗高血压病的用药规律及经验浅析

Analysis of Professor Chen Hong’s Medication Rule and Experience in the Treatment of Hypertension

目的:运用数据挖掘技术系统分析陈洪教授治疗高血压病临床用药规律,总结其用药特色及临证经验。方法:收集2021年9月1日至2022年9月1日广州中医药大学惠州医院陈洪教授门诊诊治高血压病患者处方资料,应用古今医案云平台对用药频次、性味归经、证素进行统计分析,对用药进行层次聚类、关联分析及复杂网络分析。结果:共纳入263则医案,涉及患者263例,处方263首,中药106味。使用频次前10位的中药,依次为丹参、山萸肉、桑寄生、山药、天麻、牛膝、川芎、白术、半夏、茯神。药物以性平、温,味甘、苦、辛居多,多归于肝、肾二经。关联规则得出使用频次较高的药对为丹参–山萸肉、山药–丹参等。层次聚类分析得到4个聚类组。复杂网络分析得到核心处方为丹参、天麻、白术、山萸肉、山药、桑寄生、牛膝、川芎、半夏。结论:陈洪教授治疗高血压病以渗湿化痰、活血化瘀、滋补肝肾、心神同调为主要治法,并标本同治、虚实兼顾,据高血压病患者个人病情情况,灵活加减用药。本研究通过了解名医处方治疗高血压病的用药规律,为临床治疗高血压病提供借鉴与思考。

Objective: Data mining technology is used to systematically analyze the clinical medication rules of Professor Chen Hong in the treatment of hypertension, and summarize his medication characteris-tics and clinical experience. Methods: The prescription data of hypertension patients diagnosed and treated by Professor Chen Hong in Huizhou Hospital of Guangzhou University of Chinese Medicine from September 1, 2021 to September 1, 2022 were collected. The ancient and modern medical records cloud platform was used to statistically analyze the frequency of medication, nature and flavor, meridian tropism and syndrome elements. Hierarchical clustering, correlation analysis and complex network analysis were carried out on the medication. Results: A total of 263 medical cases were included, involving 263 patients, 263 prescriptions and 106 traditional Chinese medicines. The top 10 Chinese medicines used frequently were Danshen, Shanyurou, Sangjisheng, Shanyao, Tianma, Niuxi, Chuanxiong, Baizhu, Banxia and Fushen. The drugs are mostly flat, warm, sweet, bit-ter and pungent, mostly attributed to the liver and kidney meridians. The association rules showed that the drug pairs with higher frequency of use were Danshen-Shanyurou, Shanyao-Danshen, etc. Four clustering groups were obtained by hierarchical clustering analysis. The core prescriptions obtained by complex network analysis were Danshen, Tianma, Baizhu, Shanyurou, Shanyao, Sangjisheng, Niuxi, Chuanxiong and Banxia. Conclusion: Professor Chen Hong’s treatment of hyper-tension is mainly based on the treatment of dampness and phlegm, promoting blood circulation and removing blood stasis, nourishing liver and kidney, and regulating heart and mind. According to the individual condition of patients with hypertension, he can flexibly add and subtract drugs. This study provides reference and thinking for clinical treatment of hypertension by understanding the medication rules of famous doctors in the treatment of hypertension.