HHO optimized support vector machine classifier for traditional Chinese medicine syndrome differentiation of diabetic retinopathy

AIM:To develop a classifier for traditional Chinese medicine(TCM)syndrome differentiation of diabetic retinopathy(DR),using optimized machine learning algorithms,which can provide the basis for TCM objective and intelligent syndrome differentiation.METHODS:Collated data on real-world DR cases were collected.A variety of machine learning methods were used to construct TCM syndrome classification model,and the best performance was selected as the basic model.Genetic Algorithm(GA)was used for feature selection to obtain the optimal feature combination.Harris Hawk Optimization(HHO)was used for parameter optimization,and a classification model based on feature selection and parameter optimization was constructed.The performance of the model was compared with other optimization algorithms.The models were evaluated with accuracy,precision,recall,and F1 score as indicators.RESULTS:Data on 970 cases that met screening requirements were collected.Support Vector Machine(SVM)was the best basic classification model.The accuracy rate of the model was 82.05%,the precision rate was 82.34%,the recall rate was 81.81%,and the F1 value was 81.76%.After GA screening,the optimal feature combination contained 37 feature values,which was consistent with TCM clinical practice.The model based on optimal combination and SVM(GA_SVM)had an accuracy improvement of 1.92%compared to the basic classifier.SVM model based on HHO and GA optimization(HHO_GA_SVM)had the best performance and convergence speed compared with other optimization algorithms.Compared with the basic classification model,the accuracy was improved by 3.51%.CONCLUSION:HHO and GA optimization can improve the model performance of SVM in TCM syndrome differentiation of DR.It provides a new method and research idea for TCM intelligent assisted syndrome differentiation.

Analysis of prescription rules in the treatment of diabetic heart disease based on traditional Chinese medicine inheritance support system

Diabetes is a common clinical disease and has many complications,among which diabetic heart disease is the leading cause of death in diabetic patients.This article collected the prescriptions for the treatment of diabetic heart disease,and used the traditional Chinese medicine inheritance support system to explore the prescription formulation rules.Finally,we included 43 prescriptions for analysis.We found that the rules of formulas for treating diabetic heart disease are complex,but Chinese medicines in these formulas are mainly with the effects of nourishing Qi,nourishing Yin and activating blood circulation.At the same time,we obtained 3 new prescriptions and discussed the clinical rationality of the new prescriptions.The purpose of this article is to provide reference for clinical prescription in the treatment of diabetic heart disease and the development of related new drugs.

Mechanism analysis of Traditional Chinese Medicine in treatment of Diabetic Nephropathy based on network pharmacology and Traditional Chinese Medicine inheritance support system

Diabetic nephropathy is one of the most serious complications of diabetes mellitus. In the early stage, edema and proteinuria are the main clinical manifestations. In the later stage, glomerulosclerosis and interstitial fibrosis will occur. And the prognosis is poor. Nowadays, traditional Chinese medicine has a remarkable curative effect in the treatment of diabetic nephropathy. There are more and more studies on the treatment of diabetic nephropathy with traditional Chinese medicine, but most of them focus on the syndromes of diabetic nephropathy, which are short of in-depth research and summary on the mechanism of Chinese herbal prescriptions. In this paper, the traditional Chinese medicine inheritance support system and network pharmacology BATMAN-TCM software were used to collect and analyze the relevant literature. It was found that the core compatibility of Shanzhuyu, Fuling and Shuyu in the treatment of diabetic nephropathy is closely related to the signal transduction pathway and target of diabetic nephropathy, and has a positive effect on the improvement of clinical symptoms such as proteinuria, glycometabolism disorder, edema, etc. This paper explores the core compatibility of Shanzhuyu, Fuling and Shuyu on diabetic nephropathy, in order to provide reference for clinical treatment.

The effect of traditional Chinese medicine──Tian Gui Recipeon obesity and anovulation in androgen-sterilized rats

Objective: A traditional Chinese medicine Tian Gui Recipe (TGR) has been used to effectively treat clomiphene resistant anovulatory disease and obesity, especially in polycystic ovary syndrome (PCOS) cases with hyperinsulinemia. The effect of TGR on obesity and anovulation was investigated in androgen-sterilized rats (ASR). Methods: Female SD rats at the age of 9 days were divided into 3 groups. Group ASR (n=15): anovulation was demonstrated at the age of 70 days by vaginal smear in rats while 1. 25 mg of testosterone propionate was injected subcutaneously on its 9th neonatal day. Group A+H (n = 25): TGR were administered to ASR at the age of 80 days for 3 weeks. Rats with regular estrous cycle and ovulation after herbal treatment were included in this group. Group C (n = 15): normal ovulated rats were recruited. Around the age of 112 days or on proestrous day, all rats were sacrificed under anesthesia. Serum leptin, testosterone (T), estrogen (E2), follicular stimulating hormone (FSH), luteinizing hormone (LH) levels were measured with radioimmunoassay (RIA). Double immunofluorescent staining combined with confocal laser scanning microscope and dual in situ hybridization were carried out on sections through areas of arcuate nucleus (ARC) to determine whether estrogen receptor (ER) immunoreactivity (IR) or long form of leptin receptor (OB-Rb) mRNA were expressed in neuropeptide Y (NPY) immuno-and mRNA-containing neurons, and its relationship to proopiomelanocortin (POMC) mRNA-containing neurons. Immunohistochemistry and in situ hybridization were used to observe the levels of ER, NPY, gonadotrophin releasing hormone (GnRH) and gene expression levels on NPY, OB-Rb, POMC. Meanwhile, the criteria of energy state, including daily food intake, retroperitoneal fat depot pad and body weight, were measured and evaluated. Values of immunohistochemistry and in situ hybridization were expressed in mean optic density (MOD). Results: Seventeen out of the 25 rats (68%) in Group A+H were ovulated after herbal treatment. ASR characterized with significantly high metabolic rate, energy imbalance and obesity (P<0. 01, P<0. 01, P<0. 01). The mean serum leptin, T, E2 levels of group ASR were significantly higher than those of Group C and Group A+H (P< 0. 01,P<0. 01 ), while FSH, LH levels were lower (P<0. 01, P<0. 01 ). ERs were proved to be distributing in NPY-containing neurons, OB-Rb coexpressed in NPY-syn- thesizing neurons, and both NPY and POMC mRNA expressing neurons overlapped in ARC. Compared to Group C, levels of NPY mRNA and NPY, POMC mRNA expressions were increased (P<0. 01, P<0. 01, P<0. 01 ), OB-Rb mRNA, ER and GnRH immunoreactive expression were decreased significantly in the hypothalamus of ASR (P<0. 01, P<0. 01, P<0. 01 ). These dramatic neuroendocrine changes became normal in ovulated ASR after the herbal treatment (all P>0. 05). Conclusion: The elevated peripheral E2 caused by high T and leptin levels in ASR may down-regulate their corresponding receptors oriented on hypothalamic NPY- containing neurons respectively, therefore challenge the NPY mRNA and NPY, POMC mRNA overexpressions. The overexpression, of NPY, POMC gene transcription and translation stimulate food intake, promote the deposit of adipocyte tissue, and inhibit GnRH expression and GnRH/FSH, LH release, which contribute to the occurrence of obesity and anovulation in ASR. TGR may reverse these abnormal neuroendocrine cascades by lowering the levels of T, E2 and leptin.

A study on the medication law of oral administration of traditional Chinese medicine in treating breast carbuncle based on the Traditional Chinese Medicine Prescription Dictionary

Objective:Based on the database of Traditional Chinese Medicine Prescription Dictionary,the prescription medication rules of oral administration of traditional Chinese medicine in the treatment of breast carbuncle were explored by using the software of Traditional Chinese Medicine Inheritance Support System(V2.5).Methods:To screen and retrieve the prescriptions for treating breast carbuncle in the Traditional Chinese Medicine Prescription Dictionary,and data mining was carried out by using association rule algorithm,complex system entropy clustering and so on.Results:A total of 208 prescriptions which met the inclusion criteria were selected,involving 175 traditional Chinese medicines.Among them,23 medicines were found to be more than 21 times in the treatment of breast carbuncle.The nature of the medicine is mainly cold or warm,the flavour of the medicine is mainly bitter or sweet,most of them belong to the spleen,liver,stomach.15 commonly used drug combinations and 9 new prescriptions were obtained.Conclusion:The key pathogenesis of breast carbuncle is liver depression and Qi stagnation,stomach heat blocking collaterals,the treatment is mainly to clear heat and detoxify,regulate Qi to diffuse the knot,which provides reference for the choose of traditional Chinese medicine prescription in treating breast carbuncle.

Regulating effect of Chinese herbal medicine on the peritoneal lymphatic stomata in enhancing ascites absorption of experimental hepatofibrotic mice

AIM: To observe the regulatory effect of Chinese herbal medicine on peritoneal lymphatic stomata and its significance in treating ascites in liver fibrosis model mice. METHODS: Two Chinese herbal composite prescriptions were used separately to treat the carbon tetrachloride-induced mouse model of liver fibrosis. The histo-pathologic changes of the liver sections (HE and VG stainings) were observed. The peritoneal lymphatic stomata was detected by scanning electron microscopy and computer image processing. The changes of urinary volume and sodium ion concentration were measured. RESULTS: In the model group, lots of fibrous tissue formed in liver and extended into the hepatic lobules to separate them incompletely. In the treated and prevention groups, the histo-pathologic changes of liver was rather milder, only showed much less fibrous tissue proliferation in the hepatic lobules. The peritoneal lymphatic stomata enlarged with increased density in the experimental groups (diameter: PA, 3.07 +/- 0.69 microm; PB, 2.82 +/- 0.37 microm; TA, 3.25 +/- 0.82 microm and TB, 2.82 +/- 0.56 microm; density: PA, 7.11 +/- 1.90 stomata.1000 microm(-2); PB, 8.76 +/- 1.45 stomata.1000 microm(-2); TA, 6.55 +/- 1.44 stomata.1000 microm(-2)and TB, 8.76+/-1.79 stomata.1000 microm(-2)), as compared with the model group (diameter: 2.00+/-0.52 microm density: 4.45+/-1.05 stomata.1000 microm(-2)). After treatment, the urinary volume and sodium ion excretion increased in the experimental groups (PA, 231.28+/-41.09 mmol.L(-1); PB, 171.69 +/- 27.48 mmol.L(-1) and TA, 231.44 +/- 34.12 mmol.L(-1)), which were significantly different with those in the model group (129.33 +/- 36.75 mmol.L(-1)). CONCLUSION: Chinese herbal medicine has marked effects in alleviating liver fibrosis, regulating peritoneal lymphatic stomata, improving the drainage of ascites from peritoneal cavity and causing increase of urinary volume and sodium ion excretion to reduce the water and sodium retention, and thus have favorable therapeutic effect in treating ascites.

Experimental study on a novel compound extracted from Traditional Chinese Medicine for treatment of alveolar echinococcosis

OBJECTIVE: To evaluate the efficacy of a novel compound derived from Traditional Chinese Medicine (TCM) for treatment of alveolar echinococcosis in the Kuming mouse. METHODS: The compound was extracted from TCM by serial procedures including amalgamation of TCM drugs, boiling in a beaker, cold condensation using a reflux instrument, evaporation by mild heating and finally, formation of a deep brown powder. An animal model of alveolar echinococcosis was established concurrently. A bit of alveococcus tissue derived from alveolar echinococcosis in the mouse was transplanted into the peritoneal cavity of the musculus of a Kuming mouse. The duration of infection after inoculation was classified as either 1 week or 10 weeks; the animals were again divided into treated groups and control groups. Estimation of the alveococcus inhibitory rate and electron microscopic observation served as the main methods for assessment of efficacy. The infected mice in the treated groups were intra-gastrically administered once per day with the TCM extractive powder at doses of 20 mg.kg(-1) for three months continuously. All the animals were sacrificed and examined half a month after the end of TCM treatment. RESULTS: Total wet weight of alveococcus collected from the 9 mice in the treated group after one week of infection was 37.8 g (x +/- s, 4.196 +/- 2.090 g), which was markedly lower than the amount collected from 10 mice of the control group (121.3 g, x +/- s, 12.1 +/- 4.3 g). Therefore, the inhibitory rate of the alveococcus was 65.7% (P

Detecting Non-Stationarity for Auscultation Signal of Traditional Chinese Medicine

The information about the nonstationarity of the aus-cultation signal is utilized in this paper to objectively and auto-matically identify healthy people and patients with qi-deficiency or yin-deficiency. In order to characterize the nonstationarity of the sound signal,the nonlinear cross-prediction method is used to extract features from the signal. A feature selection method based on conditional mutual information maximization criterion （CMIM） is implemented to find an optimal feature set. By means of the support vector machine （SVM） classifier,three common states （healthy,qi-deficiency and yin-deficiency） in traditional Chinese medicine are distinguished using the feature set,and a satisfactory classification accuracy of 80% is achieved in the experiment. In conclusion,the analysis based on the nonstationarity of the sound signal provides an alternative and outstanding approach to the objective auscultation of traditional Chinese medicine （TCM）.

Discrimination and feature selection of geographic origins of traditional Chinese medicine herbs with NIR spectroscopy

With the traditional Chinese medicine herbs angelicae dahuricae radix (ADR or Baizhi) and salviae miltiorrhizae radix (SMR or Danshen) as two examples, this work studies the automatic discrimination of the geographic origins of the herbs using near infrared (NIR) reflectance spectroscopy. Multi-class support vector machine (SVM) is utilized for the purpose, and recursive SVM is utilized to select the feature spectral segments that are decisive for the discrimination. With only 5 and 8 short spectral segments, discriminative accuracies of 92% are achieved on independ- ent test sample sets. This work not only provides a prototype of accurate rapid discriminating systems for quality control of herbal medicines, but also opens new possibilities in studying subtle differences in the chemical compositions of herbs from different cultivation conditions and investigating their associations with the effectiveness of the herbs.

The progress of nutritional support for chronic obstructive pulmonary disease

The patients with chronic obstructive pulmonary disease (COPD) often occur weight loss and reduced muscle mass, which leads to decreased exercise capacity and vital capacity. The nutritional status is closely related to the prognosis of patients with COPD and nutritional support has played an important role in the treatment of COPD. In order to provide proper nutritional support, this article reviews the progress of nutritional support in COPD from the causes of malnutrition, energy demand assessment, assessment of nutritional risk and nutritional support methods. Moreover, this review specially reviewed the application of traditional Chinese medicine diet.

中西医结合治疗1例高龄顽固性便秘患者的护理体会

本文总结1例高龄顽固性便秘患者的中西结合治疗和护理经验。在常规治疗的同时,依据知识转化模型(KTA),将循证指南推荐的便秘管理最佳证据进行临床实践,并依据相关中西医结合诊疗专家共识,形成基于循证的个体化中西医协同护理方案,采用中药保留灌肠软化粪石、中药离子导入促进肠蠕动、子午流注经皮穴位电刺激治疗促进气血运行,并配合营养、运动、排便等多维度护理,有效改善患者便秘症状。

《世医得效方》中消渴病用药规律探讨

目的:利用数据挖掘技术,深入分析《世医得效方》中所记载方剂治疗消渴的用药规律。方法:归纳《世医得效方》中治疗消渴所记载的方剂,利用Excel 2016软件及中医传承辅助平台(V2.5)软件创建消渴处方及中药数据库,采用数据挖掘技术,对中药频次、属性、功效进行统计分析,并对其进行关联分析、聚类分析。结果:《世医得效方》中用于治疗消渴的处方共50首,包含中草药118味;排名前4味的高频药物是人参、白茯苓、黄连、天花粉;药性以寒性为主,药味以甘味为主,主归脾经;且补虚药出现频次最高。高频用药配伍模式共7组,其中频次排名前4组依次为人参-白茯苓,五味子-白茯苓,麦冬-人参,人参-甘草。置信度≥0.6的药物关联规则按频度大小排列依次为麦冬→人参,五味子→熟地黄,熟地黄→五味子,五味子→人参等。基于无监督的熵层次聚类算法共获得4个治疗消渴的潜在新方组合,分别为麝香-山药-茯苓-辰砂,菟丝子-石斛-鹿角胶-沉香,黄芪-远志-茯苓-辰砂,麝香-木香-桔梗-茯苓-辰砂。结论:通过对《世医得效方》消渴处方用药规律进行分析,发现消渴病遵循阴虚为本,燥热为标的基本病机,治疗以甘寒养阴为主,兼顾健脾补肾、益肺生津等,配伍药物以补虚药、清热药等为主,能为现代临床合理、有效用药提供理论借鉴。

中医医院急危重症患者安全转运管理实践的应用与探讨

目的探讨中医医院临床支持中心(简称中心)在急危重症患者安全转运中的管理实践,分析其管理模式、安全转运工作量及满意度,为促进急危重症患者安全转运提供参考依据。方法总结重庆市中医院临床支持中心近10年在危急重症患者安全转运工作中的管理经验,回顾性分析2015年1月至2023年12月重庆市中医院临床支持中心120急诊急救组、重症转运组转运患者工作量。采用随机抽样法,使用自行设计的问卷调查医院急诊科、重症监护室以及相关临床科室500名医务工作者对中心工勤人员参与急危重症患者安全转运的满意度。结果中心参与转运急危重症患者达到323499总人次,未发生管道脱落、跌倒、坠床等意外责任事件。满意度调查显示,医务工作者对中心工勤人员的工作能力满意度为98%,服务态度满意度为96%,工作效率满意度为95%,职业素养满意度为80%。结论临床支持中心在大型三甲中医医院急危重症患者转运中发挥重要作用,为减轻临床医务人员的工作压力、安全转运危急重症患者提供有力的保障,在提高医务人员满意度方面起到了积极作用。今后中心可从员工激励制度、针对性培训、信息化建设3方面出发,进一步促进持续质量改进。

中医优势病种临床决策支持系统在“混合痔”中医病历质量控制中的应用

目的:运用中医优势病种临床决策支持系统,提升中医辨证分型的准确性,提升中医病历书写理法方药的一致性,提高中医病历书写质量,提高中医诊疗服务质量。方法:采集2023年3—5月运用中医优势病种临床决策支持系统的混合痔病例163例和2022年3—5月未运用中医优势病种临床决策支持系统的混合痔病例176例,回顾性调查分析两组的方药使用量、中医辨证分型准确性、中药饮片的用药记录、病历书写的理法方药一致性。结果:两组方药使用人次、人均开方次数、人均辨证次数、方药病历记录比较,差异均无统计学意义(P>0.05)。智慧医疗辨证论治组方药内容与病历记录一致性比例[95.45%(147/154)]高于传统医疗辨证论治组[90.36%(150/166)],但差异无统计学意义(P>0.05)。智慧医疗辨证论治组的病历记录中患者病象与疾病证型一致比例[96.75%(149/154)],证型、治则治法、方药三者一致比例[86.14%(143/166)],辨证证型变更比例[56.49%(87/154)]均高于传统医疗辨证论治组的86.14%(143/166)、77.77%(129/166)和7.22%(12/166),差异均有统计学意义(P<0.01或P<0.05)。结论:使用中医优势病种临床决策支持系统有助于规范中医辨证思路,培养中医思维模式,提升病历书写者理法方药的逻辑性,有利于提高中医诊疗服务质量。

传统文化背景下老年人不良中医情志特征与双向代际支持的关系研究——以石家庄市497名老年人为例

目的:探讨中国传统文化背景下双向代际支持与老年人不良中医情志特征的关系。方法:采用双向代际支持问卷、《中国健康老年人标准》中的抑郁、焦虑、社会适应与社会网络支持量表,对河北省石家庄市的497名60岁及以上的老年进行问卷调查。结果:双向代际支持与抑郁(忧)、焦虑(恐)等不良中医情志特征的发生呈负相关关系,与社会适应与社会网络支持呈正相关关系;身体健康状况、养老模式与是否再就业是影响老年代际支持水平的主要因素。结论:提高中国老年人的双向代际水平,既能降低老年抑郁(忧)、焦虑(恐)等不良中医情志特征的发生率,提升社会适应与社会支持水平,有利于更好地推广中国式居家养老模式。

中医临床决策支持系统的发展综述

从临床决策支持系统的概念出发,对中医临床决策支持系统的发展及其在中医药领域的应用和研究进展进行综述。概述了中医临床决策支持系统内涵及其构建方法和研究应用,介绍了中医临床决策支持系统利用中医自然语言处理等人工智能技术对名老中医诊疗经验进行数据挖掘并建模后形成了中医疾病知识图谱,以及历年来中医临床决策支持系统的研究进展和应用,以期为同领域研究和应用提供新思路。

中医药治疗肝郁气滞型便秘型肠易激综合征的用药规律分析

目的通过分析总结肝郁气滞型便秘型肠易激综合征(IBS-C)中药治疗的配伍规律,以期为今后的临床治疗及新型中成药的开发提供参考。方法通过应用中医传承辅助平台系统,检索中国知网、万方、维普数据库建库至2022年4月的文献,查找中文期刊数据库中关于口服中药治疗肝郁气滞型IBS-C的处方,提取相关方药信息,录入表格并整理,运用软件的频数分析、关联规则分析、聚类分析方法分析组方用药规律。结果最终筛选出口服中药治疗肝郁气滞型IBS-C的方剂23首,涉及中药62味,分析得出,中药应用总频次为241次,频次≥2的有35味中药,使用频次居前10位的中药依次为白芍、甘草、柴胡、白术、枳壳、槟榔、木香、枳实、乌药、厚朴;药物种类以补虚药和理气药为主;药性以温为主;五味以苦为主;归经以脾经为主。基于关联规则的中药组合有28个,聚类分析分为3类,提取核心方3个及新方2个。结论肝郁气滞型IBS-C临床上多遵循健脾疏肝、理气润肠的原则。核心方及新方分析提示疏肝理气为治疗大法,益气、养阴、活血亦可灵活应用于临床病因复杂多元化的患者。用药多寒温并用,常用苦、辛、甘味,调理脏腑,顺应机体。

基于数据挖掘探讨高天舒教授治疗甲状腺功能亢进症用药规律

目的:基于中医传承辅助平台软件(V2.5)挖掘高天舒教授治疗甲状腺功能亢进症(简称甲亢)的用药组方规律,传承高天舒教授治疗甲亢的临床经验。方法:整理高天舒教授于2022年5月-2023年6月期间治疗甲亢的用药处方,录入中医传承辅助平台(V2.5),采用关联规则、聚类分析等统计方法对整理好的处方药物进行用药规律分析。结果:共收集处方120首,涉及中药174味,药性以寒为主,药味多为甘、苦,归经以归肝经为主。中药使用频次居前十位的依次为海藻、昆布、牡蛎、浙贝母、夏枯草、白花蛇舌草、玄参、百合、生地黄、知母。核心处方为海藻、昆布、牡蛎、浙贝母、夏枯草、白花蛇舌草,形成潜在新处方11首。结论:高天舒教授认为“阴虚火旺,痰气互结”乃甲亢根本病机,治疗以滋阴降火散结为主,灵活运用富碘中药咸寒软坚,并根据患者个人体质不同攻补兼施,从而改善患者症状,抑制甲亢。

基于国家专利中药复方治疗高血压病的用药规律研究

目的基于数据挖掘分析治疗高血压病中药复方专利的组方规律,为新药新方的研发提供参考。方法检索并录入国家知识产权局从建库至2023年4月复方治疗高血压病相关数据,使用中医传承辅助平台(V2.5)及IBM SPSS Modeler 18.0对符合纳入标准的复方专利进行药物频次、关联规则、熵聚类分析等。结果共纳入复方专利866则,涵盖941味中药。高频单味药有钩藤、夏枯草、丹参等;高频对药有夏枯草-钩藤、钩藤-天麻等;最常用角药为丹参-钩藤-天麻;关联规则分析钩藤与桑寄生、天麻、石决明、黄芩等药联系密切;熵聚类提取核心药物组合围绕“风、火、痰、瘀、虚”病理因素立法。结论分析结果体现了中医诊治高血压病以肝火论治为主,兼顾他脏,配合化痰活血、调补阴阳之法,治病求本,标本兼顾。

基于中医传承辅助平台探析庞敏治疗心肌桥用药规律

目的运用中医传承辅助平台(V2.5)对庞敏教授治疗心肌桥的医案进行数据挖掘,总结其用药组方规律和学术思想。方法收集庞敏教授治疗心肌桥的有效病案,运用中医传承辅助平台进行用药规律分析,对核心药物组合进行网络药理学分析其治疗心肌桥的作用机制。结果心肌桥的发作高峰为9月至次年4月,最高为11月,次之为2月;发作曲线与沈阳地区平均气温呈负相关。共筛选98首处方,使用频次最高中药为柴胡、牛膝、桔梗、枳壳。中药功效主要为理气药,其次为活血化瘀药和补虚药。中药四气以温为主,其次为寒、平;五味以苦、辛、甘味为主;归经以肝经为主,其次为心经、脾经。核心药物组合为柴胡-桔梗-枳壳-牛膝。通过聚类得到新处方10个。结论庞敏教授认为气机失调为心肌桥发作的根本诱因,以“调畅气机法”为基本治则,核心药物组合为柴胡-桔梗-枳壳-牛膝,同时运用辨天、辨人、辨证、辨机、辨病的“五位一体”理论体系提供辨证诊疗思路。