摘要
目的以全国名老中医黄振翘教授治疗原发免疫性血小板减少症的验案为基础,采用数据挖掘方法对其中的用药规律进行分析。方法选择诊断明确且记录相对完整的119例357诊次病案,经过预处理后建立标准化的病案数据库。基于Microsoft Office Excel 2003、SPSS 18.0、IBM SPSS Modeler 14.1等软件,分别运用频数分析、系统聚类分析以及关联分析Apriori算法进行数据挖掘,从常用中药、药物功效分类、核心药组、常用药对、药症关联等方面,挖掘黄振翘教授治疗原发免疫性血小板减少症的用药规律及特色。结果 (1)共使用中药217种,常用药物为黄芪、生地黄、白术、炙甘草、牡丹皮、黄芩、白芍、蒲公英、熟地黄、茯苓、陈皮、生甘草、党参、墨旱莲、黄柏、水牛角、当归、茜草根、赤芍、太子参、黄连、紫苏梗、山药;常用的中药类型为补虚药、清热药、止血药。(2)通过系统聚类分析得到6个核心药组:第1组为生地黄、牡丹皮、黄芩、白芍、熟地黄、黄柏、水牛角;第2组为白术、黄芪、炙甘草;第3组为蒲公英、茯苓、陈皮、生甘草;第4组为党参、当归;第5组为墨旱莲、太子参、紫苏梗;第6组为茜草根、赤芍、黄连、山药。(3)关联规则分析发现,黄振翘教授临证常用的配伍用药,包括补阳药与补气药、补血药、利水渗湿药之间的相互配伍,清热化痰药与止咳平喘药、清热解毒药之间的相互配伍,重镇安神药、平抑肝阳药与补阴药、补气药、清热燥湿药之间的相互配伍,同时总结出一些药症关联规律。结论黄振翘教授治疗原发免疫性血小板减少症的基本原则为泻火治标制肝木、脾肾同治调阴阳,主要的治疗方法有清热凉血、益气健脾、益气养血、健脾益肾、凉血化瘀等,并总结出6类常用药物;数据挖掘方法可用于名老中医经验的研究。
Objective Based on the proven cases of primary immune thrombocytopenia that treated by Professor Huang zhenqiao,a national famous veteran practioner of traditional Chinese medicine,this study aimed to analyze the medication rules by data mining. Methods 119 medical cases（ involved 357 times visit） with definite diagnosis and relatively complete records were selected. After pretreatment,the standardized medical record database was established. Through software such as Microsoft Office Excel 2003,SPSS 18. 0 and IBM SPSS Modeler 14. 1,data mining were performed by frequency analysis,system cluster analysis and association analysis Apriori algorithm,respectively. From some aspects including commonly used Chinese materia medica,efficacy classification of Chinese materia medica,core drug groups,commonly used couplet medicines and drug and symptom correlation,Professor Huang Zhenqiao＇s medication rules and characteristics in the treatment of primary immune thrombocytopenia were discussed. Results （1）A total of 217 kinds of Chinese materia medica were used. The commonly used drugs included Radix Astragali seu Hedysari,Radix Rehmanniae Recens,Rhizoma Atractylodis Macrocephalae,Radix Glycyrrhizae Preparata,Cortex Moutan Radicis,Radix Scutellariae,Radix Paeoniae Alba,Herba Taraxaci,Radix Rehmanniae Preparata,Poria,Pericarpium Citri Reticulatae,Radix Glycyrrhizae,Radix Codonopsis,Eclipta alba,Cortex Phellodendri,Cornu Bubali,Radix Angelicae Sinensis,Radix Rubiae,Radix Paeoniae Rubra,Radix Pseudostellariae,Rhizoma Coptidis,Caulis Perillae and Rhizoma Dioscoreae. The tonifying deficiency medicine,clearing heat medicine and blood-stanching medicine were commonly used Chinese materia medica.（2） By systematic cluster analysis,six core drug groups were found. The 1 st group included Radix Rehmanniae Recens,Cortex Moutan Radicis,Radix Scutellariae,Radix Paeoniae Alba,Radix Rehmanniae Preparata,Cortex Phellodendri and Cornu Bubali; the 2 nd group included Rhizoma Atractylodis Macrocephalae,Radix Astragali seu Hedysari and Radix Glycyrrhizae Preparata; the 3 rd group included Herba Taraxaci,Poria,Pericarpium Citri Reticulatae and Radix Glycyrrhizae; the 4 th group included Radix Codonopsis and Radix Angelicae Sinensis; the 5 th group included Eclipta alba,Radix Pseudostellariae and Caulis Perillae; the 6 th group included Radix Rubiae,Radix Paeoniae Rubra,Rhizoma Coptidis and Rhizoma Dioscoreae.（3）The association rule analysis showed that Professor Huang emphasized the compatibility of medicines in clinical practice,including yang-supplementing medicine with qi-supplementing,blood-supplementing,diuresis and diffusing dampness drugs,clearing heat and resolving phlegm medicine with relieving cough and asthma drugs and clearing heat and removing toxicity drugs,medicine for tranquillization with heavy prescription and suppressing hyperactive liver yang medicine with yin-supplementing drugs,qi-supplementing drugs and clearing heat and removing dampness drugs. Meanwhile some correlation rules of drug and symptom were summarized. Conclusion Professor Huang considers that the basic principles in the treatment of primary immune thrombocytopenia are purging fire to treat manifestation and suppressing liver-wood,treating both spleen and kidney to regulate yin and yang. The main treatment methods include clearing heat and cooling blood,benefiting qi for strengthening spleen,benefiting qi for nourishing blood,invigorating spleen for benefiting kidney,cooling blood for removing blood stasis and so on,and 6 kinds of commonly used drugs are summarized. Data mining can be used in the research on experience of famous veteran practioner of traditional Chinese medicine.
出处
《上海中医药杂志》
2017年第11期11-15,22,共6页
Shanghai Journal of Traditional Chinese Medicine
基金
国家中医药管理局全国名老中医传承工作室建设项目(2011)
关键词
原发免疫性血小板减少症
紫癜
名医经验
黄振翘
数据挖掘
primary immune thrombocytopenia
purpura
experience of famous doctors
Huang Zhenqiao
data mining
