摘要
目的:通过数据挖掘及国医大师癌毒病机理论分析真实世界中西整合治疗模式下多发性骨髓瘤的症状、病机、治疗及中医治疗策略,完善癌毒病机指导下多发性骨髓瘤临床诊疗方案。方法:收录倪海雯主任2016年7月—2021年2月门诊或病房收治的多发性骨髓瘤患者病历资料及医案处方,运用Medcase Ver5.2数据挖掘系统对症状、舌脉、病机、药物进行频数、关联规则、及系统聚类分析。结果:该研究共纳入患者71例,382诊次,涉及症状101项,舌象16种,脉象9种,病机7种,中药317味。临床症状与病机集外关联规则31项;病机与中药集外关联33项;临床症状与中药集外关联31项。通过高频药物聚类分析得到5个聚类组。结论:倪海雯主任认为,多发性骨髓瘤病位在骨髓,病变脏腑主要涉及脾、肾。基于癌毒理论“虚、毒、痰、瘀、热”核心病机要素以及病机十三条理论,该病病机总属脾肾亏虚,癌毒内蕴,治疗上以健脾益肾,抗癌解毒为根本。癌毒多有夹杂,区分“痰、热、瘀、虚”之夹杂,分别投以化痰解毒、清热解毒、化瘀解毒、扶正解毒。新药时代该病的临床决策以中西整合,病证结合,分期分阶段,复法组方为原则。
Objective:To analyze the symptoms,pathogenesis,treatment and TCM treatment strategies of multiple myeloma under the integrated Chinese and Western treatment mode in the real world through data mining and the theory of cancer virus pathogenesis of Chinese medical masters,and to improve the clinical practice of multiple myeloma under the guidance of cancer virus pathogenesis.Diagnosis and treatment plan.Methods:The medical records and medical prescriptions of multiple myeloma patients who were admitted to the outpatient clinic or ward of Director Ni Haiwen from July 2016 to February 2021 were collected,and Medcase Ver5.2 data mining system was used to analyze symptoms,tongue pulse,pathogenesis,and drugs.Frequency,association rules,and systematic cluster analysis.Results:A total of 71 patients were included in this study,with 382 visits,involving 101 symptoms,16 tongue conditions,9 pulse conditions,7 pathogenesis types,and 317 traditional Chinese medicines.There are 31 out-of-set association rules between clinical symptoms and pathogenesis;33 out-of-set association rules between pathogenesis and traditional Chinese medicine;31 out-of-set association rules between clinical symptoms and traditional Chinese medicine.Five cluster groups were obtained by highfrequency drug cluster analysis.Conclusion:Director NI Haiwen believes that multiple myeloma is located in the bone marrow,and the affected viscera mainly involve the spleen and kidney.Based on the core pathogenesis elements of “deficiency,poison,phlegm,stasis,and heat” in cancer-toxin theory and the thirteen theories of pathogenesis,the pathogenesis of this disease is always spleen and kidney deficiency,and cancer toxin is contained in it.The treatment is to strengthen the spleen and kidney,Anti-cancer detoxification is fundamental.Cancer toxins are mostly mixed,distinguish between “phlegm,heat,blood stasis,and deficiency”,and take medicines for reducing phlegm and detoxification,clearing away heat and detoxification,removing blood stasis and detoxification,and strengthening the body to detoxify.In the era of new drugs,the clinical decision-making of this disease is based on the principles of integration of Chinese and Western medicine,combination of disease and syndrome,stage and stage,and compound prescription.
作者
冯小苏
孔祥图
于慧
陈晓丽
朱垚
陆明
倪海雯
FENG Xiaosu;KONG Xiangtu;YU Hui;CHEN Xiaoli;ZHU Yao;LU Ming;NI Haiwen(Nanjing University of Chinese Medicine,Jiangsu Nanjing 210023,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Nanjing 210029,China;Data Mining Center,Medchitec Co.Ltd,Jiangsu Nanjing 210029,China)
出处
《中医药临床杂志》
2023年第5期926-933,共8页
Clinical Journal of Traditional Chinese Medicine
基金
国家中医药管理局第4批全国中医优秀人才研修项目(国中医药办人教函[2017]24号)
江苏省六大人才高峰项目(RJFW-40)
江苏省“333高层次人才培养工程”(2018Ⅲ-0121)
江苏省科技型企业技术创新资金项目(BC2015022)。
关键词
多发性骨髓瘤
数据挖掘
中医
癌毒
辨证论治
Multiple myeloma
Data mining
Traditional Chinese medicine
Cancer toxicity
Syndrome differentiation and treatment
