摘要
目的 探讨朱文增教授治疗重症肌无力(myasthenia gravis,MG)的用药特点与组方规律。方法 收集2017年1月至2021年12月就诊于朱文增教授门诊且诊断为MG的初诊患者病历资料,纳入初诊处方并建立数据库,进行药物频次、四气五味、归经与功效频次统计,关联规则分析及聚类分析,发掘用药规律与经验。结果 共纳入中药处方212首,涉及药物126味,各药物累计使用5 320次,使用频次前5位的中药分别是黄芪(212次)、马钱子(212次)、紫河车(212次)、党参(211次)、甘草(211次);性味上以温性药(2 645次)、甘味药(3 492次)使用最多;归经频次前4位分别为肝经(2 927次)、肺经(2 581次)、脾经(2 534次)、肾经(1 624次);药物功效频次前5位分别是补虚药(2 215次)、解表药(1 036次)、活血药(438次)、平肝息风药(418)、清热药(114次);关联规则分析结果显示黄芪、马钱子、党参、升麻、柴胡等为核心药物,其中黄芪-马钱子-紫河车为处方必备药组;聚类分析可将药物分为9类。结论 本研究显示朱文增以肺脾肾阳气亏虚为MG的基本病机,治疗上以益气温阳为基本组方原则,重视活血通络、固表祛风、燥湿祛痰药物的配合应用。
Objective To analyze the medication rules of Professor Zhu Wenzeng in the treatment of myasthenia gravis(MG) by data mining.Methods The medical records of newly-diagnosed MG patients who visited professor Zhu Wenzeng's clinic from January 2017 to December 2021 were collected.The Chinese herbal medicine prescriptions for first visit were included and a database was established.The frequency of each herbal medicine used,four Qi,five flavors,meridians,and efficacy categories were calculated.Association rules analysis and cluster analysis were carried out to explore the characteristics of herbal medicine used.Results A total of 212 prescriptions were included,involving 126 herbal medicines.All herbal medicines were used 5 320 times in total.The top 5 herbal medicines used were astragalus membranaceus(Huangqi,212 times),Nux vomica(Maqianzi,212 times),dried human placenta(Ziheche,212 times),Codonopsis pilosula(Dangshen,211 times),and Licorice(Gancao,211 times).Warm(2 645 times) and sweet herbs(3 492 times)were used the most in the aspect of Qi and flavor.Most of the herbal medicines belong to liver meridian(2 927 times),lung meridian(2 581 times),spleen meridian(2 534 times),and kidney meridian(1 624 times).The top 5 efficacy categories applied were tonifying deficiency drugs(2 215 times),relieving exterior drugs(1 036 times),blood activating drugs(438 times),liver calming and wind calming drugs(418 times),and heat clearing drugs(114 times).The results of association rules analysis showed that Astragalus membranaceus,Nux vomica,Codonopsis pilosula,Radix Bupleuri(Chaihu) and cimicifugae foetidae(Shengma) were the core drugs,among which Huangqi-Maqianzi-Ziheche were the essential drugs for prescription.The drugs can be divided into 9 categories by cluster analysis.Conclusion Professor Zhu Wenzeng takes supplementing Qi and warming Yang as the basic principle in the treatment of MG,and attaches importance to the combined application of methods such as activating blood circulation and dredging collaterals,consolidating exterior and expelling wind,drying dampness,and removing phlegm.
作者
彭思扬
田煜坤
常玮倩
李少红
倪金霞
朱文增
PENG Siyang;TIAN Yukun;CHANG Weiqian;LI Shaohong;NI Jinxia;ZHU Wenzeng(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100007,China)
出处
《中国中医基础医学杂志》
CAS
CSCD
北大核心
2023年第12期2049-2054,共6页
JOURNAL OF BASIC CHINESE MEDICINE
基金
中国中医科学院科技创新工程项目(CI2021A01309)。
关键词
重症肌无力
数据挖掘
益气温阳
朱文增
Myasthenia gravis
Data mining
Supplement Qi and warm Yang
Zhu Wenzeng
