摘要
目的应用数据挖掘方法对中医治疗多囊卵巢综合征(Polycystic ovary syndrome,PCOS)不孕症中药组方和针灸取穴规律进行总结,为临床遣方用药提供参考。方法收集中国知网数据库从建库至2023年6月14日收录的中医药干预PCOS不孕症的医案。采用Excel建立数据库并录入古今医案云平台(V2.2.3),对PCOS不孕症中药组方和针灸取穴采用中医证候分析、药对分析、关联规则分析、聚类分析、复杂网络分析等进行数据挖掘。结果最终纳入205项研究,随机对照试验(Randomized controlled trial,RCT)文献163篇,临床经验类文献42篇,各占比79.5%和20.5%。PCOS不孕症中医证型146个,中药数292味,总用药频次为4091次,共纳入72个穴位,总计301频次。中医证候前4位由高到低分别为肾虚血瘀证、肾精亏虚证、肾阳虚证和肾虚肝郁证,病性证素排名前2位的为虚和气郁,病位证素排名前2位的为肾、肝;中药频次前5位的高频单药分别为菟丝子、当归、香附、熟地黄、茯苓;四气以温和平为主,五味以甘和辛为主,药物多归于肝、脾、肾三经;中药功效前三位的为强筋骨、调经止痛、补肝肾;中药聚类分析得出聚类组合9类;关联规则分析得出关联规则13条;穴位频次前三位的为关元、三阴交、子宫;核心处方为“关元-中极-子宫-三阴交-足三里-气海”。复杂网络分析显示关元穴、三阴交和菟丝子关联最为密切,关元穴常与香附、茯苓、半夏、枸杞子、熟地黄和山药同用;三阴交穴常与山茱萸、当归、菟丝子、熟地黄、枸杞子和山药同用;菟丝子常与关元、气海、中极、足三里和三阴交同用。结论现代中医治疗PCOS不孕症以补肝肾、调经止痛、强筋骨为主要治法,临床取穴注重表里相治、上下同调。
Objective The data mining method was applied to summarise the rules of traditional Chinese medicine(TCM)formulas and acupuncture points for the treatment of infertility in polycystic ovary syndrome,so as to provide a reference for the future clinical prescription and use of medicines.Methods Medical cases of TCM interventions for PCOS infertility included in China Knowledge Network database from establishment of the database to 14 June 2023 were collected.Excel was used to establish the database and enter into the ancient and modern medical cases cloud platform(V2.2.3),and data mining was carried out through TCM and acupuncture on TCM evidence frequency analysis,drug pair analysis,association rule analysis,cluster analysisand complex network analysis.Results Finally,205 studies were included,with 163 RCTs and 42 clinical experiences,each accounting for 79.5%and 20.5%.There were 146 TCM syndromes of PCOS infertility,with 292 flavours of traditional chinese medicines(TCMs),and the total number of medication frequencies was 4091,and a total of 72 acupoints were included for a total of 301 frequencies.The top 4 flavours of TCM symptoms from high to low were renal deficiency and blood stasis,renal essence deficiency,renal yang deficiency and renal deficiency and liver depression,the top 2 pathological elements were deficiency and qi depression,and the top 2 pathological elements were kidney and liver;the top 5 high-frequency single drugs in terms of frequency of TCM were semen cuscutae,angelica,cyperus rotundus,prepared rehmannia root and poria;the four qualities of qi were dominated by warmth and flatness,the five flavours were dominated by sweetness and acridity,and most of the medicines were attributed to the three meridians,namely,the liver,the spleen,and the kidney.The top 3 TCM efficacies were strengthening the bones and muscles,regulating menstruation and relieving pain,and tonifying the liver and kidneys;the cluster analysis of TCM yielded 9 cluster combinations;the association rule analysis yielded 13 association rules;and the top 3 acupoint frequencies were related to Guanyuan,Sanyinjiao,and the uterus;the core prescription was"Guanyuan-Zhongji-Uterus-Sanyinjiao-Zusanli-Qihai".Complex network analysis showed that Guanyuan,Sanyinjiao and semen cuscutae was the most closely related points.Guanyuan was often used together with cyperus rotundus,poria,pinellia ternata,lycii fructus,prepared rehmannia root and rhizoma dioscoreae.Sanyinjiao was often used together with corni fructus,angelica,semen cuscutae,prepared rehmannia root,lycii fructusand rhizoma dioscoreae.Semen cuscutae was often used together with Guanyuan,Qihai,Zhongji,Zusanli and Sanyinjiao.Conclusion Modern Chinese medicine treatment of PCOS infertility to tonify the liver and kidney,regulate menstruation and relieve pain,strengthen the tendons and bones as the main treatment,clinical acupuncture points focus on the surface and inside the same treatment,the upper and lower the same adjustment.
作者
罗春
马红霞
潘赐明
LUO Chun;MA Hongxia;PAN Ciming(Guangxi University of Chinese Medicine,Nanning 530000,China;The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510000,China;Yunnan University of Traditional Chinese Medicine Hall of Fame,Kunming 650500,China)
出处
《新疆医科大学学报》
CAS
2024年第1期113-120,共8页
Journal of Xinjiang Medical University
基金
国家自然科学基金项目(81973892)。
关键词
多囊卵巢综合征不孕症
古今医案云平台
数据挖掘
用药规律
取穴规律
polycystic ovary syndrome infertility
ancient and modern medical case cloud platform
data mining
medication pattern
acupuncture point pattern
