摘要
目的:通过对女童青春期异常子宫出血患儿临床实际诊疗病例资料进行数据挖掘分析其中药治疗的用药规律。方法:基于医院信息管理系统提取2020年1月至2022年12月首都医科大学附属北京儿童医院女童青春期异常子宫出血患儿的病历数据,分为止血期和调理期2个阶段,总结归纳其辨治规律。结果:纳入止血期663例患儿,1020例病历;调理期796例患儿,2047例病历。止血期涉及中药169味,排名前5位为侧柏炭、牡丹皮、小蓟、麸炒椿皮和白芍,性味以寒、苦药为最多,归经以肝经为最多,功效以止血、补虚类药物为最多;调理期涉及中药232味,排名前5位为当归、酒女贞子、炙淫羊藿、黄芪和生地黄,性味以温、甘药最多,归经以肝、肾经为最多,功效以补虚类为最多。聚类分析分别获得4类和5类核心药物组合。结论:真实世界临床数据显示肾阴亏虚、血热内扰为青春期异常子宫出血常见证型,治则先以止血为主,待崩漏缓解后,重在调补脾肾以复旧,组方注重止血、补虚、收涩和清热等药物的配伍应用。
Objective:To analyze the medication rules of TCM for abnormal uterine bleeding during puberty by data mining of clinical cases.Methods:The medical records of adolescents with abnormal uterine bleeding from January 2020 to December 2022 were extracted from the information management system of Beijing Children′s Hospital,Capital Medical University.The data were divided into two stages:hemostasis stage and conditioning stage,and the medication rules of the treatment based on syndrome differentiation were summarized.Results:A total of 663 adolescents with 1020 medical records in the hemostasis stage and 796 adolescents with 2047 medical records in the conditioning stage were included.In the hemostasis stage,169 Chinese medicinals were involved,among which the top 5 were carbonated Platycladi Cacumen,Moutan Cortex,Cirsii Herba,Ailanthi Cortex stir-fried with bran,and Paeoniae Radix Alba.The commonly used medicinals were cold and bitter,with tropism to the liver meridian and the effects of stopping bleeding and tonifying.In the conditioning stage,232 Chinese medicinals were involved,among which the top 5 were Angelicae Sinensis Radix,wine-processed Ligustri Lucidi Fructus,processed Epimedii Folium,Astragali Radix,and Rehmanniae Radix.The commonly used medicinals were warm and sweet,with tropism to the liver and kidney meridians and the effect of tonifying.The cluster analysis was conducted for high-frequency medicinals in the hemostasis stage and the conditioning stage,which revealed 4 and 5 core medicinal combinations,respectively.Conclusion:The real world clinical data showed that kidney yin deficiency and blood heat harassing internally were common syndromes of abnormal uterine bleeding during puberty.The treatment should stop bleeding first and then restore the functions of the spleen and kidney.Accordingly,the prescriptions should be formulated by compatibility of hemostatic,tonic,astringent,and heat-clearing medicinals.
作者
郭春彦
柳静
张萌
丁倩
王谦
张怡
王晓玲
GUO Chunyan;LIU Jing;ZHANG Meng;DING Qian;WANG Qian;ZHANG Yi;WANG Xiaoling(National Center for Children Health,Department of Pharmacy,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China;National Center for Children Health,Department of Traditional Chinese Medicine,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China)
出处
《世界中医药》
CAS
北大核心
2024年第10期1469-1475,1485,共8页
World Chinese Medicine
基金
“重大新药创制”国家科技重大专项(2018ZX09721003)——儿童用药品种及关键技术研发。
关键词
中医药
儿童
青春期异常子宫出血
真实世界数据
数据挖掘
关联规则
辨证论治
用药规律
TCM
Children
Adolescent
Abnormal uterine bleeding during puberty
Real word data
Data mining
Association rules
Treatment based on syndrome differentiation
Medication rules
