吕仁和教授辨治糖尿病医案用药规律分析  

Rules of Chinese herbal medicines used by Professor L Renhe on diabetes based on data mining: a study of medical records

作　　者：王世东[1,2] 肖永华[1] 刘晓峰[3] 张帆[3] 任廷革[3] 孙燕[3] 吕仁和[1] 

机构地区：[1]北京中医药大学第一临床医学院肾病内分泌科,北京100700 [2]中国中医科学院博士后流动站 [3]北京中医药大学基础医学院

出　　处：《现代中医临床》2016年第1期33-37,50,共6页Modern Chinese Clinical Medicine

基　　金：国家"十五"科技攻关课题(No.2004BA721A01Z06);国家自然科学基金资助项目(No.60672141);国家中医药管理局全国名老中医药专家传承工作室建设项目;北京市中医管理局北京中医药"薪火传承3+3工程"建设项目

摘　　要：目的应用数据挖掘技术,探讨吕仁和教授治疗糖尿病的用药规律。方法收集128例吕教授诊治的糖尿病医案,医案数据经过一致化处理之后,存储于中医医案数据库中,对其用药规律进行分析。结果吕教授治疗糖尿病医案共涉及中药210味。使用频次排名前5位的药物依次为丹参(64.06%)、牡丹皮(46.88%)、川牛膝(42.19%)、狗脊(41.41%)、赤芍(40.63%)。频次排名前10位的药物则包含丹参、牡丹皮,赤芍、白芍,枳壳、枳实3组药对。通过药对组成关系分析发现:牡丹皮、丹参药对中,以牡丹皮为主药,丹参为辅;白芍、赤芍药对中,以白芍为主,赤芍为辅。应用中医案数据库的中医知识挖掘功能,以"佛手+香橼"作为关键词,对使用该药对治疗的医案中患者的症状体征、病位、病机等相关中医辨证要素进行了分析。结论吕教授在处方用药时,注重通活血脉,善用药对治疗。应用中医医案数据库,有助于发现吕教授治疗糖尿病的用药规律,利于进行名老中医经验的挖掘。Objective Based on the data mining technique,to find out the rules of Chinese herbal medicines used by Professor L Renhe. Methods 128 medical records of diabetes patients were included.After a consistent processing,the data were stored in the medical records database of traditional Chinese medicine. Results Of all 210 Chinese herbal medicines appeared in the medical records of diabetes patients,the five medicinal herbs with leading frequency were listed： salvia miltiorrhiza（ danshen,64. 06%）,cortex moutan（ mudanpi,46. 88%）,radix cyathulae（ chuanniuxi,42. 19%）,cibotii rhizoma（ gouji,41. 41%）,and radix paeoniae rubra（ chishao,40. 63%）. Of the ten herbs with leading frequency,there were three herb pairs： danshen and mudanpi depended on mudanpi,chishao and paeoniae radix alba（ baishaoyao） depended on baishaoyao,fructus aurantii（ zhiqiao） and immature sweet orange（ zhishi）. Furthermore,the herb pair of fructus citri sarcodactylis（ foshou） and citron fruit（ xiangyuan）was analyzed,inputting ＂bergamot＂and ＂citron＂as the keywords by the TCM knowledge mining function,to catch the key factors of pattern differentiation including symptoms,disease locations and pathogenesis. Conclusion Professor L Renhe is good at using medicinal herb pairs on treating diabetes. He thinks highly of the method of activating blood to dredge vessels. On the other hand,traditional Chinese medical records database was conducive to mining the experiences of the famous specialists of TCM.

关 键 词：糖尿病 医案 用药规律 数据挖掘 名老中医 

分 类 号：R255.4[医药卫生—中医内科学]