基于聚类和关联分析探讨中晚期大肠癌的中药用药规律  

Study on the Regularity of Traditional Chinese Medicine in the Treatment of Advanced Colorectal Cancer based on Clustering and Correlation Analysis

作　　者：陈文婷[1,2] 任建琳[1] 靖琳 陶灵佳 石齐[1] 侯风刚[1] 

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]上海市徐汇区漕河泾街道社区卫生服务中心,上海200235

出　　处：《中医药导报》2017年第2期36-40,46,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金(81473628);上海市自然科学基金(14ZR1438900);上海市2016年度"科技创新行动计划"(16DZ234600);2014年上海市卫生局课题(2014LZ079A)

摘　　要：目的:探讨中晚期大肠癌中药用药规律。方法:采用双向队列研究方法,研究上海市中医医院、普陀区中心医院2005年1月至2014年7月期间收治的209例使用中药的中晚期大肠癌患者,采用聚类分析和关联分析方法,探讨中晚期大肠癌中药用药规律。结果:对209首组方进行用药规律分析,结果显示药味出现频次由高到低依次为白术、茯苓、谷芽、薏苡仁、黄芪;将高频药物进行聚类分析,得到4组聚类方;基于关联规则,得出支持度最高药对为茯苓+白术,置信度最高药对为麦芽+谷芽,一阶关联提升度最高药对为藤梨根+菝葜。结论:根据用药规律,以药测方,推测中晚期大肠癌患者基本病机为本虚标实,本虚常在于脾,标实为痰、湿、毒、瘀,虚实夹杂。治疗中晚期大肠癌患者以健脾为核心(茯苓+白术),配合清热解毒化痰之品(藤梨根+菝葜),并常辅以消食和胃之药(麦芽+谷芽)增进患者食欲,从而提高生存质量,延长患者的生存期,在临床上具有一定的应用价值。Objective： To explore the law of TCM in the treatment of advanced colorectal cancer. Methods： The 209 patients received conbined treatment of traditional Chinese medicine and Western medicine in Shanghai Hospital of Traditional Chinese Medicine and Shanghai Putuo District Central Hospital were analyzed retrospec- tively in order to observe the median survival time of patients and related factors that affect prognosis from January 2005 to July 2014. Through the frequency analysis, clustering analysis and association rules were sum- marized and analyzed the characteristics of TCM treatment of advanced colorectal cancer. Results： In the 209 complex prescriptions of herbs which were long-term administrated by 209 post-operation colorectum cancer pa- tients, the first 5 herbs with the highest application frequency were Baizhu （Atractylodes macrocephala）, Fuling （Poria cocos）, Guya（Millet sprout）, Yiyiren（Coix Lachryma-Jobi）, Hnangqi（Astragalus membranaceus）. On the basic of clustering analysis, we speculated 4 common pathogenesis and revelant treatmen. On the basic of asso- ciation rules, we summarised the use of high supprot of medicine of Atractylodes macrocephala-Poria cocos; high frequency of medicine of Guya-Mah; high lift of Tengligen-Sarsaparilla. Conclusion： According to clustering analysis and association rules, it is concluded that＂ strengthen the spleen is the core of therapy.Pathogenesis is spleen, liver-yin and kidney deficiency and phlegm,wet, toxin. Treatment of patients with advanced colorectal cancer in the spleen as the core （Atractylodes macrocephala-Poria cocos）, with phlegm detoxification product （Tengligen-Sarsaparilla）, and supplemented with digestion and stomach medicine （Guya-Malt） improving patient appetite.

关 键 词：中晚期大肠癌 中西医结合治疗 聚类分析 关联分析 

分 类 号：R273[医药卫生—中西医结合]