基于数据挖掘探究危重症患者急性胃肠损伤的中医针灸诊治规律  

Study on the Rules of Traditional Chinese Medicine and Acupuncture Diagnosis and Treatment of Acute Gastrointestinal Injury in Critically Ill Patients Based on Data Mining

作　　者：周添奕 钱风华[1] 黄馨云 顾沐恩[1] 安晓菲 郑雪 明树人 杨艳 钱义明[1] 李璟[1] 吴焕淦[3] Zhou Tianyi;Qian Fenghua;Huang Xinyun;Gu Muen;An Xiaofei;Zheng Xue;Ming Shuren;Yang Yan;Qian Yiming;Li Jing;Wu Huangan(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai200437,china;Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China;Shanghai Institute of Acupuncture and Moxibustion,Shanghai 200030,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海市宝山区中西医结合医院,上海201999 [3]上海市针灸经络研究所,上海200030

出　　处：《世界科学技术-中医药现代化》2019年第8期1606-1614,共9页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：上海市卫生计划生育委员会上海市中医药发展办公室上海市进一步加快中医药事业发展三年行动计划——上海市中医诊疗模式创新试点建设项目（ZY(2018-2020)-FWTX-6012）：多学科联合干预危重症患者急性胃肠损伤诊疗模式探讨，负责人：李璟

摘　　要：目的基于数据挖掘探索文献研究危重症患者急性胃肠损伤(Acute Gastrointestinal Injury,AGI)的中医及针灸诊治规律。方法检索中文及外文数据库中,中医治疗急性胃肠损伤的文献,并采用Excel、SPSS 21.0及IBM SPSS Modeler 18.0软件进行频数、关联分析、聚类分析实现数据挖掘。结果本研究共纳入25篇文献,涉及147频次中药使用,50种中药,应用频次前4位的中药依次是大黄、甘草、白术、陈皮,按照功效分为13大类,其中泻下药、补虚药、行气药使用频率较高。二项关联排前4的药对是茯苓-甘草,白术-甘草,芒硝-大黄,党参-甘草;三项关联分析关联度最高的是茯苓-白术-甘草。聚类分析结果共得四类药物组合。本研究涉及36频次穴位使用,穴位共涉及15个,应用频次前3位的穴位依次是天枢、中脘、足三里。按照归经,可知共涉及6条经脉,其中足阳明胃经和任脉使用频率最高。二项关联排前二的是天枢-中脘,中脘-足三里;三项关联排前二的是气海-天枢-中脘,天枢-足三里-中脘。聚类分析结果共得三类穴位组合。结论中药治疗急性胃肠损伤(AGI)以承气汤与香砂六君子汤为主,体现了AGI的基本病机为本虚标实;治疗急性胃肠损伤(AGI)常用的穴位多为经脉经过胃、肠腑。本研究为今后临床急性胃肠损伤的患者提供了治疗依据。Objective Based on data mining technology, to explore the medication rules and the acupoints selections of traditional Chinese medicine(TCM) treatment of the critical patient’s acute gastrointestinal injury(AGI).Methods The literatures on TCM treatment of AGI in this study were retrieved from Chinese and English databases. Excel, SPSS 21.0 and IBM SPSS Modeler 18.0 software were used for frequency, association analysis and clustering analysis to realize data mining.Results 25 articles were included in this study, involving 147 frequency of use of Chinese medicine, 50 kinds of traditional Chinese medicine(TCM). The top 4 Chinese herbal medicines in the application were Radix et Rhizoma Rhei, Radix Glycyrrhizae, Rhizoma Atractylodis Macrocephalae, Pericarpium Citri Reticulatae. According to the function,all the Chinese medicine can be divided into 13 categories. Purgating drugs, tonic drugs, qi-moving drugs were the most frequently used. The first 4 drug pairs of binomial association were Poria-Radix Glycyrrhizae, Rhizoma Atractylodis Macrocephalae-Radix Glycyrrhizae, Natrii Sulfas-Radix et Rhizoma Rhei, Radix Codonopsis-Radix Glycyrrhizae. Three correlation analysis of the highest correlation was Poria-Rhizoma Atractylodis Macrocephalae-Radix Glycyrrhizae.Cluster analysis resulted a total of 4 types of drug combination. This study involved the use of acupoints at 36 frequencies, involving a total of 15 acupoints. The top 3 acupoints in the application were Tianshu(ST 25), Zhongwan(RN 12), Zusanli(ST 36). According to the meridians, it was known that there were 6 meridians involved, among which the foot yangming stomach meridian and the ren meridian were the most frequently used. The first 2 binomial associations were Tianshu(ST 25)-Zhongwan(RN 12) and Zhongwan(RN 12)-Zusanli(ST 36). The first 2 links were Qihai(RN 6)-Tianshu(ST 25)-Zhongwan(RN 12), Tianshu(ST 25)-Zusanli(ST 36)-Zhongwan(RN 12). Three correlation analysis of the highest correlation were Qihai(RN6)-Tianshu(ST 25)-Zhongwan(RN 12) and Tianshu(ST25)-

关 键 词：危重症 急性胃肠损伤 中药 针灸 数据分析 用药特点 取穴规律 

分 类 号：R2-031[医药卫生—中西医结合]