基于距离聚类结合伪BIC准则研究中医临床核心处方的筛选方法  

Research on Screening Method of Clinical Core Prescriptions of Traditional Chinese Medicine Based on Distance Clustering and Pseudo-Bic Criteria

作　　者：王颖 张晓冉[3] 王俊宏[4] 房祥忠[5] 任昕昕[4] 柏冬 WANG Ying;ZHANG Xiao-ran;WANG Jun-hong;FANG Xiang-zhong;REN Xin-xin;BAI Dong(Basic Medical School,Shaanxi University of Chinese Medicine,Xianyang 712046,China;Institute of Basic Theory of Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;School of Science,Yanshan University,Qinhuangdao 066004,China;Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China;School of Mathematical Sciences,Peking University,Beijing 100871,China)

机构地区：[1]陕西中医药大学基础医学院,陕西咸阳712046 [2]中国中医科学院中医基础理论研究所,北京100700 [3]燕山大学理学院,河北秦皇岛066004 [4]北京中医药大学东直门医院,北京100700 [5]北京大学数学科学学院,北京100871

出　　处：《中国实验方剂学杂志》2021年第8期179-187,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家“重大新药创制”科技重大专项(2014ZX09304306);中国中医科学院中医基础理论研究所自主选题项目(YZ-1886)。

摘　　要：目的:该研究基于中医整体观和辨证论治的特点,采用距离聚类、距离聚类结合伪清零指令(BIC)准则2种方法模拟医生临床诊疗过程,挖掘某一临床医生治疗特定病证的核心处方。方法:该研究认为中医临床处方可分为治疗主证的核心处方和治疗兼证的随证加减用药部分。利用医院信息系统(HIS)导出治疗特定疾病病历资料,采用距离聚类、距离聚类结合伪BIC准则2种方法,对北京中医药大学东直门医院王俊宏教授治疗注意缺陷多动障碍(ADHD)气阴两虚型103首处方进行研究分析,寻找药味数量与药味使用人群比例两者关系的最优平衡折点,而筛选核心处方。结果:以距离聚类结合伪BIC准则形成的核心处方筛选方法,筛选出由石菖蒲、山楂、枸杞子、醋鸡内金、太子参等15味药组成的test4为核心处方,经中医理论分析和王俊宏教授确认符合中医治疗ADHD的理法方药特点。结论:以距离聚类结合伪BIC准则方法可有效整理、筛选中医临床核心处方,而且相比于目前核心处方筛选方法,具有符合医生临证处方过程的特点,以期该方法为传承名老中医学术经验及中药新药开发提供一定的支持。Objective: Based on the holistic view of traditional Chinese medicine(TCM)and the characteristics of syndrome differentiation and treatment,methods of distance clustering and distance clustering combined with pseudo-bit clear(BIC) criteria are adopted in this study to simulate the doctor’s clinical prescription process,and excavate a clinician’s core prescription for the treatment of a specific disease. Method:In this study,it was believed that the clinical prescriptions of TCM can be divided into the core prescription for the treatment of the main syndrome and the addition and subtraction part of the medication for the concurrent syndrome. The hospital information system(HIS)was used to export the medical records of specific diseases,and then the methods of distance clustering and distance clustering combined with pseudo-BIC criteria were adopted to analyze professor WANG Jun-hong’s 103 prescriptions for the treatment of Qi and Yin deficiency type of attention deficit hyperactivity disorder(ADHD). The core prescriptions were screened by finding the optimal balance between the number of herbs and the proportion of population using the herbs. Result: Test4 consisted of 15 herbs such as Acori Tatarinowii Rhizoma,Crataegi Fructus,Lycii Fructus,Gall1 Gigerii Endothelium Corneum,and Pseudostellariae Radix were selected as the core prescription. In analysis by TCM theory and confirmation by professor WANG Jun-hong,it was proved to meet the characteristics of TCM treatment for ADHD. Conclusion: Combination of distance clustering with pseudo-BIC criteria method can effectively sort and screen the core clinical prescriptions of TCM,and compared with the current core prescription screening methods,it is characterized by conforming to the doctor’s clinical prescription process. This research is helpful to provide certain support for inheriting the experience from famous TCM doctors and for the development of new Chinese medicines.

关 键 词：中医临床处方 核心处方 方法学 经验传承 

分 类 号：R284.2[医药卫生—中药学] R289[医药卫生—中医学]