基于数据发掘探寻肝癌中医临床用药的宏观规律  

Data Mining-Based Macroscopic Exploration of Clinical Medication of Chinese Medicine for Liver Cancer

作　　者：宋亚刚 白明[1] 崔琳琳[1] 李艳[1] 项丽玲 康乐 苗明三[1] SONG Ya-gang;BAI Ming;CUI Lin-lin;LI Yan;XIANG Li-ling;KANG Le;MIAO Ming-san(Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学,郑州450046

出　　处：《中国实验方剂学杂志》2021年第13期146-152,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家国际科技合作基地项目(2016-65);河南省科技厅“中原学者”项目(162101510003)。

摘　　要：目的:探寻中医药治疗原发性肝癌的宏观用药规律,为临床用药提供相应参考。方法:以"中医"和"肝癌"为主题词,检索中国知网、维普和万方数据库(1959年9月至2019年6月),搜集治疗原发性肝癌的中药组方,建立数据库,使用Excel等统计分析软件进行录入,并对频次、聚类和关联规则分析。结果:共纳入有效文献106篇,剔除加减方,剩余有效处方92首,其中涉及中药共计281味,频次累计出现1181次,使用频次排名前5位的中药依次为茯苓、黄芪、柴胡、白芍、党参;所属类别分别为补虚药、清热药、活血化瘀药、利水渗湿药和理气药;通过对频次?10的药物性味进行分析,结果显示,治疗原发性肝癌以甘、苦、辛味,寒、温、平性药,归脾、肝经药物居多。通过对高频药物聚类分析得到4类组合,关联规则分析得出10个潜在组合药对,根据肝癌不同阶段的主要证型变化,对高频药物及潜在药对组合与肝癌不同阶段证型的治疗进行了对应分类。结论:益气健脾、清热解毒、活血化瘀是中医治疗原发性肝癌的基本法则,三类药物配比组合是肝癌治疗的主要方向;高频药物及聚类分析得到10个潜在药对组合为原发性肝癌临床分期分证型治疗提供参考,拟对临床用药具有一定的参考价值。Objective:To explore the macroscopic medication rule of Chinese medicine for the treatment of primary liver cancer and provide references for clinical medication.Method:The databases of CNKI,VIP,and Wanfang Data were searched for research articles published from September 1959 to June 2019 with the terms of"Chinese medicine"and"liver cancer".A database was established based on the collected Chinese medicinal prescriptions for the treatment of primary liver cancer.The frequency,clustering,and association rules were analyzed by Excel,etc.Result:In this study,106 effective articles were included,and after the modified prescriptions were removed,92 effective prescriptions were screened out,involving 281 Chinese herbal medicines used for 1181 times in total.The top 5 high-frequency drugs were Poria(deficiencytonifying),Astragali Radix(heat-clearing),Bupleuri Radix(blood-activating and stasis-resolving),Paeoniae Radix Alba(urination-promoting and dampness-draining),and Codonopsis Radix(Qi-regulating).The analysis of drug flavor with a frequency higher than 10 showed that most of the drugs were sweet,bitter,and pungent in flavor,cold,warm,and plain in nature,and acted on spleen and liver meridians.Four combinations and 10 herbal pairs were obtained by the cluster analysis of high-frequency drugs and association analysis,respectively.The high-frequency drugs and potential herbal pairs were classified targeting the specific clinical syndromes in different stages of liver cancer.Conclusion:Replenishing Qi,invigorating spleen,clearing heat,removing toxin,activating blood,and resolving stasis were the basic principles for the treatment of primary liver cancer.The combination of those drugs was the main therapeutic strategy.In addition,the resulting 10 potential herbal pairs from high-frequency drugs and cluster analysis could inspire the clinical treatment of primary liver cancer in different clinical stages with various clinical syndromes,which was of reference value for the clinical medication.

关 键 词：原发性肝癌 中医临床 用药规律 高频药物 聚类分析 临床证型 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R289[医药卫生—基础医学]