中医药治疗胃食管反流性咳嗽用药规律的数据挖掘研究  

Data Mining Study on the Medication Laws of TCM in the Treatment of Gastroesophageal Reflux Cough

作　　者：钱家骅 薛鸿浩[2] 陆城华 孟凯 杨伟杰 王雄彪[1] Qian Jiahua;Xue Honghao;Lu Chenghua;Meng Kai;Yang Weijie;Wang Xiongbiao(Putuo Hospital Affil­iated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)

机构地区：[1]上海中医药大学附属普陀医院,上海200062 [2]上海中医药大学附属龙华医院,上海200032 [3]上海市徐汇区中心医院,上海200031 [4]上海交通大学医学院附属瑞金医院,上海200025

出　　处：《中国中医急症》2021年第9期1532-1536,1540,共6页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82004265);陆鸿元上海市名老中医学术经验研究工作室(SHGZS-2017012);上海市普陀区卫生健康系统临床特色专科建设计划(2020tszk02)。

摘　　要：目的基于数据挖掘的方法分析和总结中医药治疗胃食管反流性咳嗽的组方用药规律。方法检索中国期刊全文数据库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(维普网)自建库以来至2020年11月30日收录的中医药治疗胃食管反流性咳嗽的文献,经筛选后建立数据库,利用中医传承计算平台中的"统计分析"模块,统计用药频次,对中药的四气、五味及归经进行数据统计;运用"关联规则""聚类分析"模块对组方规律进行分析,挖掘核心药物及类方。结果 1)对最终筛选出的232首处方、涉及的208味中药进行分析,使用频次在前10位的中药分别是甘草、半夏、陈皮、枳壳、茯苓、柴胡、黄连、旋覆花、赭石、党参;药味以苦味为主,药性以温性居多;归经主入肺经,其次为脾经和胃经。2)关联规则分析,按药物组合出现的频次将其由高到低排序,前3位分别是"甘草,半夏""半夏,陈皮""甘草,枳壳";高置信度规则有"甘草,干姜,黄芩→半夏""半夏,大枣→甘草""甘草,黄连,干姜→半夏"。3)k-means聚类分析,演化出5个现代医家治疗胃食管反流性咳嗽的核心类方,即:"甘草,半夏,旋覆花,赭石,大枣""半夏,枳壳,桔梗,陈皮,甘草""半夏,茯苓,甘草,白术,陈皮""甘草,黄连,吴茱萸,柴胡,枇杷叶""甘草,半夏,厚朴,枳壳,苦杏仁"。结论现代医家治疗胃食管反流性咳嗽用药以调和寒热、降逆化痰、清泻肝火、补益脾胃为主,中药处方分别以半夏泻心汤、旋覆代赭汤、左金丸、六君子汤为基础,结合疏肝、止咳、制酸药物进行化裁。该结果直观地展现了现代医家的治疗思想、用药特点及规律,为临床用药和新方的开发提供了理论依据和数据支持。Objective:To analyze and summarize the medication laws of prescriptions of TCM for the treatment of gastroesophageal reflux cough based on data mining. Methods:CNKI,Wanfang Data and VIP network were searched for the literatures on TCM treatment of gastroesophageal reflux cough from the establishment of them to November 30,2020. After screening,the database was established,and the frequency of medication was counted by using the“statistical analysis”module in the Traditional Chinese Medicine Inheritance computing platform;the data of four Qi,five flavors and meridian tropism of Traditional Chinese Medicine were statistically analyzed;the“association rules”and“cluster analysis”modules were used to analyze the rules of prescription formation,and core drugs and class prescriptions were mined. Results:1)The 232 prescriptions and 208 herbs involved were analyzed. The top 10 herbs used were Gancao(Iicorice Root),Banxia(Pinellia Ternate),Chenpi(Tangerine Peel),Zhiqiao(FructusAurantii),Fuling(PoriaCocos),Chaihu(RadixBupleuri),Huanglian(CoptisChinensis),Xuanfuhua(FlosConvolvulus),Zheshi(Ochre)and Dangshen(Codonopsis Pilosula). The main taste of the above drugs was bitter,and the drug properties were warm. Meridian was the main channel of lung,followed by spleen and stomach.2)According to the frequency of drug combinations,the top three were“Gancao(licorice),Banxia(Pinellia)”,“Banxia(Pinellia),Chenpi(Tangerine Peel)”,“Gancao(licorice),Zhiqiao(Fructus Aurantii)”;high confidence rules were“Gancao(licorice),Ganjiang(Dried Ginger),Huangqin(Scutellaria Baicalensis→Banxia(Pinellia)”,“Banxia(Pinellia),Dazao(Jujube)→Gancao(licorice)”,“Gancao(licorice),Huanglian(Coptis),Ganjiang(Dried Ginger)→Banxia(Pinellia)”. 3)By k-means cluster analysis,five core prescriptions for gastroesophageal reflux cough have been developed,namely:“Gancao(licorice),Banxia(Pinellia),Xuanfuhua(Flos Convolvulus),Zheshi(Ochre),Dazao(Jujube)”,“Banxia(Pinellia),Zhiqiao(Fructus Aurantii),Jiegeng(Platycodon Grandiflo

关 键 词：胃食管反流性咳嗽 中医药 用药规律 数据挖掘 

分 类 号：R573.9[医药卫生—消化系统]