基于《医部全录》呕吐门数据挖掘探讨化疗所致恶心呕吐的治疗思路  

Treatment thoughts of chemotherapy-induced nausea and vomiting based on the Literature Research and Data Mining of vomiting recorded in the Yibu Quanlu

作　　者：陈婷 方灿途 李陆振 CHEN Ting;FANG Cantu;LI Luzhen(Department of Oncology,Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Zhongshan,Guangdong 528400)

机构地区：[1]广州中医药大学附属中山中医院肿瘤科,广东中山528400

出　　处：《河北中医》2022年第6期1020-1025,1029,共7页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的基于《医部全录》呕吐门数据挖掘探讨化疗所致恶心呕吐(CINV)的治疗思路。方法整理《医部全录》呕吐门中复方135首,录入中医传承辅助平台(TCMISS)V2.5,结合书中记录的各医家对于病因、病机、诊疗等认识,运用关联规则和复杂系统熵聚类等方法计算药物的使用频次,分析组方规律并演算新方剂,探索其中规律,为CINV治疗提供思路。结果录入135首《医部全录》呕吐门中方剂,涉及药物147味。古人治疗呕吐病因主要归为外邪、情志不遂、脾胃虚弱、饮食不节,病机主要为胃失和降、胃气上逆,证型主要为脾胃虚弱、胃阳亏虚、肝气反胃、食滞胃脘、外邪犯胃、痰饮内停。用药频次>10次有18味,以人参、甘草、半夏为主,用药多为温性药物,味苦、辛、甘为主,多入脾、胃、肺经,挖掘出核心组合6个及新方剂3个。结论古人对于呕吐相关诊治较为详尽,用药关联度不大,数据具有离散性,思路发散各有所长。CINV以脾胃虚弱、脾阳虚衰、肝气犯胃、痰饮内停、胃寒呕吐为主,临床过程中对于CINV不同分型论治可参考《医部全录》呕吐门数据挖掘中关于用药处方、将息方面的内容。Objective To explore Treatment thoughts of chemotherapy-induced nausea and vomiting(CINV)based on the Literature Research and Data Mining of vomiting recorded in the Yibu Quanlu.Methods Collecting 135 prescriptions from vomiting recorded in the Yibu Quanlu,and perform this data entry into traditional Chinese medicine inheritance support system(TCMISS)V2.5.Focusing on the acknowledgement for the etiology,pathogenesis,diagnosis and treatment by ancient physicians in this book,TCMISS association rules and complex system entropy clustering method were used to count use frequency of drug,verifying prescription rules and evolving new prescriptions,aiming to provide ideas in the treatment of CINV.Results Totally 135 prescriptions from vomiting-gate were recorded and 147 drugs were involved.In the thought of ancient physicians,the vomiting etiology was mainly attributed to exogenous evil,emotional upset,weakness of spleen and stomach,and irregular diet.The pathogenesis was mainly stomach disharmony,reverse stomach qi;and the syndrome types were mainly weakness of spleen and stomach,deficiency of stomach Yang,liver qi reversing stomach,stomach-energy stasis due to improper diet,external evil invading stomach,and congestion of fluid-retention.In terms of medication frequency,there were 18 in medication frequencies more than 10 times,mainly for ginseng,licorice,Pinellia;Most of the drugs were warm drugs,mainly for bitter,pungent and sweet taste,mostly for spleen,stomach and lung meristem.Six core combinations and three new prescriptions were found.Conclusion The vomiting-related diagnosis and treatment of ancient physicians is more detailed.The data is discrete with little correlation between the use of drugs,which means they diverged their ideas in different ways.The pattern of syndromes of CINV are mainly characterized by weakness of spleen-stomach,spleen-Yang deficiency and decline,liver qi reversing stomach,congestion of fluid-retention,and gastrofrigid vomiting.In the clinical process,it can refer to the data mining of

关 键 词：恶心 呕吐 化学诱导 中医药学文献 《医部全录》 

分 类 号：R442.1[医药卫生—诊断学] R-7[医药卫生—临床医学] R-37