基于数据挖掘分析冯毅治疗慢性阻塞性肺疾病临床经验  

Analysis of Clinical Experience of FENG Yi Treating Chronic Obstructive Pulmonary Disease Based on Data Mining

作　　者：张威[1] 王鹏[1] 杨宏志[1] 郑岚[1] 饶婷婷 蔡光元 冯毅(指导)[2] ZHANG Wei;WANG Peng;YANG Hongzhi;ZHENG Lan;RAO Tingting;CAI Guangyuan;FENG Yi

机构地区：[1]湖北中医药大学,湖北武汉430000 [2]湖北省中医院,湖北武汉430000

出　　处：《新中医》2022年第18期164-170,共7页New Chinese Medicine

基　　金：湖北省科学技术厅重点研发计划项目(2020BAB027)。

摘　　要：目的:基于数据挖掘分析研究冯毅主任治疗慢性阻塞性肺疾病的用药规律。方法:依照纳入标准,收集冯毅主任治疗慢性阻塞性肺疾病临床病例共1 602例,通过EpiData 3.1软件录入,并运用古今医案云平台以及SPSSAU对病例数据的性别、年龄、主要症状、舌苔脉象、证型分布、药物频次、药物关联度及证型与药物关联度进行数据挖掘分析。结果:经统计发现,出现频次最高的症状依次是呼吸困难、咳嗽、咳痰、乏力,百分比均超过60%;舌质多为淡红、暗红和红,舌苔以白薄苔和白厚苔最为多见,二者相加占比37.46%,舌苔中厚苔占比55.69%;脉象以沉细脉最多见,占比12.30%;主要证型依次是痰热壅肺、痰浊阻肺、肺肾气阴两虚、痰瘀阻肺、肺脾气虚,其次为外寒内饮、肺肾气虚、肺阳虚衰、肺气虚等证型;1 602例病例共215味中药中,排前20位的药物依次是地龙、茯苓、炒白术、炙麻黄、炙甘草、黄芪、白芥子、射干、白僵蚕、瓜蒌皮、防风、苦杏仁、黄芩、紫苏叶、麦冬、太子参、厚朴、甘草、半夏、补骨脂。高频药物关联分析支持度设置在0.3以上、置信度在0.7以上的药物组合有20对。排前5位的有炒白术-茯苓,白僵蚕-地龙,白芥子-地龙,太子参-黄芪,苦杏仁-炙麻黄。证型与药物的关联分析,置信度0.5以上时,共获得9种证型,即外寒内饮、痰瘀阻肺、痰热壅肺、肺气虚、肺脾气虚、肺肾气虚、肺肾气阴两虚、肺阳虚衰、痰浊阻肺,及9类核心组方。结论:冯毅认为慢性阻塞性肺疾病的主要病因病机是气虚、阳虚、外感风邪等,主要病理产物为痰和瘀,治法以益气温阳为主,疏风宣肺、降气化痰为辅,随证运用活血祛瘀之品。Objective:To study the clinical experience of Director FENG Yi in the treatment of chronic obstructive pulmonary disease based on data mining analysis. Methods:A total of 1 602 clinical cases of FENG Yi treating chronic obstructive pulmonary disease were collected according to the inclusion criteria and were recorded by EpiData 3.1 software. The analysis of gender, age, major symptoms, tongue coating and pulse manifestation, distributions of syndrome types, frequency of medicines, medicine association degree and correlation between syndrome types and medicines of case data based on data mining was performed by Ancient and Modern Medical Cases Cloud Platform and SPSSAU. Results:According to statistics,the symptoms with the highest frequency were dyspnea,cough,expectoration and fatigue in order of frequency,with percentages exceeding 60%;the tongue body was mostly light red,dark red and red,the tongue coating was mostly white and thin coating as well as white and thick coating, accounting for 37.46%, and the proportion of thick tongue coating was 55.69%;the most common pulse manifestation was deep and thready pulse,accounting for 12.30%;the main syndrome types were phlegm-heat obstructing the lung,phlegm turbidity obstructing the lung,dual deficiency of qi and yin in lung and kidney,phlegm-stasis obstructing the lung,and dual deficiency of the lung-spleen,followed by the syndrome types including exterior cold with interior fluid retention, lung-kidney qi deficiency, and lung yang deficiency. Among 215 Chinese herbal medicines in the 1 602 cases,the top20 medicines in the list were Pheretima,Poria,Rhizoma Atractylodis Macrocephalae, Herba Ephedrae,Radix et Rhizoma Glycyrrhizae Praeparata cum Melle, Radix Astragali, Semen Sinapis, Rhizoma Belamcandae, Bombyx Batryticatus, Pericarpium Trichosanthis, Radix Saposhnikoviae, Semen Armeniacae Amarum,Radix Scutellariae,Folium Perillae,Radix Ophiopogonis,Radix Pseudostellariae,Cortex Magnoliae Officinalis, Radix et Rhizoma Glycyrrhizae, Rhizoma Pinelliae and Fructus Psoralea

关 键 词：慢性阻塞性肺疾病 数据挖掘 临床经验 冯毅 

分 类 号：R563[医药卫生—呼吸系统]