基于数据挖掘的顽固性失眠医案辨证用药规律分析  

Data Mining-Based Analysis of Medication Characteristics of Syndrome Differentiation in Medical Cases of Intractable Insomnia

作　　者：代婷 冯志海[2] 李健[2] 冯文帅 DAI Ting;FENG Zhi-hai;LI Jian;FENG Wen-shuai(The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450003,China;Department of Endocrinology,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China;College of Traditional Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]河南中医药大学第一临床医学院,河南郑州450003 [2]河南中医药大学第一附属医院内分泌科,河南郑州450003 [3]天津中医药大学中医学院,天津301617

出　　处：《现代中药研究与实践》2022年第5期87-91,共5页Research and Practice on Chinese Medicines

基　　金：河南省中医药科学研究专项课题(20-21ZY2001);河南省首批青苗人才培养项目(2100601-CZ0133-34)。

摘　　要：目的基于数据挖掘技术研究顽固性失眠组方用药规律,归纳辨治特色,指导临床运用。方法通过检索CNKI、Wanfang、VIP、PubMed数据库,检索出中药复方治疗顽固性失眠的相关病例,提取出具有完整中药组成的方药,统计其用药频次、性味归经及对高频中药进行关联规则、聚类分析。结果共纳入158诊次具有完整处方的中医药治疗顽固性失眠案例,提取高频中医证型7种,涉及病位证素5个,病性证素9个;挖掘中药211味,用药总频次2089次,挖掘出高频药物(频次≥20)38种,药物类别以安神药、补虚药、活血化瘀药为主;药性多平温,药味多甘、苦、辛、酸,主要归心、肝、脾、肺、肾经;二项关联中支持度、置信度最高的分别是龙骨-牡蛎、竹茹-半夏,三项关联中支持度、置信度最高的分别是首乌藤-酸枣仁-甘草、牡蛎-茯苓-龙骨;聚类算法提取出6个核心聚类方。结论顽固性失眠的中医证型以心肾不交为主,病机多属阳不交阴,阴阳失衡,故以平衡阴阳、宁心安神为切入点,重用养心安神与重镇安神之法,随证配伍化瘀、理气、化痰、清热、益气、补血等治法,用药规律为脏腑同治、气血同调、寒热同用、辛开苦降、补泻兼施。Objective To study the prescription and medication rules of intractable insomnia,summarize the characteristics of syndrome differentiation and treatment,and guide clinical application.Methods Through the retrieval of CNKI,Wanfang,VIP and PubMed database,we retrieved the related cases of refractory insomnia treated with Chinese medicine compound prescriptions,extracted the prescriptions with a complete composition of Chinese medicine,counted the frequency of drug use,nature,taste and meridian tropism,and conducted association rules and clustering analysis on high-frequency Chinese medicines.Results A total of 158 cases with complete prescription of traditional Chinese medicine treating intractable insomnia were included in the study,and 7 high-frequency TCM syndrome types were extracted,involving 5 elements of disease location syndrome and 9 elements of disease nature syndrome.A total of 211 Chinese medicinals were excavated,with a total medication frequency of 2089 times,and 38 high-frequency drugs(frequency≥20)were excavated,with the tranquilizer,deficiency-tonifying,and blood-activating and stasis-resolving drugs as the main drug categories.Due to its mild and mild nature and bitter and bitter taste,the herbs mainly enter the heart,liver,spleen,lung and kidney meridians.The ones with the highest degree of support and confidence in the two correlations were Os Draconis-Concha Ostreae and Caulis Bambusae In Taenia-Rhizoma Pinelliae,and those with the highest degree of support and confidence in the three correlations were Caulis Polygoni Multiflori-Semen Ziziphi Spinosae-Radix Glycyrrhizae and Concha Ostreae-Poria-Os Draconis.The clustering algorithm extracts 6 core clustering parties.Conclusion The traditional Chinese medicine syndrome type of intractable insomnia focuses on the heart and kidney failing to communicate,and the pathogenesis is mostly yang failing to communicate with yin and yin being imbalanced.Therefore,with balancing yin and yang,tranquillizing mind and tranquilizing mind as the breakthrough po

关 键 词：顽固性失眠 数据挖掘 中药 用药规律 

分 类 号：R285.6[医药卫生—中药学]