基于数据挖掘的杨文明教授治疗慢性失眠用药规律研究  

Graduate School,Anhui University of Chinese Medicine,Hefei 230038,Anhui,China Corresponding Author YANG Wenming,E-mail:[e-mail]

作　　者：胡胜 杨文明[2,3] 钱南南 忻凌 方妍妍[2] HU Sheng;YANG Wenming;QIAN Nannan;XIN Ling;FANG Yanyan(Graduate School,Anhui University of Chinese Medicine,Hefei 230038,Anhui,China)

机构地区：[1]安徽中医药大学研究生院,合肥230038 [2]安徽中医药大学第一附属医院,合肥230031 [3]新安医学教育部重点实验室,合肥230038

出　　处：《中西医结合心脑血管病杂志》2023年第5期805-811,共7页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家中医药脑病循证能力提升及平台建设基金项目(No.2019XZZX-NB001);安徽中医药大学新安医学教育部重点实验室开放基金项目(No.2020xayx12);安徽省高校协同创新项目(No.GXXT-2020-025)。

摘　　要：目的:系统整理杨文明教授临证病案,挖掘其治疗慢性失眠的经验及学术思想。方法:从安徽中医药大学第一附属医院杨文明教授专家门诊临床数据库中提取2018年12月—2021年12月就诊的600例病人的病案资料,严格遵循纳入标准和排除标准后获取以慢性失眠为诊断的2 949份病案,共涉及314味中药,总应用频次47 765次,导出符合要求的病案资料及中药处方形成Excel表格,运用Microsoft Excel 2010、SPSS Statistics 23.0、IBM SPSS Modeler 18.0软件进行频次分析、聚类分析、关联规则分析、复杂网络分析。结果:通过对2 949例次病案进行分析,显示不寐常见的3个证型有肝郁化火证、肝气郁结证、瘀血内阻证;对2 949首处方进行分析,涉及药物共314味,共计47 765药次,可得出杨文明教授治疗慢性失眠的常用药物为牡丹皮、栀子、郁金、柴胡、黄连、赤芍、枳壳、丹参、夏枯草、酸枣仁、当归、川芎、百合、龙骨、牡蛎等;对314味中药性味归经及功效使用频次分析,药性排名前3位依次为寒、凉、平,药味频次排名前3位依次为苦、辛、甘,归经排名前3位依次为肝、心、脾经,功效排名前3位的依次为清热药、理气药、活血化瘀药,并通过关联规则分析得出22组关联性强的药对,聚类分析则得出6类潜在药物组合。结论:杨文明教授治疗慢性失眠经验丰富,独具特色,认为不寐临床多以实证为主,辨证多“从火、郁、瘀论治”,以清热泻火、疏肝理气、活血化瘀为主要治法,并主张昼夜分治,调理安神。Objective:To sort out the clinical medical records of Professor Yang Wenming,and to explore his experience and academic thoughts in treating chronic insomnia.Methods:The medical records of 600 patients from December 2018 to December 2021 were extracted from the clinical database of expert outpatient department of Professor Yang Wenming of the First Affiliated Hospital of Anhui University of Chinese Medicine.A total of 2949 medical records diagnosed with"chronic insomnia"were obtained after strictly following the inclusion and exclusion criteria,involving 314 TCM.The total application frequency was 47765 times,and the medical records and Chinese medicine prescriptions meeting the requirements were exported and formed into Excel tables.Microsoft Excel 2010,SPSS Statistics 23.0,IBM SPSS Modeler 18.0 software were used for frequency analysis,cluster analysis,association rules analysis,complex network analysis.Results:According to the analysis of 2949 cases of insomnia,the three common syndrome-types were liver stagnation and fire,liver Qi stagnation,and blood stasis.Through the analysis of 2949 prescriptions,involving a total of 314 drugs,a total of 47765 drugs,it can be concluded that Professor Yang Wenming's commonly used drugs for the treatment of chronic insomnia are Peony bark,Gardenia,Radix Curcumae,Bupleurum,Coptis chinensis,Red Peony Root,Fructus aurantii,Salvia miltiorrhiza,Spica Prunellae,Semen Ziziphi,Radix Angelicae Sinensis,Rhizoma Chuanxiong,Bulbus Lilii,Os Draconis,Oyster,etc.According to the analysis of 314 TCM flavor channels and frequency of efficacy use,the top 3 medicinal properties were Han,Liang,and Ping,respectively.The top 3 drug flavor frequency were bitter,pungent,and sweet.The top 3 channels were liver,heart,and spleen.The top 3 efficacy drugs were heat-clearing drugs,Qi-regulating drugs,and blood-activating drugs to remove blood stasis,and 22 groups of strongly correlated drug pairs were obtained through association rule analysis,and 6 categories of potential drug combinations were obtaine

关 键 词：慢性失眠 中医药 经验用药 数据挖掘 

分 类 号：R249[医药卫生—中医临床基础] R256.23[医药卫生—中医学]