基于R语言技术探讨“动静观”指导下失眠辨治的用药规律  

Exploring Rules of Medication for Insomnia Management under Guidance of “Dynamic and Static View” Based on R Language Technology

作　　者：王雅惠 吴康 王丽平 陆梦馨 徐玲玲 陈琛 王月 陈天竹 史昕玥 邹忆怀[2] WANG Yahui;WU Kang;WANG Liping;LU Mengxin;XU Lingling;CHEN Chen;WANG Yue;CHEN Tianzhu;SHI Xinyue;ZOU Yihuai(Department of Physical Medicine and Rehabilitation,Beijing Tsinghua Changgeng Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Encephalopathy,Dongzhimen Hospital Afiliated to Shanghai University of Traditional Chinese Medicine,Beijing 100029,China;China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]清华大学附属北京清华长庚医院,清华大学临床医学院,北京102218 [2]北京中医药大学东直门医院脑病科,北京100700 [3]中日友好医院,北京100029

出　　处：《辽宁中医杂志》2023年第2期11-15,I0002,共6页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81873257);国家“十二五”科技支撑计划资助项目(2013BAI13B02)。

摘　　要：目的 应用数据挖掘中的R语言技术,总结邹忆怀教授临床辨治失眠的用药规律。方法 纳入邹师门诊治疗的失眠患者153例,建立Microsoft Excel数据库,录入患者诊疗信息,运用R语言编程技术进行药物频数频率分析、关联规则分析及相关性分析。结果 共收集处方207首,涉及药物103味,使用频次>30的中药共计30味,使用频率在前10味的药物依次为茯苓、佛手、菊花、柏子仁、砂仁、枳壳、合欢皮、柴胡、陈皮、酸枣仁;依据药物功效分类,使用频次最高的为安神类药物,其次为清热类和理气类药物;性味归经方面,四气中寒药最多,温、平次之,五味以甘、苦、辛常见,归经多入于心、肝、脾。关联规则分析得出的药对(队)中共涉及20味中药,大致可分为安心神、调脾胃和调肝气三类,如生龙骨-生牡蛎、川芎-酸枣仁-茯苓、半夏-陈皮、柴胡-佛手等;症-药关联规则中得出复寐困难-佛手菊花、寐浅-柏子仁茯苓、入睡困难-黄连肉桂等对应关系;相关性分析对关联规则结果进行了进一步的验证与补充。结论 邹忆怀教授以“动静观”立论辨治失眠,基于“动证失眠”和“静证失眠”的临床特点辨证用药,使动静有常,阴阳和合;强调不同类型安神药物配伍使用,使神安得寐,睡眠得续;同时重视失眠病因的特殊社会、心理、生理属性,注重从肝脾论治,和调脾胃枢机,畅达肝胆之气。Objective To summarize the medication rules of Professor ZOU Yihuai in the treatment of insomnia based on R language.Methods A total of 153 patients with insomnia were included in ZOU′s outpatient treatment.The Microsoft Excel database was established and the diagnosis and treatment information of the patients was entered.The frequency of drug use, the drug frequency analysis, the association rule analysis and the correlation analysis were conducted by R language program.Results A total of 207 prescriptions were collected, involving 103 drugs.A total of 30 Chinese drugs with a frequency more than 30 were collected.The top 10 medicines used in turn were Fuling(Poria),Foshou(Citri Sarcodactylis Fructus),Juhua(Chrysanthemi Flos),Baiziren(Platycladi Semen),Sharen(Amomi Fructus),Zhiqiao(Aurantii Fructus),Hehuanpi(Albiziae Cortex),Chaihu(Bupleuri Radix),Chenpi(Citri Reticulatae Pericarpium)and Suanzaoren(Ziziphi Spinosae Semen).According to the classification of drug effect, the most frequently used drugs were tranquilizing drugs, followed by heat-clearing drugs and Qi-regulating drugs.The cold drugs were the most, followed by warm and flat drugs.Sweet, bitter and pungent tastes were the most common tastes.The meridians mainly involved the heart, liver and spleen meridians.The drug pairs(teams)obtained from the analysis of association rules involved a total of 20 drugs.The drug-drug association rules can be divided into three categories consisting of calming the mind, regulating stomach and spleen and regulating liver Qi, such as Shenglonggu(Fossilia Ossia Mastodi)-Shengmuli(Ostreae Concha),Chuanxiong(Chuanxiong Rhizoma)-Suanzaoren(Ziziphi Spinosae Semen)-Fuling(Poria),Banxia(Pinelliae Rhizoma)-Chenpi(Citri Reticulatae Pericarpium),Chaihu(Bupleuri Radix)-Foshou(Citri Sarcodactylis Fructus).The association rules between symptoms and drugs were as follows: difficulty in returning to sleep-Foshou(Citri Sarcodactylis Fructus)/Juhua(Chrysanthemi Flos),light sleep-Baiziren(Platycladi Semen)/-Fuling(Poria),difficulty in fal

关 键 词：失眠 用药规律 R语言 关联规则 动静观 

分 类 号：R256.23[医药卫生—中医内科学]