基于数据挖掘探究古籍文献中糖尿病肾脏病的证候演变及用药规律  

Research on the Evolution of Syndromes and Medication Rules of Diabetic Kidney Disease in Ancient Literature Based on Data Mining

作　　者：文晓晨 马晓燕[2] 宫成军[2] WEN Xiaochen;MA Xiaoyan;GONG Chengjun

机构地区：[1]辽宁中医药大学,辽宁沈阳110032 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《新中医》2023年第8期1-12,共12页New Chinese Medicine

基　　金：辽宁省自然基金指导计划(2019-ZD-0439);全国名老中医药专家传承工作室建设项目([2022]75号)。

摘　　要：目的:应用数据挖掘技术分析古代医家对糖尿病肾脏病(DKD)证候演变的认识及用药规律。方法:基于《中华医典》建立DKD病位、病性要素和方药数据库,使用SPSS modeler 18.0软件进行关联规则分析、网络关系挖掘,运用Gephi分析软件进行知识图谱可视化分析,应用SPSS26.0软件进行方剂药物聚类分析。结果:共检索出167条既有DKD相关病位要素又有相关病性要素的条文,共9种病位要素,以肾为主,其次为心、肺等;共16种病性要素,以火(热)为主,其次为阴虚、津(液)伤等。DKD病位、病性要素关联规则分析结果显示,胃-火(热)、胃+肾-火(热)、胃+心-火(热)、胃+肺-火(热)关联较密切;网络关系挖掘结果显示,肾-火(热)、肾-阴虚、肾-津(液)伤等关联较密切。知识谱图可视化分析结果显示,病位要素以肾、心、肺、脾、胃、肝等表述最多,病性要素以火(热)、阴虚、气虚、津(液)伤、燥、血虚、阳虚、痰等表述最多;模块化区分示肾、心、肺等形成共现层次接近的要素群;阳虚、痰、湿等形成共现层次接近的要素群。共检索出方剂416首,根据使用频次得出常用药物46种,药性以寒、温、平为主;药味以甘、苦、辛为主;归经以肾、肺、心为主;以补虚药、清热药、利水渗湿药、收涩药为主。聚类分析结果得出6条核心处方,内涵六味地黄丸、生脉饮、白茯苓丸、桑螵蛸散、熟干地黄散、金匮肾气丸、济生肾气丸、四物汤等。结论:糖尿病肾脏病的证候总体呈“热-虚-瘀”的演变规律,热多属虚热,湿为核心,瘀血贯穿始终。以益气养阴、清热润燥生津、健脾补肾、化湿利水消肿、活血化瘀为主要治则。Objective:To analyze the evolution of syndromes and medication rules of diabetic kidney disease(DKD)of ancient physicians based on data mining.Methods:Based on the Chinese Medical Code,the database of disease-location syndrome elements,disease-nature syndrome elements and prescriptions of DKD was established.SPSS modeler 18.0 software was used for association rules analysis and network relationship mining.Gephi analysis software was used for visual analysis of knowledge maps,and SPSS26.0 software was used for clustering analysis of prescriptions and medicines.Results:A total of 167 articles related to nature of disease factors and locational syndrome factors of DKD were retrieved,including 9 disease-location syndrome elements,mainly kidney,followed by heart and lung,etc;and16 disease-nature syndrome elements , mainly fire (heat) , followed by yin deficiency , fluid (humor)consumption , etc. The results of association rules analysis of disease- location and disease- naturesyndrome elements of disease factors of DKD showed that the following elements were closely related:stomach-fire (heat),stomach and kidney-fire (heat),stomach and heart-fire (heat),stomach and lungfire(heat);the results of network relationship mining showed that the following elements were closelyrelated:kidney-fire (heat),kidney-yin deficiency,and kidney-fluid (humor) consumption. The results ofvisual analysis of knowledge maps showed that the disease- location syndrome elements were mostexpressed in kidney,heart,lung,spleen,stomach and liver,and the disease-nature syndrome elementswere most expressed in fire (heat), yin deficiency, qi deficiency, fluid (humor) consumption, dryness,blood deficiency,yang deficiency,phlegm,etc;modularization showed that kidney,heart and lung forma group of elements with similar co-occurrence levels,and yang deficiency,phlegm and dampness form agroup of elements with similar co-occurrence levels. A total of 416 prescriptions were retrieved. Accordingto the frequency of use,46 commonly- used drugs were obtained,main

关 键 词：糖尿病肾脏病 证候规律 用药规律 数据挖掘技术 

分 类 号：R587.2[医药卫生—内分泌]