基于数据挖掘探究中医治疗老年肾病综合征的用药规律  

Study on Medication Rules of TCM Therapies on Senile Nephrotic Syndrome by Means of Data Mining

作　　者：毛敏 王洪海 MAO Min;WANG Honghai(Shandong University of Traditional Chinese Medicine,Ji'nan(250355),China)

机构地区：[1]山东中医药大学中医学院,济南250355

出　　处：《浙江中医药大学学报》2023年第5期544-552,共9页Journal of Zhejiang Chinese Medical University

基　　金：山东省研究生教育质量提升计划项目(SDYAL19145)。

摘　　要：[目的]探讨中医治疗老年肾病综合征的一般用药规律。[方法]在中国知网、维普网、万方数据库中,检索自建库以来至2022年6月22日有关中医治疗老年肾病综合征的全部病案,分别采用Excel 2019、SPSS 21.0和SPSS Modeler 18.0软件对用药频次、药物归经、常用药物等数据进行频次统计、聚类分析、关联规则分析。[结果]通过筛选,共得到28篇文献,37则病案,41首方剂,113味中药,根据频次统计结果,将使用频次≥8次的药物确定为高频药物,共计16味,药物性味以苦、甘,寒、温为主,多入肝、脾、肾经。根据聚类分析结果,可将16味高频药物分为7组,主要包括补益脾肾组、利水渗湿组、活血化瘀组等。箱型图显示核心药物为黄芪,依患者实际症状与体征,可酌情灵活增减的药物为茯苓、丹参。根据关联规则分析出的高频药对有黄芪-丹参,黄芪-茯苓-山药,黄芪-丹参-白术,黄芪-白术-茯苓等。[结论]中医治疗老年肾病综合征,“本虚”“标实”两手抓,寒温并用,补泻共施,常用药物以补益药、利水渗湿药、活血化瘀药为主。[Objective] To discuss general medication rules in the treatment of senile nephrotic syndrome. [Methods] Retrieve all medical records relevant to traditional Chinese medicine(TCM) treatment for senile nephrotic syndrome that were saved in China National Knowledge Infrastructure(CNKI), CQVIP and Wanfang Databases since their establishment till Jun 22, 2022. These analyses were performed on statistics such as frequency statistics, cluster and association rules of medication frequency, medication channel tropism and commonly used drugs, using respectively Excel 2019, SPSS 21.0 and SPSS Modeler 18.0 softwares. [Results] Through screening,28 articles, 37 medical records, 41 prescriptions and 113 Chinese drugs were obtained. According to frequency statistics, the drugs whose usage frequency ≥8 were defined as drugs of higher frequency, which, totaling 16, with bitterness, sweetness, coldness and warmness accounting for the majority in flavors and properties, mainly function through liver, spleen and kidney channels. These 16higher frequency medicines were sorted into 7 groups, including group of invigorating the spleen and kidney, group of clearing dampness and promoting diuresis, and group of promoting blood circulation and removing blood stasis, etc. According to the box plot,the Hedysarum Multijugum Maxim. is considered core drug, and on the basis of patients' actual symptom and physical sign, Poria Cocos and Radix Salviae could be added or reduced as needed. In accordance with the analysis on the basis of association rules, the higher frequency drug pairs include Hedysarum Multijugum Maxim.-Radix Salviae, Hedysarum Multijugum Maxim.-Poria Cocos-Rhizoma Dioscoreae, Hedysarum Multijugum Maxim.-Radix Salviae-Atractylodes Macrocephala Koidz. and Hedysarum Multijugum Maxim-Atractylodes Macrocephala Koidz.-Poria Cocos. [Conclusion] In TCM treatment for senile nephrotic syndrome, medical measures should be taken against both deficiency of vital energy as well as deficiency in the root and excess in the branch, both cold

关 键 词：老年肾病综合征 用药规律 数据挖掘 聚类分析 关联规则 补益脾肾 活血化瘀 利水渗湿 

分 类 号：R692[医药卫生—泌尿科学]