基于数据库数据的COPD古方用药特点分析、急性加重期和稳定期用药核心组方筛选  

Analysis of characteristics of ancient prescriptions for COPD based on database data and screening of core prescriptions for acute exacerbation and stable phase

作　　者：杨爽[1] 王琰[1] 苟欢 童俞嘉 安新颖 YANG Shuang;WANG Yan;GOU Huan;TONG Yujia;AN Xinying(Institute of Medical Information,Chinese Academy of Medical Sciences/Peking Union Medical College,Beijing 100020,China)

机构地区：[1]北京协和医学院中国医学科学院医学信息研究所,北京100020

出　　处：《山东医药》2023年第21期45-50,共6页Shandong Medical Journal

基　　金：中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-033)。

摘　　要：目的基于国家人口健康科学数据中心《慢性阻塞性肺疾病方剂数据库》数据分析慢性阻塞性肺疾病(COPD)古方用药特点,并筛选急性加重期和稳定期用药核心组方,为中医防治COPD的临床用药提供借鉴。方法从国家人口健康科学数据中心平台《慢性阻塞性肺疾病方剂数据库》获取、筛选后纳入治疗COPD的中药古方743首,建立COPD古方常用药物数据库。运用描述性统计方法对纳入古方的药物频次、高频药物功效类别、药物性味归经进行归纳总结,分析COPD古方的用药特点。借助共现分析、关联规则分析观察COPD急性加重期、稳定期古方中药物组合的支持度、置信度、提升度,以关联规则分组矩阵结果为依据,参照药物频次统计结果、高频药对共现分析结果,将高置信度的药物组合中药物重复度较高的组合进行归纳合并,筛选COPD不同时期用药的潜在核心组方。利用改良后的BK算法计算潜在核心组方核心性的置信度(CBWN)和其在α置信度水平下的支持度(SBCα),评估潜在核心组方的代表性和核心性,筛选核心组方。结果建立的COPD古方常用药物数据库中涵盖药物447种,高频药物为甘草、杏仁、肉桂,药物功效以化痰止咳平喘药、补虚药、理气药为主,药性以温、寒、平为主,药味以辛、苦、甘为主,归经以肺、肝、脾、胃为主。COPD急性加重期、稳定期古方用药频次前三位均是甘草、杏仁、肉桂。急性加重期药物组合80对、稳定期药物组合121对。COPD急性加重期的潜在核心组方包括“款冬花-细辛-紫菀-干姜-肉桂-甘草”、“半夏-桔梗-甘草-陈皮”、“肉桂-麻黄-杏仁-甘草-石膏”,其中“半夏-桔梗-甘草-陈皮”组方的CBWN和SBC0.7均为最大,明确为COPD急性加重期的用药核心组方。COPD稳定期的潜在核心组方包括“黄芪-肉桂-人参-茯苓-甘草”、“茯苓-麦门冬-人参-肉桂-甘草”、“半Objective To analyze the characteristics of ancient prescriptions for chronic obstructive pulmonary disease(COPD)based on the data of"Chronic Obstructive Pulmonary Disease Prescription Database"of National Population Health Science Data Center,and to screen the core prescriptions for acute exacerbation and stable phase,so as to provide reference for the clinical use of traditional Chinese medicine to prevent and treat COPD.Methods Totally 743 traditional Chinese medicine prescriptions for COPD from“the Chronic Obstructive Pulmonary Disease Prescription Database”were included,and a database of commonly used COPD prescriptions was established.Descriptive statistical methods were used to summarize the drug frequency,high frequency drug efficacy category,and drug flavor classification,and meanwhile,the drug characteristics of COPD ancient prescriptions were analyzed.Co-occurrence analysis and association rule analysis were used to observe the support degree,confidence degree and promotion degree of drug combinations in COPD acute exacerbation and stable stage.Based on the results of association rule grouping matrix,the drug frequency statistics and high-frequency drug pair co-occurrence analysis results were used to summarize and combine the drug combinations with high confidence and high drug repetition rate to screen the potential core prescriptions for different COPD periods.The improved BK algorithm was used to calculate the confidence based on whole network(CBWN)of the potential core group and its support at theαconfidence level(SBC-α),and we evaluated the representativeness and core of the potential core prescriptions,and screened the core prescriptions.Results A total of 447 kinds of drugs were included in the database of commonly used COPD prescriptions.The high frequency drugs were Gancao(Radix Glycyrrhizae Uralensis),Xingren(almond)and Rougui(Cinnamomi Cortex).The main drugs were phlegm-relieving cough and asthmatizing drugs,deficient-tonifying drugs and Qi-regulating drugs.The main drug properties we

关 键 词：中药方剂 慢性阻塞性肺疾病 关联规则 BK算法 

分 类 号：R563[医药卫生—呼吸系统]