基于数据挖掘探讨中医药治疗稳定型心绞痛证治规律  

Exploration on the law of syndrome and treatment of TCM in the treatment of stable angina pectoris based on data mining

作　　者：李亨达 史攀博 薛宁 陈亚南 韩梦阳 李亚东 孙天福[2] Li Hengda;Shi Panbo;Xue Ning;Chen Yanan;Han Mengyang;Li Yadong;Sun Tianfu(Henan University of Chinese Medicine,Zhengzhou 450000,China;Department of Cardiovascular Medicine No.2 Ward,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学,郑州450000 [2]河南中医药大学第一附属医院心血管内科二病区,郑州450000

出　　处：《国际中医中药杂志》2024年第2期229-236,共8页International Journal of Traditional Chinese Medicine

基　　金：河南中医药研究专项课题(2019JDZX104);河南省中医药科学研究专项课题(20-21ZY3006)。

摘　　要：目的利用数据挖掘技术总结中医药辨证治疗稳定型心绞痛(SAP)的组方思路及配伍规律。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(重庆维普)、中国生物医学文献服务系统(SinoMed)建库至2022年2月28日有关中医药治疗SAP的临床研究文献, 采用Clementine 12.0、Excel 2016、SPSS Statistics 22.0软件对中药数据进行频次统计、聚类分析及关联规则分析, 总结核心处方。结果纳入处方289首, 涉及中药185味, 包含中医证型38种。基于SAP"病"的整体研究发现, 临床治疗SAP以活血化瘀药、补虚扶正药、理气化痰药为主, 使用频次较高的中药包括川芎、丹参、甘草、黄芪、当归等;常用药对包括川芎-当归、川芎-红花、川芎-枳实等。药物复杂网络图及聚类分析显示, 补阳还五汤化裁方是治疗SAP的基本方;基于SAP"证"的研究发现, 气虚血瘀证、痰瘀互结证、气滞血瘀证是SAP较为常见的中医证型, 三者用药均以温、平为主;药味均以甘、辛、苦为主, 多归肝、脾、肺、心经。其中, 气虚血瘀证以黄芪、川芎、丹参等高频药物组成的补阳还五汤为基本方;痰瘀互结证常以制半夏、川芎、薤白等高频药物组成的瓜蒌薤白半夏汤合桃红四物汤为基本方;气滞血瘀证以川芎、当归、枳壳等高频药物组成的血府逐瘀汤为基本方。药物聚类分析气虚血瘀证与气滞血瘀证可分为3类, 痰瘀互结证可分为4类。结论虚、瘀、痰、滞是SAP的重要病理因素, 其中气虚为发病基础, 血瘀贯穿本病始终, 或兼痰浊及气滞之证。围绕着本虚标实的病机, 临床多治以补虚药和活血化瘀药, 辨证选方。Objective To summarize the thinking and compatibility law of TCM in the treatment of stable angina pectoris(SAP)based on syndrome differentiation using data mining technology.Methods The clinical studies of TCM treatment for SAP in databases of CNKI,Wanfang Data,VIP and SinoMed China Biomedical Literature Service System were retrieved from the establishment of the databases to February 28,2022.The frequency statistic,clustering analysis and association rule analysis of TCM data were conducted using Clementine 12.0,Excel 2016,SPSS Statistics 22.0 software,and core prescriptions were summarized.Results Totally 289 prescriptions were included,involving 185 kinds of Chinese materia medica,including 38 TCM syndrome types.Based on the overall study of SAP"disease",the clinical treatment of SAP was mainly based on the drugs for activating blood circulation and removing blood stasis,tonifying deficiency and strengthening healthy qi,and regulating qi and resolving phlegm.The single Chinese materia medica with high frequency of use were Chuanxiaong Rhizoma,Salviea Miltiorrhizae Radix et Rhizoma,Glycyrrhizae Radix et Rhizoma,Angelicae Sinensis Radix,Angelicae Sinensis Radix,etc.The commonly used drug pairs included Chuanxiaong Rhizoma-Angelicae Sinensis Radix,Chuanxiaong Rhizoma-Carthami Flos,Chuanxiaong Rhizoma-Aurantii Fructus Immaturus,etc.The drug complex network diagram and clustering analysis showed that the prescription of Buyang Huanwu Decoction was the basic prescription for the treatment of SAP;based on the specific research of SAP"syndrome",the most common TCM syndromes of SAP were qi deficiency and blood stasis,phlegm and blood stasis,and qi stagnation and blood stasis.The drug properties of the three drugs were mainly warm and mild;the tastes were mainly sweet,pungent and bitter,and most of them belong to the liver,spleen,lung and heart meridian;in terms of specific medication,the basic prescription of qi deficiency and blood stasis syndrome was Buyang Huanwu Decoction,which was composed of high-frequency drugs

关 键 词：心绞痛 稳定型数据挖掘中医药病证结合用药规律 

分 类 号：R259[医药卫生—中西医结合]