基于名医医案挖掘中医治疗慢性阻塞性肺疾病用药规律  

Exploration of Medication Rules of Chinese Medicine for Chronic Obstructive Pulmonary Disease Based on Medical Records of Famous Doctors

作　　者：官友敏 张晓虹 庄泽钦 罗晓君 刘健红[2] 龙文杰 GUAN Youmin;ZHANG Xiaohong;ZHUANG Zeqin;LUO Xiaojun;LIU Jianhong;LONG Wenjie(Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510405,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510405,China)

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《新中医》2023年第24期7-13,共7页New Chinese Medicine

基　　金：广东省基础与应用基础研究基金项目(2020A1515110520)。

摘　　要：目的:基于数据挖掘研究名医治疗慢性阻塞性肺疾病的用药规律。方法:收集并且整理广州中医药大学图书馆中《呼吸病名医医案解析》《中医名家呼吸病辨治实录》《近现代中医名家临证类案(肺病卷)》等7本书籍中治疗慢性阻塞性肺疾病的完整医案,提取数据,基于中医传承计算平台V3.0统计症状频次、证候频次、药物频次等;对药物核心组合进行关联分析(设置支持度为17.5%,置信度为0.6);根据无监督的k均值聚类算法提取核心类方(设置聚类个数为3)。结果:共纳入44个医案,103首方,涉及药物229味。症状频次前10位的有咳嗽、气喘、咳痰、胸闷、水肿、气短、纳差、心悸、气促、发绀。频次排在前10味的是甘草、杏仁、茯苓、半夏、紫苏子、桑白皮、桔梗、陈皮、白术、黄芪。核心组合频次较高为甘草-杏仁、甘草-茯苓、甘草-半夏等;核心药物为二陈汤合定喘汤加减;聚类分析得到3个核心组方分别为杏仁、茯苓和甘草,半夏、白术和甘草,黄芪、五味子和甘草;治法主要为化痰、平喘、清热和补气。结论:名医在辨证论治上大多基于本虚标实的病机,遵循“急则治其标,缓则治其本”的原则,注重扶正固本,补气为主,同时兼顾祛痰、化湿、降气等。Objective:To study the medication rules of famous doctors in the treatment of chronic obstructive pulmonary disease based on data mining.Methods:The complete medical records for the treatment of chronic obstructive pulmonary disease were collected and sorted out from seven books in the library of Guangzhou University of Chinese Medicine,including Analysis of Medical Records of Famous Doctors of Respiratory Diseases,Record of Differentiation and Treatment of Respiratory Diseases of Famous Chinese Medicine Doctors,and Clinical Cases of Modern Chinese Medicine Doctors(Lung Disease Volume).Data were extracted and the frequency of symptoms,syndromes,and medicines were counted based on the Traditional Chinese Medicine Inheritance Computing Platform V3.0.Association analysis was performed for the core medicine combination(set support level of 17.5%,confidence level of 0.6).The core prescriptions were extracted according to the unsupervised K-means clustering algorithm(set the number of clusters to 3).Results:A total of 44 medical cases and 103 prescriptions,involving 229 medicinals,were included.The top 10 symptoms were cough,wheezing,sputum,chest tightness,edema,shortness of breath,poor appetite,palpitation,shortness of breath,and cyanosis.The top 10 medicinals were Glycyrrhizae Radix et Rhizoma,Armeniacae Semen Amarum,Poria,Pinelliae Rhizoma,Perillae Fructus,Mori Cortex,Platycodonis Radix,Citri Reticulatae Pericarpium,Atractylodis Macrocephalae Rhizoma,and Astragali Radix.The core combinations with high frequency were Glycyrrhizae Radix et Rhizoma-Armeniacae Semen Amarum,Glycyrrhizae Radix et Rhizoma-Poria,Glycyrrhizae Radix et Rhizoma-Pinelliae Rhizoma,etc.;the core medicine was modified Erchen Decoction combined with Dingchuan Decoction.The cluster analysis showed that the three core compositions were Armeniacae Semen Amarum,Poria and Glycyrrhizae Radix et Rhizoma,Pinelliae Rhizoma,Atractylodis Macrocephalae Rhizoma and Glycyrrhizae Radix et Rhizoma,and Astragali Radix,Schisandrae Chinensis Fructus and Glycyrrhizae

关 键 词：慢性阻塞性肺疾病 名医医案 中医传承计算平台 用药规律 

分 类 号：R563[医药卫生—呼吸系统]