基于数据挖掘探讨国医大师张磊治疗“滞脉”用药规律  

Exploration on the medication law of national TCM master Zhang Lei in the treatment of"stagnant pulse"based on data mining

作　　者：庞雨 邱帆 甄林强 赵璐[2] Pang Yu;Qiu Fan;Zhen Linqiang;Zhao Lu(Henan University of Chinese Medicine,Zhengzhou 450008,China;Department of Endocrinology,the Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450008,China)

机构地区：[1]河南中医药大学,郑州450008 [2]河南中医药大学第三附属医院内分泌科,郑州450008

出　　处：《国际中医中药杂志》2024年第8期1071-1076,共6页International Journal of Traditional Chinese Medicine

基　　金：第五批全国中医临床优秀人才(国中医药人教函〔2022〕1号);第三届国医大师全国名中医传承工作室(国中医药办人教函〔2018〕119号);河南省中医药科学研究专项(2023ZXZX1174)。

摘　　要：目的基于数据挖掘探讨国医大师张磊治疗"滞脉"患者的用药规律及思路。方法收集张老2021年4月1日-2022年8月1日于河南中医药大学第三附属医院诊治的"滞脉"患者医案,采用Excel 2019及IBM SPSS Modeler 14.1进行中药使用频次统计、中药属性分析、关联规则分析,运用IBM SPSS Statistics 21对高频中药进行聚类分析,并结合张老临床诊疗经验进行归纳总结。结果共收集医案213份,纳入处方332首,涉及患者证型主要有肝郁气滞、木土壅郁等;涉及中药243味,总频次3459次,其中频次排名前5位中药依次为甘草(163次)、柴胡(117次)、清半夏(110次)、茯苓(108次)、黄芩(104次),用药药性以寒、温性为主,药味以甘、苦、辛味为主,归经以脾、肺、肝、胃、心经为主,常用药对为柴胡-当归,基础方为柴胡、清半夏、甘草、茯苓、白芍、黄芩、当归、陈皮、香附。聚类分析得到4类核心方,类1大枣、生姜、党参、炙甘草、清半夏、黄芩、黄连、牡蛎;类2神曲、苍术、川芎;类3香附、栀子、柴胡、薄荷、牡丹皮、白芍、当归、茯苓、陈皮、白术、甘草;类4薏苡仁、大黄。结论张老对"滞脉"的治疗以解郁为主,注重寒热平调,兼以顾护正气,以助祛邪并防止传变。Objective:To explore the medication law and ideas of national TCM master Zhang Lei in the treatment of patients with"stagnant pulse"based on data mining.Methods:Medical records of Professor Zhang's diagnosis and treatment of"stagnant pulse"disease from 1 April 2021 to 1 August 2022 in the Third Affiliated Hospital of Henan University of Chinese Medicine were collected.Excel 2019 and IBM SPSS Modeler 14.1 were used for frequency statistics,attribute analysis of Chinese materia medica,and association rule analysis.Clustering analysis of drugs was conducted using IBM SPSS Statistics 21,and conclusion and summary were performed based on Professor Zhang's clinical diagnosis and treatment experience.Results:Totally 213 medical records were collected,including 332 prescriptions.The main syndromes involved in patients were liver depression and qi stagnation,wood and soil stagnation,etc.The prescriptions involves a total of 243 kinds of Chinese materia medica.The top 5 kinds of Chinese materia medica in terms of medication frequency ranking were Glycyrrhizae Radix et Rhizoma(163 times),Bupleuri Radix(117 times),Pinelliae Rhizoma Praeparatum cum Alumine(110 times),Poria(108 times),Scutellariae Radix(104 times).Professor Zhang's medication for treating patients with"stagnant pulse"was mainly cold and warm;the tastes were mainly sweet,bitter,and pungent;the main meridians were spleen,lung,liver,stomach,and heart;the common medicinal pair was Bupleuri Radix-Angelicae Sinensis Radix,and the basic prescription included Bupleuri Radix,Pinelliae Rhizoma Praeparatum cum Alumine,Glycyrrhizae Radix et Rhizoma,Poria,Paeoniae Radix alba,Scutellariae Radix,Angelicae Sinensis Radix,Citri Reticulatae Pericarpium,Cyperi Rhizoma.Clustering analysis yielded four core categories:category 1 Jujubae Fructus,Zingiberis Rhizoma Recens,Codonopsis Radix,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Pinelliae Rhizoma Praeparatum cum Alumine,Scutellariae Radix,Coptidis Rhizoma,Ostreae Concha;category 2 Massa Medicata Fermentata,Astrctylodis Rhi

关 键 词：数据挖掘 辨脉论治 用药规律 张磊 国医大师 滞脉 

分 类 号：R249[医药卫生—中医临床基础] TP311.13[医药卫生—中医学]