基于数据挖掘的中医药治疗晚期肺癌辨治规律探讨  

Discussion on the Rule of Syndrome Differentiation and Treatment of Advanced Lung Cancer by Traditional Chinese Medicine Based on Data Mining

作　　者：赵鼎[1] 刘杰[1] 马金凤[1] 乐根明 吕海波 徐景毅 翟长云[1] ZHAO Ding;LIU Jie;MA Jin-feng;YUE Gen-ming;LYU Hai-bo;XU Jing-yi;ZHAI Chang-yun(Department of Oncology,Yancheng TCM Hospital Affiliated to Nanjing University of Chinese Medicine/Yancheng TCM Hospital,Yancheng 224000,Jiangsu,China)

机构地区：[1]南京中医药大学附属盐城中医院/盐城市中医院肿瘤科,江苏盐城224000

出　　处：《医学信息》2024年第18期37-43,共7页Journal of Medical Information

基　　金：盐城市医学科技发展计划项目(编号:YK2018026)。

摘　　要：目的探讨中医药治疗晚期肺癌的辨治规律及处方用药。方法通过Medcase V5.2仓公诊籍国医脉案数据记录挖掘系统,运用频数分析与关联规则分析,从症状、病因、病机、处方用药等方面对2016-2020年盐城市中医院肿瘤科收治住院的中医药治疗晚期肺癌的病案进行数据挖掘。结果纳入患者共计171例,587诊次,其中男120例,女51例。晚期肺癌患者临床表现主要有咳嗽、易醒、入睡困难、食欲不振、疲倦乏力、痰少、痰黏、痰白、气喘、大便秘结等,舌象中频数较高的有质淡红、质红、苔白腻、苔少、苔薄白、质淡,脉象频数较高的有细、弦、滑、弱、沉脉,病机依次为气阴两虚、癌毒郁肺、痰湿蕴肺、虚火内灼、肺失润降、肺脾气虚、肺失宣肃、痰瘀阻肺、痰饮停肺及脾虚失运,常用药物有茯苓、生黄芪、生甘草、法半夏、陈皮、麦冬、百合、炒白术、白花蛇舌草、党参、当归、五味子、熟地黄、蜂房、玄参等。临床症状中咳嗽-疲倦乏力、咳嗽-入睡困难、咳嗽-食欲不振之间密切相关,常用的病机组合为肺脾气虚-痰湿蕴肺、肺脾气虚-痰饮停肺、肺失润降-气阴两虚等,肺脾气虚-痰湿蕴肺的病机与入睡困难、易醒的临床症状紧密关联。结论晚期肺癌临床症状以肺脏局部症状为主,饮食、睡眠、大便等全身症状亦不少见;病机围绕气阴两虚为主,癌毒郁肺为特色病机,病位涉及肺、脾、心、肾等脏腑,病因涉及痰、湿、瘀、饮、热、气、癌毒;治疗上根据核心病机制定治法,益气养阴为核心治法,抗癌解毒贯穿始终,化痰、燥湿、逐瘀、清热、理气多种治法配合使用,非独治肺脾,亦可从心肾治之,多种功效的药物配伍使用以增加疗效。Objective To explore the rule of syndrome differentiation and treatment and prescription medication of traditional Chinese medicine in the treatment of advanced lung cancer.Methods Through the Medcase V5.2 warehouse public medical record data mining system,frequency analysis and association rule analysis were used to mine the medical records of advanced lung cancer treated with traditional Chinese medicine in the oncology department of Yancheng Hospital of Traditional Chinese Medicine from 2016 to 2020 from the aspects of symptoms,etiology,pathogenesis and prescription medication.Results A total of 171 patients with 587 visiting times were included,including 120 males and 51 females.The clinical manifestations of patients with advanced lung cancer mainly include cough,easy to wake up,difficulty in falling asleep,loss of appetite,fatigue,less phlegm,phlegm stickiness,white phlegm,asthma,constipation and so on.the tongue manifestations in higher frequencies were pale red tongue,red tongue,white slimy fur,fur deficiency,thin white fur and light tongue;the pulse conditions in higher frequencies were fine pulse,string-like pulse,slippery pulse,weak pulse and sunken pulse;the pathogenesis was deficiency of both Qi and Yin,cancer toxin depressed lung,phlegm dampness accumulation in lung,deficiency fire burning internal,lung dehydration and depression,deficiency of lung and spleen Qi,lung loss of consciousness and sobriety,phlegm stasis obstructing lung,phlegm retention accumulation in lung and spleen deficiency failing in transportation;the common drugs were Fuling,Shenghuangqi,Shenggancao,Fabanxia,Chenpi,Maidong,Baihe,Chaobaizhu,Baihuasheshecao,Dangshen,Danggui,Wuweizi,Shudihuang,Fengfang,Xuanshen and others successively.Among the clinical symptoms,cough-fatigue,cough-difficulties in falling asleep,and cough-loss of appetite are closely related.The commonly used pathogenesis combinations were lung and spleen qi deficiency-phlegm-dampness accumulation in lung,lung and spleen qi deficiency-phlegm retention in lung,lung l

关 键 词：晚期肺癌 中医药 辨治规律 

分 类 号：R244.9[医药卫生—针灸推拿学]