基于数据挖掘法探讨原发性肝癌中国肝癌分期方案各期中医治疗用药规律  

Medication rules of traditional Chinese medicine treatment in various stages of primary liver cancer of China liver cancer staging based on data mining

作　　者：袁征[1] 杨月艳[2] 霍介格[3] 叶放[4] 方南元[1] 陈沁磊 方晶 何晶[1] YUAN Zheng;YANG Yueyan;HUO Jiege;YE Fang;FANG Nanyuan;CHEN Qinlei;FANG Jing;HE Jing(Department of Infectious Diseases,Jiangsu Province Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu,210029;Department of Pharmacy,Jiangsu Province Hospital of Traditional Chinese Medicine,Nanjing,Jiangsu,210029;Department of Oncology,Jiangsu Province Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing,Jiangsu,210028;the First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing,Jiangsu,210023)

机构地区：[1]江苏省中医院感染科,江苏南京210029 [2]江苏省中医院药学部,江苏南京210029 [3]江苏省中西医结合医院肿瘤科,江苏南京210028 [4]南京中医药大学第一临床医学院,江苏南京210023

出　　处：《实用临床医药杂志》2024年第23期36-41,共6页Journal of Clinical Medicine in Practice

基　　金：江苏省社会发展重点研发计划项目(BE2019723);全国名老中医药专家传承工作室建设项目-周珉全国名老中医药专家传承工作室(国中医药人教函〔2022〕75号)。

摘　　要：目的挖掘分析周珉教授治疗中国肝癌分期方案(CNLC)不同分期原发性肝癌的组方用药规律。方法收集周珉教授门诊治疗原发性肝癌病案,将患者的病案临床资料录入“中医传承辅助系统(V2.50)”,建立数据库。运用频数分析、药物关联分析、聚类分析等数据挖掘方法,并结合周珉教授治疗CNLC各期肝癌的经验,进行不同分期的原发性肝癌病机探讨及用药规律分析。结果共收集113例原发性肝癌患者的方剂202首,涉及230味中药,挖掘出各期的高频使用药物及药物组合规律。各期频率较高的药物有茯苓、陈皮、薏苡仁、炒白术、法半夏等;Ⅰ期高频药物还有肿节风、香附、僵蚕、姜黄;Ⅱ期和Ⅲ期高频药物有肿节风、仙鹤草、半枝莲、白花蛇舌草、僵蚕、泽漆、香附、麦冬等;Ⅳ期高频药物还有玉米须、藿香、炒麦芽、鸡内金、炒谷芽等。药性以寒性最多,药味以甘、苦味最多,归经多分布于脾、胃经。各期出现频率较高的药物组合多出自四君子汤、二陈汤;药物功效以清热类和化湿类为主;聚类分析筛选出各期具有特色的新方剂。结论通过中医传承平台对周珉治疗原发性肝癌CNLC各期的方剂进行数据挖掘,结合其对该病的病机认识及临床经验进行分析,总结原发性肝癌的病机特点为湿热痰毒、气阴两伤,确立清热化湿、健脾养阴的基本治法,注重扶正祛邪、分期论治,针对不同并发症灵活遣方用药。Objective To explore and analyze the prescription patterns of Professor Zhou Min in treating primary liver cancer at different stages according to the China Liver Cancer Staging(CNLC)system.Methods The clinical records of outpatients with primary liver cancer treated by Professor Zhou Min were collected and entered into the Traditional Chinese Medicine Inheritance Support System(Version 2.50)to establish a database.Data mining methods such as frequency analysis,drug association analysis,and cluster analysis were employed,the pathogenesis of primary liver cancer the prescription patterns at different stages was explored and medication rules were analyzed according to Professor Zhou Min's experience in treating liver cancer at various CNLC stages.Results A total of 202 prescriptions from 113 patients with primary liver cancer were collected,involving 230 traditional Chinese medicines.The high-frequency drugs and drug combinations at each stage were identified.The drugs with higher frequencies at each stage included Fuling,Chenpi,Yiyiren,fried Baishu,and Fabanxia.For stage Ⅰ,high-frequency drugs also included Zhongjiefeng,Xiangfu,Jiangcan,and Jianghuang.For stages Ⅱ and Ⅲ,high-frequency drugs further encompassed Zhongjiefeng,Xianhecao,Banzhilian,Baihua Sheshecao,Jiangcan,Zeqi,Xiangfu,and Maidong.For stage Ⅳ,high-frequency drugs also include Maydis stigma,Huoxiang,fried Maiya,Jineijin,and fried Guya.The majority of the drugs were cold in nature,with sweet and bitter tastes being the most common,and their meridian tropism were mostly distributed in the spleen and stomach meridians.The drug combinations with higher frequencies at each stage were mostly derived from Sijunzi Decoction and Erchen Decoction.The drug efficacies were mainly heat-clearing and dampness-resolving.Cluster analysis screened out new prescriptions with unique characteristics at each stage.Conclusion By performing data mining on the prescriptions used by Professor Zhou Min in treating primary liver cancer at various CNLC stages through the T

关 键 词：原发性肝癌 中国肝癌分期方案 中医药 数据挖掘 

分 类 号：R735.7[医药卫生—肿瘤] R256.42[医药卫生—临床医学] R319