基于隐结构模型和关联规则分析缺血性脑卒中的方药规律  

Regularity of prescriptions for ischemic stroke based on latent structure combined with association rules

作　　者：平兴枫 黄宗轩[2] 李凯[2] 谢广敏 吕军影[2] Ping Xingfeng;Huang Zongxuan;Li Kai;Xie Guangmin;Lyu Junying(First Clinical Medical School of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China;First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西医科大学第一临床医学院,广西壮族自治区南宁市530021 [2]广西医科大学第一附属医院,广西壮族自治区南宁市530021

出　　处：《中国组织工程研究》2025年第29期6277-6284,共8页Chinese Journal of Tissue Engineering Research

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2014]20号),项目负责人:吕军影;广西医疗卫生适宜技术开发与推广应用项目(合同编号:S2018050),项目负责人:吕军影;广西中医药重点学科建设项目(合同编号:GZXK-Z-20-52),项目负责人:吕军影。

摘　　要：背景:目前中医药治疗缺血性脑卒中积累了丰富的经验,应用隐结构结合关联规则分析深入挖掘及总结“药-方-证”规律,有利于促进缺血性脑卒中防治策略的优化。目的:探讨中医药治疗缺血性脑卒中的方药规律,为临床辨证论治缺血性脑卒中提供借鉴。方法:系统检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)中关于中医药治疗缺血性脑卒中的临床研究文献,检索时限:1990-01-01/2024-08-15。筛选文献并提取相关资料导入Excel 2019软件建立数据库,统计分析中药频次、性味归经、功效类别及证型,使用Lantern 5.0及Rstudio软件对使用频率≥4%的高频中药进行隐结构模型、综合聚类及关联规则分析,总结缺血性脑卒中的用药规律及推测中医证型。结果与结论:①共纳入文献231篇,涉及中药203味,累计使用频次2524次;②高频中药有川芎、地龙、当归、黄芪、丹参、赤芍、红花、水蛭、桃仁、半夏等,药性主要为温、寒、平性,药味以苦、甘、辛味为主,药物主要归肝、脾、心经,功效以活血化瘀药、补虚药、平肝息风药及化痰止咳平喘药使用频次较高;③隐结构模型分析共获得7个隐变量、14个隐类,6个综合聚类模型,19个核心方剂,推测缺血性脑卒中主要中医证型为气虚血瘀证、风痰阻络证、痰瘀阻络证、痰热腑实证;④关联规则分析共筛选出29条强关联规则,其中2项关联规则2条,3项关联规则27条,支持度最高为当归-川芎,置信度最高为当归+甘草-川芎。结果表明,缺血性脑卒中是以气血亏虚、肝肾阴虚为本,风、痰、瘀、火为标的本虚标实之证,治则以益气扶正、活血化瘀为主,结合“痰热”“气滞”“阴虚”“肝火”等病理因素,辅以清热化痰、行气通滞、滋养肝肾、清肝泻火等治法。BACKGROUND:Currently,traditional Chinese medicine has accumulated extensive experience in the treatment and management of ischemic stroke.The application of latent structure combined with association rule analysis to deeply explore and summarize the“medicine-prescription-syndrome”rules is conducive to promoting the optimization of ischemic stroke prevention and treatment strategies.OBJECTIVE:To explore the rules of Chinese medicine in the treatment of ischemic stroke,and provide a reference for the clinical treatment of ischemic stroke based on syndrome differentiation METHODS:A systematic search was conducted for clinical research literature on traditional Chinese medicine treatment of ischemic stroke from China National Knowledge Infrastructure(CNKI),WanFang,VIP,and SinoMed databases,covering the period from January 1,1990,to August 15,2024.The relevant studies were selected and the data were extracted into an Excel 2019 database for analysis.The frequency of use of Chinese herbs,their properties,meridional tropism,therapeutic effects and associated syndromes were analyzed.High-frequency herbs(≥4%)were subjected to latent structure modeling,comprehensive clustering,and association rule analysis using Lantern 5.0 and RStudio software,followed by summary of medication patterns and potential traditional Chinese medicine syndromes for ischemic stroke.RESULTS AND CONCLUSION:(1)A total of 231 articles were included,involving 203 kinds of traditional Chinese medicine,and the frequency of use was 2524 times.(2)The high-frequency Chinese herbs were Chuanxiong,Earthworm,Angelica,Astragalus,Salviorrhiza,red peony root,safflower,leech,peach kernel,and pinellia.These herbs had predominantly warm,cold,or neutral properties,with bitter,sweet,and pungent flavors.Primary meridional tropism targets the liver,spleen and heart.Drug for invigorating blood circulation and eliminating stasis,deficiency tonifying drug,calming liver wind drug,expectorant cough suppressant and anti-asthmatic drug were used more frequently.(3)The l

关 键 词：缺血性脑卒中 隐结构模型 关联规则 方药规律 综合聚类 数据挖掘 LTM-EAST算法 中医药 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R259