基于古今医案云平台分析中医药治疗急性心肌梗死用药规律  

Analysis on the Medication Law of Traditional Chinese Medicine in Treating Acute Myocardial Infarction Based on Ancient and Modern Medical Record Cloud Platform

作　　者：黄飞 范文权 陈超[2] 祝丹[2] 陈启兰[2] 张杰 HUANG Fei;FAN Wenquan;CHEN Chao;ZHU Dan;CHEN Qilan;ZHANG Jie(Deqing County Hospital of Traditional Chinese Medicine,Deqing Zhejiang 313216,China;Hangzhou TCM Hospital of Zhejiang Chinese Medical University,Hangzhou Zhejiang 310007,China)

机构地区：[1]德清县中医院,浙江德清313216 [2]浙江中医药大学附属杭州市中医院,浙江杭州310007

出　　处：《新中医》2025年第5期7-13,共7页New Chinese Medicine

基　　金：浙江省中医药科技计划项目(2024ZL117);浙江省中医药科技计划项目(2022ZQ062);祝光礼全国名老中医药专家传承工作室建设项目(GZS202201)。

摘　　要：目的:运用古今医案云平台软件分析中医药治疗急性心肌梗死的用药规律。方法:检索中国知网、万方学术期刊全文数据库、维普中文科技期刊数据库、PubMed、Embase、Web of Science数据库中公开发表的中医药治疗急性心肌梗死的文献,提取中药处方数据,应用古今医案云平台软件的数据挖掘模块进行药物频次的统计、属性(四气、五味、归经、功效)分析、关联规则分析、聚类分析和复杂网络分析。结果:①共检索到194首中药处方,涉及中药191味,累计频次1745次。使用频次>20次的中药有20味,排名前5的中药依次为丹参、黄芪、川芎、赤芍、当归。②中药属性分析结果。四气:以温为主,其次为微寒、平、寒、微温。五味:以甘为主,其次为辛、苦、微苦、酸。归经:以肝为主,其次为心、肺、脾、胃。药物功效:以活血祛瘀为主,其次为生津养血、通经止痛、凉血消痈、清心除烦。③关联规则分析结果。按照支持度从高到低排列,排名前5的药对依次是黄芪-丹参、川芎-丹参、赤芍-丹参、当归-川芎、赤芍-川芎。④聚类分析结果。共得到3个聚类。第1类:丹参、黄芪、川芎;第2类:麦冬、三七、人参、瓜蒌、炙甘草、桂枝;第3类:当归、红花、桃仁、赤芍、党参、甘草。⑤复杂网络分析结果。得出核心处方药物组成为黄芪、丹参、川芎、赤芍、当归、党参、红花、麦冬、三七、甘草。核心处方为补阳还五汤加减。结论:中医药治疗急性心肌梗死以活血化瘀、补气健脾为主,辅以行气、凉血、养阴、生津,用药以味甘、性温、归肝经为主,临证应气血同调,标本兼顾,五脏一体,识机辨证,在急性心肌梗死的治疗全程运用中医药干预,可改善急性心肌梗死预后和减少并发症,提升中医药干预危重症的水平和力度。Objective:To analyze the medication law of traditional Chinese medicine(TCM)in treating acute myocardial infarction by using the Ancient and Modern Medical Record Cloud Platform.Methods:The literature on the treatment of acute myocardial infarction with TCM published in China National Knowledge Infrustructure,WanFang Data Knowledge Service Platform,China Science and Technology Journal Database,PubMed,Embase,and Web of Science databases was searched.Extract TCM prescription data.The data mining module of the Ancient and Modern Medical Record Cloud Platform was used to conduct drug frequency statistics,attribute(four qi,five flavors,meridian tropism,efficacy)analysis,association rule analysis,cluster analysis and complex network analysis.Results:①A total of 194 Chinese medicine prescriptions were retrieved,involving 191 Chinese medicines,with a cumulative frequency of 1745 times.There are 20 Chinese medicines that are used more than 20 times,and the top 5 Chinese medicines are Salviae Miltiorrhizae Radix et Rhizoma,Astragali Radix,chuanxiong Rhizoma,Paeoniae Radix Rubra and Angelicae sinensis Radix.②Analysis results of attributes of Chinese medicine.Four Qi:mainly warm,followed by slightly cold,neutral,cold and slightly warm.Five flavors:mainly sweet,followed by pungent,bitter,slightly bitter and sour.Meridian tropism:mainly liver,followed by heart,lung,spleen and stomach.Drug efficacy:it mainly promotes blood circulation and removes blood stasis,followed by promoting fluid circulation and nourishing blood,dredging menstruation and relieving pain,cooling blood and eliminating carbuncle,clearing the heart and relieving troubles.③Analysis results of association rules.According to the degree of support from high to low,the top 5 medicine pairs are Astragali Radix-Salviae Miltiorrhizae Radix et Rhizoma,Chuanxiong Rhizoma-Salviae Miltiorrhizae Radix et Rhizoma,Paeoniae Radix Rubra-Salviae Miltiorrhizae Radix et Rhizoma,Angelicae Sinensis Radix-Chuanxiong Rhizoma,and Paeoniae Radix Rubra-Chuanxiong Rhizoma.④Resul

关 键 词：急性心肌梗死 中医药 用药规律 数据挖掘 古今医案云平台 

分 类 号：R256.22[医药卫生—中医内科学]