基于真实世界数据探讨中医药治疗非小细胞肺癌的用药规律  

Exploration on medication pattern of traditional Chinese medicine treatment for non-small cell lung cancer based on real world data

作　　者：李俊雅 史阳琳 杨建雅[1] 李亚[1] 李素云[1] LI Junya;SHI Yanglin;YANG Jianya;LI Ya;LI Suyun(National Regional Traditional Chinese Medicine(Lung Disease)Diagnosis and Treatment Center of the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院国家区域中医(肺病)诊疗中心,郑州450000 [2]河南中医药大学第一临床医学院,郑州450000

出　　处：《药物流行病学杂志》2025年第4期398-409,共12页Chinese Journal of Pharmacoepidemiology

基　　金：中医药创新团队及人才支持计划项目(ZYYCXTD-C-202206);河南省中医学“双一流”创建科学研究专项课题(HSRPDFCTCM-2023-3-09);河南省呼吸疾病临床医学研究中心资助项目;河南省科技研发计划联合基金(14207908);河南省国家中医药传承创新中心科研专项(2023ZXZX1154)。

摘　　要：目的挖掘真实世界中医药治疗非小细胞肺癌(NSCLC)的组方规律及核心用药特征。方法通过医院信息系统(HIS)调取河南中医药大学第一附属医院呼吸科2020年1月1日—2023年12月31日NSCLC患者门诊处方数据,构建标准化中药数据库。采用Lantern 5.0软件构建隐结构模型,结合SPSS Modeler 18.0软件进行关联规则分析、SPSS26.0软件进行高频中药聚类分析,系统解析辨证用药规律。结果共纳入中药处方620首,涉及329味中药,总用药频次10461次。使用频次最高的中药依次为陈皮、茯苓、党参、黄芪等;药物类别以补虚类为主;药性以温性为主;药味以甘为主;归经多归肺经。获得20个核心方剂,如血府逐瘀汤等,核心药物组合以“女贞子-甘草-黄芪”“龙葵-薏苡仁-黄芪”等补气养阴、解毒散结的药对为主。结论治疗NSCLC的中药处方多用甘温之品,以扶正祛邪为治则,兼顾补气养阴、清热解毒、活血化瘀等法,核心方剂选用辨证结合血府逐瘀汤、百合固金汤等经典方剂化裁。通过对真实世界数据的挖掘揭示的组方规律及核心药群,为优化NSCLC临床治疗方案提供循证依据。Objective To explore the prescription patterns and core medication characteristics of traditional Chinese medicine(TCM)in the real-world treatment of non-small cell lung cancer(NSCLC).Methods Outpatient prescription data for NSCLC patients treated in the department of respiratory medicine at the First Affiliated Hospital of Henan University of Chinese Medicine from January 1,2020,to December 31,2023,were extracted through the Hospital Information System(HIS)to establish a standardized Chinese herbal medicine database.Latent structure models were constructed using Lantern 5.0 software,while association rule analysis was conducted with SPSS Modeler 18.0 software.Additionally,clustering analysis of high-frequency herbs was performed using SPSS 26.0 software to systematically analyse the laws of medicine identification and administration.Results A total of 620 TCM prescriptions involving 329 herbs were included,with a cumulative frequency of 10,461 herb applications.The most frequently used herbs were Citri Reticulatae pericarpium,Poria,Codonopsis radix,and Astragali radix.Tonifying and replenishing herbs constituted the primary category,with warm-natured and sweet-flavored herbs predominating.Most herbs targeted the lung meridian.Twenty core prescriptions,such as Xuefu Zhuyu decoction were identified.Core herb combinations included"Ligustri Lucidi fructus-Glycyrrhizae radix et rhizoma-Astragali radix"and"Solani nigri herba-Coicis semen-Astragali radix,"primarily reflecting therapeutic strategies of supplementing Qi,nourishing yin,detoxifying,and dispersing toxins.Conclusion TCM prescriptions for NSCLC predominantly utilize sweet and warm-natured herbs,adhering to the principle of strengthening the body's resistance and eliminating pathogenic factors.Therapeutic approaches integrate methods such as supplementing qi and nourishing yin,clearing heat and detoxifying,and activating blood circulation and resolving stasis.Core prescriptions are derived from classical formulas like Xuefu Zhuyu decoction and Baihe Gujin deco

关 键 词：非小细胞肺癌 中医药 真实世界数据 隐结构模型 关联规则 用药规律 

分 类 号：R289[医药卫生—方剂学]