基于真实世界数据分析的中医药治疗甲状腺结节的用药规律研究

Medication rules of traditional Chinese medicine in treatment of thyroid nodules based on real-world data analysis

  • 摘要:
    目的 基于真实世界数据挖掘技术分析中医药治疗甲状腺结节的用药规律。
    方法 收集2018年8月—2023年8月就诊于青岛市中医医院甲乳外科的临床第一诊断为甲状腺结节患者的中药处方, 运用中医传承辅助平台(V3.0)分析其用药规律。
    结果 共筛选出治疗甲状腺结节的中药处方1 206首,涉及中药291味; 用药频次居于前5位的是浙贝母、夏枯草、柴胡、茯苓、半夏; 药物功能类别以清热、补虚、化痰、活血、理气类为主; 药性以寒为主,药味以苦、甘、辛为主,归经以肺、肝、脾经为主; 关联规则分析得到17个高频药物组合,浙贝母-夏枯草药对出现频率最高; 16条关联规则中,玄参→浙贝母、香附→柴胡置信度最高; 聚类分析发现6个核心药物组合。
    结论 中医临床治疗甲状腺结节以化痰散结、行气活血、益气养血为主要思路; 常用浙贝母-夏枯草药对清热化痰散结,并以消瘰丸为基础方化痰软坚散结。

     

    Abstract:
    Objective To analyze medication rules of traditional Chinese medicine in the treatment of thyroid nodules based on real-world data mining technology.
    Methods Chinese medicine prescriptions for patients with thyroid nodules as clinical first diagnosis in the Department of Thyroid and Breast Surgery in Qingdao Hospital of Traditional Chinese Medicine from August 2018 to August 2023 were collected, and the Traditional Chinese Medicine Inheritance Assistant Platform (V3.0) was used to analyze the medication rules.
    Results A total of 1 206 traditional Chinese medicine prescriptions for the treatment of thyroid nodules were screened, involving 291 traditional Chinese medicines; the top five most frequently used drugs were Fritillaria thunbergii, Prunella vulgaris, Bupleurum chinense, Poria cocos, and Pinellia ternata; the main function of drugs were clearing heat, tonifying deficiency, resolving phlegm, activating blood circulation, and regulating qi; the main property of the drugs was cold, the main tastes of drugs were bitter, sweet and spicy, and the meridians involved were mainly the lung, liver and spleen meridians; association rule analysis identified 17 high-frequency drug combinations, with Fritillaria thunbergii-Prunella vulgaris as the most frequently occurring drug pair; among the 16 association rules, Radix Scrophulariae-Fritillaria thunbergii and Rhizoma Cyperi-Bupleurum chinense had the highest confidence level; clustering analysis found 6 core drug combinations.
    Conclusion The main idea of clinical treatment of thyroid nodules in traditional Chinese medicine is to resolve phlegm and reduce nodules, promote qi circulation and blood circulation, and nourish qi and blood; the common herbal combination of Fritillaria thunbergii and Prunella vulgaris is used to clear heat, resolve phlegm, and reduce nodules, and the basic formula for resolving scrofula is based on Xiaoluo Pills, which resolves phlegm, softens hardened nodules, and reduces nodules.

     

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