基于数据挖掘探讨李天望教授脾胃病用药规律

Exploration of professor Li Tianwang's medication rules for spleen and stomach diseases based on data mining

  • 摘要:
    目的 基于数据挖掘总结李天望教授治疗脾胃病的用药规律, 学习其诊疗经验, 以指导中医临床遣方用药。
    方法 收集并选取李天望教授2015年1月-2019年12月治疗脾胃病的门诊中药处方共21 159首, 建立中药数据库, 统计药物频次, 进行药物关联规则分析和聚类分析。
    结果 除甘草外, 李天望教授治疗脾胃病常用中药(频率≥1%)共162味, 高频中药(频率≥30%)26味, 使用频次最高的中药为白术(18 692次)。常用药物包括白术、茯苓、合欢皮、党参、柴胡、白芍等。关联规则分析结果显示, 党参-白术、茯苓-白术、党参-茯苓、白术-茯苓、玫瑰花-合欢皮等药对关联度较高。复杂网络分析显示, 核心药物包括党参、白术、佛手、黄连、鸡内金、香附、合欢皮等。聚类分析显示, 青皮-佛手、枳实-厚朴、黄连-吴茱萸-干姜、薏苡仁-木香-陈皮-山药等药物常搭配使用。
    结论 李天望教授认为脾胃病基本病机属虚实夹杂, 虚证以脾虚为主, 实证以肝郁、痰湿、气滞为主。治法以疏肝解郁、健脾益气、燥湿化痰为主, 佐以消食、温中、降逆。

     

    Abstract:
    Objective To summarize professor LI Tianwang's medication rules for treating spleen and stomach diseases based on data mining, learn his diagnostic and therapeutic experiences to provide guidance for clinical prescription of traditional Chinese medicine (TCM).
    Methods A total of 21, 159 TCM prescriptions for spleen and stomach diseases treated by professor LI Tianwang in outpatient department from January 2015 to December 2019 were collected and selected. TCM database was established, and drug frequencies were statistically analyzed. Association rule analysis and cluster analysis were conducted on the drugs.
    Results Excluding Gancao, professor LI Tianwang commonly used 162 TCM herbs (frequency ≥1%) for treating spleen and stomach diseases, with 26 high-frequency herbs (frequency ≥30%). The most frequently used herb was Baizhu, with a usage frequency of 18, 692 times. Commonly used herbs included Baizhu, Fuling, Hehuanpi, Dangshen, Chaihu, and Baishao. The results of association rule analysis indicated high associations in herb pairs such as Dangshen-Baizhu, Fuling-Baizhu, Dangshen-Fuling, Baizhu-Fuling, and Meiguihua-Hehuanpi. Complex network analysis revealed that core drugs included Dangshen, Baizhu, Foshou, Huanglian, Jineijin, Xiangfu, and Hehuanpi. Cluster analysis showed that herb combinations such as Qingpi-Foshou, Zhishi-Houpo, Huanglian-Wuzhuyu-Ganjiang, and Yiyiren-Muxiang-Chenpi-Shanyao were frequently used together.
    Conclusion Professor LI Tianwang believes that the basic pathogenesis of spleen and stomach diseases involves deficiency mingled with excess. The deficiency syndrome is mainly characterized by spleen deficiency, while the excess syndrome is mainly characterized by liver stagnation, phlegm-dampness, and qi stagnation. The treatment principles focus on soothing the liver and relieving depression, invigorating the spleen and replenishing qi, and drying dampness and resolving phlegm, supplemented by promoting digestion, warming the middle, and lowering adverse qi.

     

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