基于中药数据策略模式分析平台分析治疗原发性肝癌中药处方的用药规律
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篇名: 基于中药数据策略模式分析平台分析治疗原发性肝癌中药处方的用药规律
TITLE: Analysis of Medication Rules of TCM Prescription against Primary Hepatic Carcinoma Based on TCM Data Analysis Platform Based on Strategy Pattern
摘要: 目的:建立“中药数据策略模式分析平台”(TCMDP),并据此对临床治疗原发性肝癌(PHC)的中药处方进行组方规律分析,为临床治疗PHC提供有益参考。方法:根据策略模式思想研发了封装有频次统计、关联、聚类、分类等多个方法及其涵盖的不同算法的TCMDP软件。从南昌市4所省级三级甲等医院信息系统和中国知网、PubMed数据库中,收集治疗PHC的中药有效处方并建立相应的PHC处方数据库(PDOPHC)。将该数据库中的中药处方导入TCMDP,借助CMC-DD改进聚类算法、融合深度和宽度搜索后改进的WD-GetRules算法和频次统计方法分析上述处方的证型分布,并以其中的痰瘀互结证型肝癌(TYPHC)为例进行药物功效类别、四气五味归经、药性组合、核心药对和核心药物组合的数据挖掘。结果:共收集到907张治疗PHC的中药处方,主要涉及痰瘀互结证、正虚瘀结证、肝脾血瘀证等10个证型。其中,TYPHC相关的中药处方中常用补虚药、化痰药、活血化瘀药等;四气多为寒、温、平,五味多为甘、苦、辛,归经多为脾、肝、胃、肺、心、肾经;药性组合多为温甘脾、温辛脾和寒苦肝等模式;用药频次≥30次的药对共有36对;处方中的强关联规则共31条,核心药物组合8组。WD-GetRules算法结果显示,临床治疗TYPHC的处方中以白术、党参、茯苓、甘草等4味中药处于核心地位,且常与多种药物配伍出现,这与四者通常组方为四君子汤以达健气补脾之功有关;CMC-DD算法结果显示,临床治疗TYPHC以健补脾胃、补益气血为主,同时又从疏肝理气、化痰、清热解毒、活血化瘀、滋阴等多角度治疗TYPHC。结论:临床上治疗TYPHC的中药处方主要采用健脾益气、疏肝理气、活血化瘀等方法多角度进行治疗,符合医家“扶正祛邪”的用药法则;应用TCMDP能多层次、多方位地实现中药数据的挖掘与分析,可为中药方剂配伍规律的挖掘研究提供一种新的有效途径。
ABSTRACT: OBJECTIVE:To estab lish“TCM Data Analysis Platform Based on Strategy Pattern ”(TCMDP),and to analyze the medication rules of TCM prescription against primary hepatic carcinoma (PHC),so as to provide reference for TCM prescription screening. METHODS :According to the idea of strategy pattern ,TCMDP software was developed ,and the frequency statistics,association,clustering,classification and other methods and the different algorithms covered were encapsulated. Effective TCM prescriptions against PHC were collected and screened from 4 tertiary-grade class-A hospitals in Nanchang city and CNKI , PubMed. A database of prescriptions for PHC (PDOPHC)was established ,and TCM prescriptions in the data base were put into TCMDP. Clustering algorithm modified by CMC-DD ,modified WD-Get Rules algorithm after merging depth and width search and frequency statistics were used to analyze the distribution of prescription syndrome. Taking phlegm-blood stasis syndrome type (TYPHC)as example ,data mining was carried out on drug efficacy category ,four properties ,five flavors and channel tropism , drug property combination ,key couplet medicines and key drug combination. RESULTS :A total of 907 TCM prescriptions against PHC were collected ,mainly involving 10 syndrome types ,such as phlegm-blood stasis syndrome ,deficiency of the vital essential and blood stasis syndrome and liver and spleen blood stasis syndrome. TCM related to TYPHC commonly used in pre- scriptions were tonifying deficiency medicine , phlegm-re- solving medicine ,promoting blood circulation and removing blood stasi s medicine ,etc.Four properties were mostly cold ,warm and calm ;the five flavors were most ly swe et,bitter and pungent ;channel tropism were mostly spleen ,liver,stomach, lung,heart and kidney ;drug combination were mostly warming-sweet-spleen ,warming-pungent-spleen and cold-bitter-liver ,etc.; there were 36 couplet medicines with frequency ≥30 times;there were 31 strong association rules and 8 key drug combinations in the prescriptions. WD-Get Rules results showed that in the TCM prescriptions against PHC ,Atractylodes macrocephala ,Codonopsis pilosula,Poria cocos and Glycyrrhiza uralensis were in the key position. They were often combined with many kinds of drugs , which were related to the effect of Sijunzi decoction on strengthening Qi and tonifying spleen. CMC-DD results showed that therapy for TYPHC focused on strengthening the spleen and stomach ,replenishing Qi and blood ;and at the same time ,it treated TYPHC with phlegm-blood stasis syndrome from multiple angles ,such as soothing the liver and regulating Qi ,eliminating phlegm ,clearing heat and detoxification ,promoting blood circulation and nourishing Yin. CONCLUSIONS :Clinical treatment of TYPHC mainly adopts the methods of invigorating the spleen and replenishing Qi ,soothing the liver and regulating Qi ,promoting blood circulation and removing blood stasis ,which conforms to the medication principle of “strengthening the body and eliminating pathogenic factors”. The application of TCMDP can realize the data mining and analysis of TCM in multi-level and multi-directional way , which provides a new and effective way for the mining and research of compatibility rules of TCM prescriptions.
期刊: 2020年第31卷第24期
作者: 潘树茂,章新友,吴地尧,郭永坤,丁亮,谈荣珍
AUTHORS: PAN Shumao ,ZHANG Xinyou ,WU Diyao,GUO Yongkun ,DING Liang,TAN Rongzhen
关键字: 中药数据策略模式分析平台;策略模式;中药处方;原发性肝癌;痰瘀互结证型;数据挖掘;组方规律
KEYWORDS: TCM Data Analysis Platform Based on Strategy Pattern ;Strategy pattern ;TCM prescription ;Primary hepatic
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