基于聚类分析挖掘沈敏鹤辨治肝癌用药规律
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R735.7

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浙江省中医药科学研究基金项目(2014ZA036);浙江省卫生高层次创新人才培养工程项目


Cluster Analysis Administration Law of SHEN Minhe for Syndrome Differentiation and Treatment of Liver Cancer
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    摘要:

    目的:挖掘沈敏鹤辨治肝癌的用药规律。方法:纳入2014年1月1日—2016年12月31日沈敏鹤主任中医师门诊89例肝癌患者,共525诊次,将患者临床信息转化为方剂基础数据库,对处方药味频数、药物累计频数、药物性味采用描述性分析,对频数最高的51种药物进行系统聚类分析。结果:每剂处方的药味数介于3~14味,其中平均数是10.097味;89例肝癌患者525诊次中,共用药275种,累计用药频次5 244次。其中,用药次数最多者为茯苓;药性使用频次最多者为“平”,药味使用频次最多者为“甘”,药物类别频数最多者为“补虚药”。聚类分析将药物分为20类,涉及方剂小柴胡汤、六味地黄丸、茵陈蒿汤、天麻钩藤饮,药对黄连和吴茱萸、桔梗和枳壳、麦冬和枸杞子等。结论:沈敏鹤辨治肝癌以补益肝脾为主,辅以清热解毒、利水渗湿、化痰散结之法;临证遣方用药善用经方,药用精当,直击主症。

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    Objective: To explore the administration law of SHEN Minhe in treating liver cancer based on syndrome differentiation.Methods:Collected 89 cases of patients with liver cancer from Chinese medicine chief physician SHEN Minhe during January 1st, 2014 to December 31st, 2016, total clinical visits being 525.Clinical information of patients was established into a basic database of prescriptions.The flavor frequency,accumulative frequency of medicine,natures and tastes of medicine in prescriptions were analyzed by descriptive analysis,and 51 kinds of medicine in the highest frequency were analyzed by hierarchical cluster analysis.Results:The number of flavors ranged from 3 to 14 in each prescription,with an average of 10.097.Among 525 clinical visits of 89 cases of patients with liver cancer,275 kinds of medicines were used in total.The cumulative frequency of medicine was 5 244,in which the medicine with the highest frequency was poria,the most frequently used nature of medicine was"neutral",while the most frequently appeared flavor of medicine was"sweet",the most frequently used medicinal category was"tonifying medicine".These kinds of medicine were classified into 20 categories by cluster analysis,involving prescriptions such as Xiaochaihu tang,Liuwe Dihuang pills,Yinchenhao tang and Tianma Gouteng yin,as well as herb pairs like rhizoma coptidis and fructus evodiae,radix platycodonis and fructus aurantii,radix ophiopogonis and fructus lycii and so on.Conclusion:SHEN Minhe mainly uses treatment of tonifying and replenishing the liver and spleen for liver cancer based on syndrome differentiation,and supplements with treatments like clearing heat and detoxifying,promoting urination and percolating dampness,as well as dissolving phlegm and dissipating masses.SHEN Minhe is good at using classical formulas from the perspective of clinical prescriptions and medication,using medicine precisely and appropriately and focusing on primary symptoms directly.

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袁莉,阮善明,沈敏鹤.基于聚类分析挖掘沈敏鹤辨治肝癌用药规律[J].新中医,2018,50(4):15-20

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  • 在线发布日期: 2018-04-10
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