基于聚类分析1 300份处方总结沈敏鹤辨治肺癌经验
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R734.2

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浙江省博士后科研项目(ZJ2020128)


Experience Summary of SHEN Minhe Treating Lung Cancer Based on Syndrome Differentiation Based on Cluster Analysis of 1,300 Prescriptions
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    摘要:

    目的:总结沈敏鹤主任中医师辨治肺癌的用药规律。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172 例肺癌患者的1 300 份诊治处方,将患者就诊处方的药味频数、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:1 300 份处方每剂处方药味数介于2~17 味,平均10.38 味;1 300 份处方中共用药451 种,累计用药频次13 512。其中,用药次数最多者为茯苓;药性使用频次最多的为“平”,药味使用频次最多的为“甘”,药物类别频数最多的为补虚药。系统聚类分析将药物分为21 类,涉及方剂有二陈汤、小柴胡汤、天麻钩藤饮,药对有枳实-厚朴、干姜-红枣、麦冬-五味子、生黄芪-炒酸枣仁、白花蛇舌草-鲜芦根、北沙参-枸杞子等。结论:沈敏鹤辨治肺癌以补脾益肺为主,辅以清热解毒、解表宣肺、化痰利水之法;临证遣方用药善用经方,药用精少。

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    Abstract: Objective: To summarize the administration rules in treating the lung cancer by SHEN Minhe, a chief practitioner of Chinese medicine. Methods:A total of 1,300 prescriptions involving 172 cases of patients with the lung cancer treated by Director SHEN Minhe from January 1st, 2014 to December 31st, 2016 were enrolled. The number of Chinese herbs,the cumulative frequency of Chinese herbs,and the nature and flavor of Chinese herbs in 1,300 prescriptions were analyzed by descriptive analysis. Hierarchical cluster analysis was carried out on the top 51 Chinese herbs with the highest frequency. Results: Among 1,300 prescriptions, the number of Chinese herbs ranged from 2 to 17 in each prescription, with an average of 10.38. Among 1,300 prescriptions,451 kinds of Chinese herbs were used;the cumulative frequency of Chinese herbs was 13,512. Among 451 Chinese herbs,the one with the highest frequency was poria;the most frequently used nature of Chinese herbs was “neutral”; the most frequently used flavor of Chinese herbs was “sweet”, and the category of Chinese herbs with the highest frequency was Chinese medicine for supplementing deficiency. Chinese herbs in 1,300 prescriptions were classified into 21 categories by hierarchical cluster analysis,involving prescriptions such as Erchen tang,Xiaochaihu tang,and Tianma Gouteng yin,as well as herb pairs like Fructus Aurantii Immaturus and Cortex Magnoliae Officinalis,Rhizoma Zingiberis and jujube,Radix Ophiopogonis and Fructus Schisandrae Chinensis,Radix Astragali and fried Semen Ziziphi Spinosae, Herba Hedyotis Diffusae and fresh Rhizoma Phragmitis, and Radix Glehniae and Fructus Lycii. Conclusion:In the treatment of the lung cancer based on syndrome differentiation,SHEN Minhe mainly uses the treatment of tonifying the spleen and replenishing the lung, with supplementary treatment, namely clearing heat and detoxicating, releasing the exterior and diffusing the lung, and resolving phlegm and inducing diuresis. SHEN Hemin is good at using classical prescriptions from the perspective of clinical treatment,and using medicine precisely and appropriately.

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袁莉,阮善明,指导:沈敏鹤.基于聚类分析1 300份处方总结沈敏鹤辨治肺癌经验[J].新中医,2021,53(2):87-92

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  • 在线发布日期: 2021-01-27
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