基于数据挖掘探讨吴标辨治肺恶性肿瘤用药规律
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R734.2

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全国第六批老中医药专家学术经验继承项目(国中医药人教发〔2017〕29号)


Administration Rules of Syndrome Differentiation and Treatment of Lung Malignant Tumor by WU Biao Based on Data Mining
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    摘要:

    目的:基于数据挖掘探讨和总结吴标教授辨治肺恶性肿瘤的学术思想和用药规律。方法:以吴标教授在新乡医学院第一附属医院门诊及病房辨治肺恶性肿瘤病例为研究对象,提取处方药物建立数据库,用SPSS Statistics 19.0 统计学软件进行频率、因子分析、聚类分析,总结吴标辨治肺恶性肿瘤的用药规律。结果:共收集123 首处方,涉及药物143 味,总用药频数为2 332 次,用药频数≥20 次的高频中药共31 味,频数最高的前10 味中药依次为麦芽、陈皮、六神曲、白术、茯苓、半枝莲、甘草、全蝎、半夏、白花蛇舌草。高频药物性味以温性、平性和甘味、苦味为主,在归经方面排名前3 位的分别是脾经、胃经、肺经。频数≥20 次的高频中药进行因子分析,共提取出11 个公因子,公因子F1 药物为白术、茯苓、西洋参、人参、北沙参,具有健脾补肺、调补气阴的作用;公因子F2 药物为半枝莲、全蝎、白花蛇舌草,具有清热解毒、活血散结的作用;公因子F3 药物为猫人参、石上柏、蜂房,具有化痰、解毒、散结之效。频数≥20 次的高频中药聚类分析得到药物组合4 类。C1、C2 类药物以扶正为主,以六君子汤为基础方,加益气补肺药;C3、C4 类药物以祛邪为主,具化痰祛湿、散结消肿、清热解毒之效。结论:吴标教授辨治肺恶性肿瘤从虚、痰、瘀、毒论治,肺恶性肿瘤的基本病机为本虚标实,以扶正祛邪为基本治疗大法,处方多以益气养阴,健脾补肺,而且脾在肺先,同时辅以祛湿化浊、活血化瘀、解毒排痰。

    Abstract:

    Abstract: Objective: To discuss and summarize academic thought and administration rules of Professor WU Biao in syndrome differentiation and treatment of lung malignant tumors on the basis of data mining. Methods: Cases with lung malignant tumors that were treated by Professor WU Biao in the outpatient and ward of the First Affiliated Hospital of Xinxiang Medical University were selected as the research objects, and the prescriptions and medicines were extracted to build database. The frequency,factor analysis and cluster analysis were carried out with SPSS Statistics 19.0 statistical software to summarize the administration rules of WU Biao in syndrome differentiation and treatment of lung malignant tumors. Results: A total of 123 prescriptions were collected, involving 143 Chinese medicines. The total frequency of medicines use was 2,332 times, and there were 31 Chinese medicines with a frequency of use more than 20 times. The top 10 Chinese medicines with the highest frequency were Fructus Hordei Germinatus, Pericarpium Citri Reticulatae, Massa Medicata Fermentata, Rhizoma Atractylodis Macrocephalae, Poria, Herba Scutellariae Barbatae, Radix et Rhizoma Glycyrrhizae, Scorpio,Rhizoma Pinelliae,and Herba Hedyotis Diffusae. Chinese medicines with high frequency are mainly warm or neutral and sweet or bitter. The top 3 meridian entries are the spleen meridian,the stomach meridian,and the lung meridian. Factor analysis was carried out for high-frequency Chinese medicines with a frequency more than 20 times , and a total of 11 common factors were extracted. The common factor F1 medicines were Rhizoma Atractylodis Macrocephalae, Poria, Radix Panacis Quinquefolii,Radix et Rhizoma Ginseng and Radix Glehniae,which had the effects of fortifying the spleen and strengthening the lung, and regulating and tonifying qi and yin. The common factor F2 medicines were Herba Scutellariae Barbatae,Scorpio,and Herba Hedyotis Diffusae,which had the effects of clearing heat and detoxifying and activating blood and dissipating masses. The common factor F3 medicines were Actinidia valvata Dunn,Herba Selaginellae Doederleinii,and Nidus Vespae,which had the effects of resolving phlegm,detoxifying and dissipating masses. Four medicine combinations were found out by cluster analysis of high- frequency Chinese medicines with a frequency more than 20 times. C1 and C2 medicines were mainly to reinforce the healthy qi, and Liujunzi tang was the basic prescription with additional use of qiboosting and lung-supplementing Chinese medicines. C3 and C4 medicines were mainly to dispel pathogen and had effects of resolving phlegm and dispelling dampness,dissipating masses and dispersing swelling,and clearing heat and detoxifying. Conclusion: Professor WU Biao treats lung malignant tumors from deficiency, phlegm, blood stasis and toxin. The basic pathogenesis of lung malignant tumors is based on root deficiency and tip excess, and the basic treatment method is to reinforce healthy qi and dispel pathogen. The prescriptions are mostly to boost qi and nourish yin,and fortify the spleen and supplement the lung; and the spleen precedes the lung, supplemented by removing dampness and turbidity, promoting blood circulation and removing blood stasis,detoxifying and expelling phlegm.

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贾奎,孙乾,冯龙,赵福成,刘振洲.基于数据挖掘探讨吴标辨治肺恶性肿瘤用药规律[J].新中医,2022,54(10):16-21

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  • 在线发布日期: 2022-05-24
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