基于数据挖掘比较广陈皮和蒸陈皮的用药规律
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R283.1

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Comparison of Administration Rules of Pericarpium Citri Reticulatae and Steamed Pericarpium Citri Reticulatae Based on Data Mining
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    摘要:

    目的:基于数据挖掘比较分析广陈皮和蒸陈皮在临床中的用药规律。方法:收集广州中医药大学第二附属医院门诊开具的含广陈皮及含蒸陈皮的处方,运用古今医案云平台V2.3.5 分析比较患者的基本信息(包括性别、年龄),广陈皮与蒸陈皮的剂量分布,病证与药物配伍的关系等。结果:共收集处方1 753 张,其中含广陈皮的处方756 张,含蒸陈皮的处方997 张。两种处方中患者基本信息包括性别及平均年龄分别比较,差异均无统计学意义(P>0.05)。两种处方中60~69 岁患者占比均最高,50~59 岁均次之;而含蒸陈皮方中0~9 岁患者占比显著高于含广陈皮方,差异有统计学意义(P<0.05)。处方中广陈皮剂量为1~20 g,平均剂量(7.57±3.00) g,5 g 剂量出现频数最高;蒸陈皮剂量为1~30 g,平均剂量(8.54±4.22) g,10 g 剂量出现频数最高。两种处方中广陈皮与蒸陈皮平均剂量比较,差异有统计学意义(P<0.05)。两种处方中频率超过1%的中医疾病中有6 种证型是相同的,其中含广陈皮方治疗胃痞病的占比最高,含蒸陈皮方治疗不寐的占比最高。出现频数前10 位的中医证候中有5 种证型是相同的,含广陈皮方治疗气虚痰结证占比最高,含蒸陈皮方治疗肝郁脾虚证占比最高。高频出现的病位前10 位中有7 个病位是相同的,分别是脾、肝、胃脘、肾、肺、心、表。含广陈皮方中涉及药物403 种,共计10 425 次。含蒸陈皮方中涉及药物417 种,共计13 820 次。配伍使用频率前10 位的中药中有8 种中药是相同的,分别是:茯苓、甘草、白术、法半夏、炙甘草、党参、白芍、柴胡。两种处方中涉及药物性味归经分布相似,药性温者最多,平、微寒次之;药味甘者最多,苦、辛次之;归经入脾者最多,肺、胃次之。两种处方中涉及药物经关联分析,频数前3 位的药物组合均为白术-茯苓、甘草-茯苓、茯苓-法半夏。结论:含两种陈皮的处方的临床应用相似度较高,但亦存在差异,如0~9 岁患者应用蒸陈皮的比例显著高于广陈皮,含广陈皮方治疗胃痞病的占比最高,含蒸陈皮方治疗不寐的占比最高,可为临床运用提供参考。

    Abstract:

    Abstract:Objective:To compare and analyze clinical administration rules of Pericarpium Citri Reticulatae and steamed Pericarpium Citri Reticulatae based on data mining. Methods: Prescriptions containing Pericarpium Citri Reticulatae and steamed Pericarpium Citri Reticulatae prescribed by the Outpatient Department of Guangdong Hospital of Traditional Chinese Medicine were collected. The Ancient and Modern Medical Records Cloud Platform(V2.3.5) was used to analyze and compare the basic information of patients(including gender and age), the dosage distribution of Pericarpium Citri Reticulatae and steamed Pericarpium Citri Reticulatae,and the correlation between disease syndrome and medicine compatibility. Results: A total of 1753 prescriptions were collected,and there were 756 prescriptions containing Pericarpium Citri Reticulatae and 997 prescriptions containing steamed Pericarpium Citri Reticulatae. There was no significant difference being found in the comparisons of basic information of patients,including gender and average age,between the two prescriptions(P>0.05). In the two prescriptions,the proportion of patients aged 60~69 was the highest,followed by those aged 50~59,while the proportion of patients aged 0~9 in the prescription containing steamed Pericarpium Citri Reticulatae was significantly higher than that in the prescription containing Pericarpium Citri Reticulatae, the difference being significant(P<0.05). In the prescription,the dosage of Pericarpium Citri Reticulatae ranged from 1 to 20 g,the average dosage was (7.57±3.00) g,and the frequency of 5 g was the highest;the dosage range of steamed Pericarpium Citri Reticulatae was 1~30 g,the average dosage was (8.54 ± 4.22) g, and the frequency of 10 g was the highest. The comparison of average dosage between Pericarpium Citri Reticulatae and steamed Pericarpium Citri Reticulatae in the two prescriptions showed significance in differences(P<0.05). More than 1% of frequency diseases in Chinese medicine in the two prescriptions,six syndrome types were the same,among which prescription with Pericarpium Citri Reticulatae had the highest proportion in the treatment of gastric stuffiness and the prescription with steamed Pericarpium Citri Reticulatae had the highest proportion in the treatment of insomnia. Among the top 10 Chinese medicine syndromes with high frequency,five syndrome types were the same;the prescription with Pericarpium Citri Reticulatae had the highest proportion in the treatment of qi deficiency and phlegm binding syndrome and the prescription with steamed Pericarpium Citri Reticulatae had the highest proportion in the treatment of the liver constrain and spleen deficiency syndrome. Seven of the top 10 high- frequency disease sites were the same, namely the spleen, the liver, the stomach cavity, the kidney, the lung, the heart and the exterior. There were 403 kinds of Chinese medicines involved in Pericarpium Citri Reticulatae prescription,with a total of 10 425 times;417 kinds of Chinese medicines were involved in steamed Pericarpium Citri Reticulatae prescription,with a total of 13 820 times. Among the top 10 Chinese medicines in terms of frequency of compatibility, eight kinds of Chinese medicines were the same, namely Poria, Radix et Rhizoma Glycyrrhizae, Rhizoma Atractylodis Macrocephalae, Rhizoma Pinelliae Praeparatum, Radix et Rhizoma Glycyrrhizae Praeparata cum Melle,Radix Codonopsis,Radix Paeoniae Alba and Radix Bupleuri. The distribution of properties, flavors and meridian entries of Chinese medicines involved in the two prescriptions was similar; Chinese medicines with warm nature accounted for the most,followed by the neutral and the mild cold nature;Chinese medicines with sweet flavor accounted for the most,followed by the bitter and the pungent flavor;Chinese medicines with the spleen meridian entry accounted for the most, followed by the lung and the stomach. After the correlation analysis of Chinese medicines involved in the two prescriptions, the top three medicine combinations with high frequency were Rhizoma Atractylodis Macrocephalae- Poria, Radix et Rhizoma Glycyrrhizae- Poria, and Poria- Rhizoma Pinelliae Praeparatum. Conclusion: The clinical application of the prescriptions containing two kinds of Pericarpium Citri Reticulatae has high similarity, but there are also differences. For example, the proportion of steamed Pericarpium Citri Reticulatae in patients aged 0~9 years is significantly higher than that of Pericarpium Citri Reticulatae;the proportion of Pericarpium Citri Reticulatae prescription in the treatment of gastric stiffness is the highest, and the proportion of steamed ericarpium Citri Reticulatae prescription in the treatment of insomnia is the highest,which can provide reference for clinical application.

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朱晨,杨柳青,王琳,区炳雄.基于数据挖掘比较广陈皮和蒸陈皮的用药规律[J].新中医,2022,54(12):23-28

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  • 在线发布日期: 2022-06-22
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