基于医院信息系统数据挖掘真实世界多囊卵巢综合征中药用药规律
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R711.75

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湖北省高等学校优秀中青年科技创新团队项目(T201708);姜惠中治疗多囊卵巢综合征临床经验传承的研究(ZY2019M001);全国 名中医传承工作室建设项目(国中医药办人教函〔2022〕245号)


Study on Chinese Medicinal Medication Rules of Treating Polycystic Ovary Syndrome Based on Real-World Data Mining of Hospital Information System
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    摘要:

    目的:基于医院信息系统(HIS) 数据挖掘真实世界多囊卵巢综合征(PCOS) 中药用药规律。方 法:选取2020 年11 月—2022 年4 月在余姚市妇幼保健院妇科、湖北省中医院妇科就诊且治疗有效的患者 208例,将病历资料录入临床科研一体化电子病历系统,建立Excel数据库,采用Python语言程序包进行计算, 以Apriori算法分析处方药物关联关系的强弱;并基于熵层次聚类等算法实现新方分析,总结分析真实世界 PCOS的用药规律。结果:共纳入208例患者,涉及713首处方,涉及157味中药,总用药频次8 163次。高频 药物包括菟丝子(352次)、太子参(343次)、续断(319次)、白术(276次)、肉苁蓉(264次);药物药性常 见温性,其次为寒性、平性;药物药味常见甘/淡味,其次为辛味、苦/涩味;药物归经以归肝经、肾经、脾经 为主;药物功效首见补虚药,其次为活血化瘀药、理气药、清热解毒药。基于关联规则分析,得到药对12对 和角药15组,其中常用药对有太子参-肉苁蓉、太子参-鹿角霜、太子参-白术、太子参-石斛、太子参-桑寄 生,常用角药有太子参-石斛-续断、太子参-续断-菟丝子、太子参-白术-续断、太子参-续断-肉苁蓉。基于 聚类分析得到5组新处方,皆以补肾药物为主,辅以疏肝、健脾、祛瘀、化痰之药物。结论:PCOS核心病机 为肾虚肝郁。用药以甘温类、归肝经药物为主,常用药对、角药以及核心药物组合均体现了补肾、疏肝、活 血、化痰等治法。

    Abstract:

    Abstract: Objective: To study the Chinese medicinal medication rules of treating polycystic ovary syndrome (PCOS) in the real world based on the data mining of Hospital Information System (HIS). Methods: The cases of 208 patients who received effective treatment in the Gynecology Department of Yuyao Maternity and Child Health Care Hospital and Hubei Provincial Hospital of Traditional Chinese Medicine from November 2020 to April 2022 were selected, and their medical records were entered into the Integrated Electronic Medical Record System for Clinical Research. An Excel database was established, and Python Language Package was used for calculation; Apriori algorithm was used to analyze the strength of association between prescribed medicines. And based on the entropy hierarchical clustering algorithm, the analysis of new prescriptions was carried out and the administration rules of treating PCOS in the real world was summed up and analyzed. Results: A total of 208 patients were included,involving 713 prescriptions and 157 Chinese medicinals,with a total frequency of 8 163 times. The high-frequency Chinese medicinals included Semen Cuscutae (352 times), Pseudostellariae Radix (343 times),Dipsaci Radix (319 times),Atractylodis Macrocephalae Rhizoma (276 times) and Cistanches Herba (264 times). The medicinal natures were mainly warm,followed by cold and neutral. The medicinal flavors were mainly sweet or bland,followed by acrid and bitter or astringent. The channel entries were mainly the liver channel,the kidney channel and the spleen channel. The therapeutic effects of the herbs were mainly deficiency-supplementing herbs, followed by blood-invigorating and stasis-dissolving herbs, qi-rectifying herbs and heat-clearing and toxins-resolving herbs. Based on association rule analysis, 12 pairs of herbal pairs and 15 groups of triplet medicinals were obtained, among which the commonly used herbal pairs were Pseudostellariae Radix-Cistanches Herba,Pseudostellariae Radix-Cervi Cornu Degelatinatum, Pseudostellariae Radix-Atractylodis Macrocephalae Rhizoma, Pseudostellariae Radix-Dendrobii Caulis, and Pseudostellariae Radix-Taxilli Herba, and the commonly used triplet medicinals were Pseudostellariae Radix-Dendrobii Caulis-Dipsaci Radix, Pseudostellariae Radix-Dipsaci Radix-Cuscutae Semen,Pseudostellariae Radix-Atractylodis Macrocephalae Rhizoma-Dipsaci Radix,and Pseudostellariae Radix-Dipsaci Radix-Cistanches Herba. Based on cluster analysis, five groups of new prescriptions were obtained, which mainly included herbs for tonifying the kidney, supplemented with herbs for soothing the liver,strengthening the spleen,dispelling stasis and resolving phlegm. Conclusion: The core pathogenesis of PCOS is kidney deficiency and liver constraint. The mainly used herbs are sweet and warm,and enter the liver channel. The commonly used herbal pairs,triplet medicinals and core herbal combinations all reflect the treatment methods of tonifying the kidney, soothing the liver, invigorating blood,resolving phlegm and so on.

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施雪清,沈锡镕,熊梦欣,邓阿黎.基于医院信息系统数据挖掘真实世界多囊卵巢综合征中药用药规律[J].新中医,2024,56(20):15-20

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  • 在线发布日期: 2024-10-29
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