基于数据挖掘的慢加急性(亚急性)肝衰竭证素分布特点及用药规律研究

摘要

目的 运用数据挖掘方法,分析乙型肝炎相关性慢加急性(亚急性)肝衰竭(hepatitis B-associated Acute-on-Chron-ic Liver Failure,HBV-ACLF)辨证及组方规律,进而探讨其证治规律和用药特点.方法 收集湖南中医药大学第一附属医院住院HBV-ACLF患者病例资料,录入数据库,由研究人员对录入数据进行字段提取后,相关数据进行频数分析、关联规则、社会网络等分析.结果 根据对247例患者病例数据分析,其主证型从高到低依次为:湿热瘀黄证、湿热内蕴兼脾虚证、寒湿困脾证;药物频次≥12的药物43味,使用频率居于前10位的药物分别为茵陈、赤芍、丹参、白术、甘草、薏苡仁、石菖蒲、黄芩、虎杖、滑石,以清热、凉血解毒、利水渗湿、活血补气药物为主.结论 HBV-ACLF病位主要在肝、脾,证型以湿热瘀黄证、脾虚瘀黄证、寒湿困脾证为主,治疗多以祛湿退黄、化瘀解毒、温阳健脾为法.%Objective To investigate the rules of TCM syndromes and prescriptions of hepatitis B virus and Acute-on-Chronic Liver Failure Disease (HBV-ACLF) by using data mining. Methods The data patients with HBV-ACLF from our hospital were collected. Then the researchers extracted the field and analyzed it, using frequency analysis, association rule, social network and so on. Results According to the analysis of the data of 247 patients with acute hepatic failure, the major pattern of syndrome from high frequency to low in turn: damp heat and blood stasis yellow card, muggy and spleen deficient syn-drome and syndrome of cold-dampness; as for the herbs being used, of which the frequency more than 12 are 43. The top 10 herbs of using frequency respectively as oriental wormwood, radix paeoniae rubra, the root of red-rooted salvia, white atractylodes rhizome, licorice, coix seed, acorus tatarinowii, scutellaria, polygonum cuspidatum and talc, mainly with the effects of clearing away heat, cooling blood and detoxicating, promoting diuresis and dampness, promoting blood circulation and invigorating Qi. Conclusion The HBV-A-CLF1 may be located in liver and spleen, with the primary syndromes: damp heat and blood stasis yellow card, spleen deficiency and blood stasis yellow card, syndrome of cold-dampness disturbing spleen. These diseases are usually treated with methods of clear-ing damp and removing jaundice, dissolving blood stasis and detoxication, warming Yang and tonifying spleen.