基于数据挖掘的沈忠源教授治疗乙肝肝硬化用药规律分析

摘要

Through the clinical research information sharing system,this study was aimed to explore the law of Professor Shen Zhongyuan's treatment of hepatitis B liver cirrhosis,and to inherit academic thoughts of senior famous traditional Chinese medicine (TCM) doctors.The structured electronic medical record system was used.The information of Professor Shen Zhongyuan expert outpatient with hepatitis B cirrhosis was collected from September 2012 to September 2015.And then,the medical data were extracted and analyzed to find out the medication regularity of hepatitis B cirrhosis and the distribution rule of the taste tropism of herbal medicine in the treatment.The results showed that 388 cases of hepatitis B cirrhosis patients with a total of 127 kinds of herbal medicine.The cumulative using frequency of herbal medicine was 5595.The most commonly used 10 types of Chinese medicine were turmeric,citrus aurantium,cuttlefish bone,atractylodes,rhizoma coptidis,salvia miltiorrhiza,lobelia,artemisia capillaris,fructus trichosanthis,and chicken's gizzard-membrane.The taste of mostly used Chinese medicine is bitter and sweet,followed by acrid.The nature of Chinese medicine is cold,slightly cold,warm and even.The meridian tropism of Chinese medicine is mainly to the liver and spleen meridian.It was concluded that Professor Shen in treatment of hepatitis B cirrhosis drug laws was often to use heat-clearing and toxin-relieving,qi-reinforcing and spleen-invigorating medicine,liver-soothing and qi-regulating medicine,blood-activating and stasis-removing medicine.The nature of herbal medicine used is mostly cold,slightly cold,warm and even.It is based on the TCM syndrome differentiation and treatment thought of “regulating yin-yang to maintain the balance.” It showed the important principle of “toxin-removing,stasis-removing,liver-regulating and spleen-strengthening” by professor Shen.%目的:将沈忠源教授治疗乙肝肝硬化的临床病例资料录入临床科研信息共享系统进行分析从而探讨其用药规律,传承名老中医的学术思想.方法:利用结构化电子病历系统,对2012年9月至2015年9月沈忠源教授专家门诊乙肝肝硬化的患者信息进行采集,并对其中药用药进行数据挖掘与分析,发现其治疗乙肝肝硬化的用药规律及性味归经分布规律.结果:①388例乙肝肝硬化患者所用中药共计127种,累计使用中药5 595频次,最常用的中药前10味分别为郁金、枳壳、乌贼骨、白术、黄连、丹参、半边莲、茵陈蒿、瓜蒌、鸡内金;②最常用的中药药味主要是苦味和甘味,其次是辛味;药性以寒、微寒、温、平为主;常用中药的归经以归肝、脾经中药为主.结论:沈教授治疗乙肝肝硬化多以清热解毒、益气健脾、疏肝理气、活血化瘀药物为主,药性多为寒、微寒、温、平,是基于中医“平调阴阳,以平为期”的辨证论治思想,体现了沈教授“解毒祛瘀、理肝健脾”的重要原则.